title: The vulvodynia guideline.
abstract: OBJECTIVE
  To provide a review of the literature and make known expert opinion regarding the treatment of vulvodynia.
  
  
  METHODS
  Experts reviewed the existing literature to provide new definitions for vulvar pain and to describe treatments for this condition.
  
  
  RESULTS
  Vulvodynia has been redefined by the International Society for the Study of Vulvovaginal Disease as vulvar discomfort in the absence of gross anatomic or neurologic findings. Classification is based further on whether the pain is generalized or localized and whether it is provoked, unprovoked, or both. Treatments described include general vulvar care, topical medications, oral medications, injectables, biofeedback and physical therapy, dietary changes with supplementations, acupuncture, hypnotherapy, and surgery. No one treatment is clearly the best for an individual patient.
  
  
  CONCLUSIONS
  Vulvodynia has many possible treatments, but very few controlled trials have been performed to verify efficacy of these treatments. Provided are guidelines based largely on expert opinion to assist the patient and practitioner in dealing with this condition.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan Hospitals, Ann Arbor, MI 48109, USA. haefner@umich.edu
authors.forename: Hope K
authors.initials: HK
authors.lastname: Haefner
authors.forename: Michael E
authors.initials: ME
authors.lastname: Collins
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Davis
authors.forename: Libby
authors.initials: L
authors.lastname: Edwards
authors.forename: David C
authors.initials: DC
authors.lastname: Foster
authors.forename: Elizabeth Dee Heaton
authors.initials: ED
authors.lastname: Hartmann
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Kaufman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Lynch
authors.forename: Lynette J
authors.initials: LJ
authors.lastname: Margesson
authors.forename: Micheline
authors.initials: M
authors.lastname: Moyal-Barracco
authors.forename: Claudia K
authors.initials: CK
authors.lastname: Piper
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Reed
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Stewart
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wilkinson
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000465:Algorithms; D000927:Anticonvulsants / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage; D010146:Pain / Q000145:classification*; D014844:Vulva / Q000601:surgery; D014845:Vulvar Diseases / Q000145:classification / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D008012:Lidocaine