Controceptive Pill causing v?

Was just looking through Dr Andrew Goldstein's website and as I am sure most of us are aware, he believes there are many causes for v pain and it is impreritive to find each women's individual cause in order to treat it correctly.

Vulvodynia:

"Odyne was the "Greek goddess of pain." Therefore, the term vulvodynia literally means "vulvar pain." Vulvodynia is currently defined as "vulvar discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable disease" This classification acknowledges that vulvar pain may be attributable to diagnosable and treatable disorders such as infections (yeast, trichomonas), dermatologic disorders (lichen sclerosus, lichen planus, plasma cell vulvitis), hormonal (atrophic vulvovaginitis) and neurologic disorders (pudendal neuralgia, pudendal nerve entrapment, and post-herpetic neuralgia.) However, these definable causes of vulvar pain are not defined as vulvodynia. Therefore, while many women are referred to the Centers for Vulvovaginal Disorders with the diagnosis of "vulvodynia," the physicians at the CVVD only rarely give this diagnosis because they are very skilled in the diagnosis of the specific diseases that cause vulvar pain.

It is estimated that 1.3 % of women have vulvodynia. In 2002, a sample of women were invited to participate in a web-based survey and 94.5% responded. A history of pain of vulvar pain was reported by 28 %, with 7.8% reporting pain within the past six months, 3 % reporting pain that lasted three or more months, and 1.7% reporting pain lasting three or more months that occurred within the past six months. The authors concluded that as many as 14 million women in the United States may experience chronic vulvar pain during their lifetime. Thus, even if only a small percentage of these women have true vulvodynia, the number of women with the problem is enormous. Unfortunately, at least 30% will suffer without seeking medical care.

The cause of vulvodynia remains elusive, but it most likely occurs from a variety of sources and represents many different disease processes. Possible causes include abnormalities of embryologic development, genetic and/or immunologic factors, hormonal factors, peripheral and central neuropathy (nerve damage), allergic reactions, tightness of the muscles of the pelvic floor, and nerve entrapment. In essence, it is likely that there are many different diseases that yield similar symptoms and cause "vulvodynia."

It is also very important to know what does not cause vulvodynia. In the past decade many of the earlier theories regarding the etiology vulvodynia have been called into question. Recent studies have shown that HPV (human papilloma virus) does not play a significant role in vulvodynia. In addition, the early hypothesis of increased urinary oxalate has also been refuted. Lastly, despite the fact that many women with vulvodynia report a past history of candidiasis, its role as a causative agent of vulvodynia is also uncertain largely because the inaccuracy of self diagnosis of candidiasis.

While a few clinicians believe that vulvodynia occurs directly as a result of psychological or sexual dysfunction. This viewpoint, however, is rejected by most patients and by the physicians of the Centers for Vulvovaginal Disorders. However, almost all agree that the presence of chronic pain, such as with vulvodynia, can have profound psychosocial ramifications."

also I wanted everyones opinion on birth control pills. Did your pain start while on them?
http://www.cvvd.org/vulvar_vestibulitis

There is then the other side of the argument that not all women on birth control have v pain otherwise there would have been a direct link made and it would be in text books by now. Just wondering what the general opinion on this theory is? I have an appointment with a new urogyne and I want to know if I should ask her about this. My hormones have never been looked into. And according to Dr Goldstein, if it is caused by hormones it will show up in specific bloodwork.

Claire xxx

I hadn't been on the pill for about 5 years before I got V, I was previously on Yasmin though which I've seen alot of women with V mention. I used to get yeast infections alot when I was early 20's but that stopped and I'd had a handful in the 15 years or so from then up to getting V so neither sound related in my case. I do believe hormones can contribute and have tried to get mine tested but all doctors have refused with the "if you have what is considered a normal cycle your hormones are fine" and "hormones fluctuate all month so there's nothing to be gained from testing them" routines. I'm more likely to be perimenopausal though now as I'm almost 38 and my Mum was totally menopausal at 45.

Great post, the statistics are quite interesting.

I've never been on birth control but have had quite a few stubborn yeast infections, not sure where the yeast infections ended and the vulvodynia began.

Thats the same as me, It started with a yeast infection that went away and then came back a few times, then the swabs started coming back normal but the pain was still there. Started with just Vulva burning around the entrance, I had intemitant pain daily, then constant burning and now it seems my bladder and ureathra have decided to get in on the action. I wish doctors new more. It's all just theory and it does my head in.

Hey ladies,

Aussie: Yes, in the beginning I had some burning...then it spread to the perineum and yes, back there, too. Now, I am experiencing some stress incontinence (urinary leaking)...geez, do I need an adult diaper now too ???

Wheres all the research thats suppose to be happening?

I wanted to post about my story to reiterate that there are DEFINITELY cases where VVS is caused by hormonal contraceptives, even when not immediately obvious.
I want to desperately encourage anyone who has VVS to come off hormonal contraceptives if possible.

In 2012, I had unprotected sex and took the morning after pill. I developed vestibule redness/soreness/itchiness. The clinic confirmed a Yeast & BV infection, explaining that this was common after sex (though I had never had any vaginal problems for years before). They also put me on the Pill (Microgynon 30). The infections cleared (tested negative) but my symptoms remained constant.

My symptoms extended beyond vestibule pain. I also had itchiness, redness & subtle inflammation of the whole vestibule (localised to this area), my vestibule skin started to tear during sex, get more inflammed & very regularly develop new infections (Yeast/Bacterial). I also had a lot of discomfort/itchiness in & around my anus.

Firstly, this made me question whether I had VVS because I didn't just have pain of the vestibule, as I kept getting infections too (now I understand that women with VVS are often simply more prone to infections & discomfort of the whole area).
Secondly, I assumed my VVS must have been caused by the infections (proliferation of nerves in the vestibule after infection), because the symptoms I had felt like they were permanent, that the skin itself was not normal anymore & seemed irreparable.

I didn't come off the Pill until mid 2013, when I had read more info about a link. I felt I should just come off it in case it might have been making anything worse.

The reality was (by my complete surprise and total elation) that within a month, my vestibule returned to completely normal and ALL other related symptoms also disappeared — the anal discomfort/itchiness & bring prone to developing infections.

I hadn't thought the Pill could be causing my VVS, because I had developed the infections before I started the Pill (I didn't consider at the time that just before I got the infections, I had taken the morning after pill which is a huge dose of progesterone). I also had no understanding of hormones & no idea how they could cause pain in a specific area of the body like this! Every doctor I asked said there was no way the Pill was relevant, which made me have little hope.

I believe there are 2 main causes for VVS — hormonal or a response to an infection. But there can be an overlap, and I didn't consider the Pill could be the cause because I kept getting the infections. But I was mistaken (and so were over 10 doctors & specialists).

I really hope this can help any women suffering.

As a side point, unfortunately, after being perfectly normal for 18 months, this year I developed infections (no hormones involved) and VVS has fully returned. I feel that my body has learned how it responded to infections when I was on the Pill, and now the nerves are irritated again = VVS Sad

A2015

Just to reiterate what a lot of you have said, my pain began about 18 months after I started the combined pill. A consultant did a blood test, said my estrogen was ridiculously high, and took me off it immediately. I was pain free for about six months.

Every since then I've had on and off pain, as well as multiple cysts and, the latest, a worryingly thickened womb lining at the wrong time of the month, all of which are related to hormones.

I've tried to discuss with several doctors and consultants whether my pain could be associated with these two things (ie, the hormones linked to them rocketing and making me extremely sore) but they just pass you on to someone else.

I am adamant that if I had a similar thing where I could have a blood test every week to monitor the hormones I could be given something to help bring my levels back to normal and I would be fine. However, it's so hard to get through to GPs and consultants, they just say 'your hormones change throughout the month'. Yes, I know that!! Ahhhh!

It's even more frustrating when you know that a lack of estrogen and excessive estrogen cause the same pain, so you never know where you stand.

I just thought I'd let you know that I'm another who seems to have begun this journey from the pill & hormone issues!