The vulvodynia guideline.
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.
Haefner
Hope K
HK
Department of Obstetrics and Gynecology, University of Michigan Hospitals, Ann Arbor, MI 48109, USA. haefner@umich.edu
Collins
Michael E
ME
Davis
Gordon D
GD
Edwards
Libby
L
Foster
David C
DC
Hartmann
Elizabeth Dee Heaton
ED
Kaufman
Raymond H
RH
Lynch
Peter J
PJ
Margesson
Lynette J
LJ
Moyal-Barracco
Micheline
M
Piper
Claudia K
CK
Reed
Barbara D
BD
Stewart
Elizabeth G
EG
Wilkinson
Edward J
EJ
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*
D000927:Anticonvulsants; D000928:Antidepressive Agents; D008012:Lidocaine