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Re: Fw: vulvodynia

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I've treated this often. Very low success rate, but the favourite herbs for

me are Corydalis yanhusuo and Vib. prun internally. Creams, gels etc can

help. I've even incorporated kava into creams.

I must now apologise to Graham because below I have pasted a copy of one of

the 'Vulval Pain Society' newsletters, and it is quite long. However, there

is such a lot of info on it (orthodox and complimentary) and lots of

contacts etc that I think it is worth presenting in its entirety.

Hope this helps

Stuart Fitz

Vulval Pain Society Newletter

In this issue

1 Who is the Vulval Pain Society?

3 Support group drive

5 Members¹ survey

13Over to youŠ.

17 Contacts

WELCOME!

Enclosed in this issue (finally) is the members¹ survey. A total of 238

members took time to fill in the detailed questionnaire regarding symptoms,

treatments and experiences. Many thanks to you all and we hope the

information enclosed is of value to you. Many questionnaires showed similar

experiences and frustrations. As you will see from the survey the treatments

greatly varied. The VPS evaluation was very useful to us as it highlighted

several deficiencies in our service, which need to address. In general the

newsletters were well presented, but more members experiences and research

updates were suggested. The library service was poorly evaluated partly

because so many of you have been waiting for books to be dispatched! This

has been a problem because books have not been returned despite our efforts

to remind people. So sorry! Other suggestions for the future would be the

establishment of more support groups and local contact (see later) and a

telephone help line. The work reported in this survey will hopefully be

presented at meetings for health professionals later this year.

, Diane, Marina, Gail

JUST WHO IS THE VULVAL PAIN SOCIETY?

The team responsible for developing and running the VPS on a day-to-day

basis include

Nunns

Marina Folch

Diane Hamdy

Gail Garner

In addition there are many who provide vital support to women with vulval

symptoms through their input into support groups around the country. t

Chapman, Fabia Brackenbury and Emma Byron have all dedicated so much of

their time and effort into their groups.

The website has been very popular. Our thanks go out to Lizzie who

has been so helpful with setting up the site and promoting vulval pain as an

important health issue. She was in ŒRed¹ magazine this month.

Nunns

I currently work as a doctor in the speciality of gynaecology in Leicester

in the UK. My involvement with women with vulval pain began in 1995 when I

worked in a vulval clinic in Bolton. To my surprise many of the women

attending that clinic did not complain of a variety of text-book vulval

conditions, but over one half of the clinic attendees had vulval pain

syndromes. Time and time again, myself and Diane, the clinic sister, would

see women with a long history of vulval pain who had not been diagnosed

properly and who had tried endless useless treatments. There was invariably

a sense of anger and frustration with each new consultation. Forming the

society in 1996 enabled us to spread basic information to women around the

country.

When I was in Bolton I completed nearly 2 years researching vulval

vestibulitis and completed a thesis on the clinical features and possible

causes of vulval vestibulitis. Much of the research I produced from the

thesis has been covered in these newsletters. Although it has not been

essential that a health professional should start a group such as the VPS, I

believe my medical training has helped as so many enquiries have been

medically orientated and this has also helped to try and produced accurate

factsheets on all issues relating to vulval symptoms. Many other vulval

conditions causes symptoms like vulvodynia and many women need specific

direction when they write to us with other conditions

Marina Folch

I also work as a doctor in the field of obstetrics and gynaecology. I first

became involved with the group when working with in 1996 in Leicester.

My involvement is with the day-to-day running of the group. Working as a

gynaecologist I see vulval pain in my clinics and realize that it a

neglected aspect of womens¹ health.

Diane Hamdy

Hello, just to give you a bit of background, I am a Registered general nurse

and Registered midwife, although I haven¹t practiced as a midwife for many

years. I have a long history of working in sexual and reproductive health

since qualifying in 1980. I developed my interest in vulval pain whilst

working with in Bolton in 1996, hence the beginning of the Vulval Pain

Society.

Since starting the Vulval Pain Society with , I¹ve had a couple of job

changes and a geographical change to the South of England I now live and

work in Berkshire. Since 1998 I have been working in Dermatology, as a

Dermatology Specialist nurse, but still participate in the monthly Vulval

clinic run in my area by the Consultant Dermatologist. Since starting this

new job, and being fortunate enough to have Gail as secretary my role with

the VPS has decreased, (I am now able to have a social life). However, I

still maintain a keen interest in the VPS and promoting the cause of women

with vulval pain.

Gail Garner

I am a medical secretary working in Derby and am Œemployed¹ by the VPS to

help run the group, open mail and send out responses. I work closely with

with the overall running of the group.

LOCAL SUPPORT NETWORKS NEEDED

Many of you who completed the survey requested that there should be more

local support and wanted more support groups to be formed. Membership is

currently around 500 and as you can see from the questionnaire there is

great potential to start some regional groups. Enclosed with this newsletter

is a form inviting you to go on a Œlocal list¹ of contacts in your area.

Either you yourself can be contacted and have your details published in the

newsletter (or just on our database), or you can just simply request a list

Distribution of members of the VPS

England

Bedfordshire 6

Berkshire 11

Bristol 7

Buckinghamshire 9

Cambridgeshire 3

Cheshire 9

Cornwall 4

Cumbria 5

Derbyshire 5

Devon 12

Dorset 6

Durham 2

East Riding of Yorkshire 5

East Sussex 7

Essex 12

Gloucestershire 9

Greater London 44

Greater Manchester 9

Hampshire 19

Herefordshire 2

Herefordshire 15

Kent 15

Lancashire 7

Leicestershire 8

Lincolnshire 6

Merseyside 6

Norfolk 4

North Yorkshire 3

Northamptonshire 5

Northumberland 1

Nottinghamshire 10

Oxfordshire 10

Shropshire 1

Somerset 6

South Yorkshire 14

Staffordshire 5

Suffolk 12

Surrey 14

Tyne and Wear 1

Warwickshire 7

West Midlands 12

West Sussex 9

West Yorkshire 8

Wiltshire 4

Worcestershire 5

Wales

Blaenau Gwent 2

Caephilly 1

Cardiff 1

Carmarthenshire 3

Ceredigion 1

Gwynedd 1

Pembrokeshire 1

Powys 1

Swansea 2

Scotland

Aberdeen City 1

Borders 1

Edinburgh 2

Glasgow 2

Clackmannanshire 1

East Ayrshire 1

Falkirk 1

Highland 3

Renfrewshire 1

South Ayrshire 1

Channel Islands

Guernsey 1

Isle of Man 1

Northern Ireland 5

Southern Ireland 4

USA 2

Germany 2

Australia 2

Netherlands 1

France 1

Canada 1

Turkey 1

of women in your area so you can make your own contact. This will hopefully

give you support other than the newsletters. If you do manage to meet up let

us know and we can out details into the newsletter.

VULVAL PAIN SOCIETY MEMBERS SURVEY

Last year we sent out a questionnaire with newsletter 14 to gather

information on all members that had joined. The group had been going for

around 3 years at this stage and we felt it was important to gather

information on members¹ experiences and publish this in a future newsletter.

We also needed to evaluate the group so to improve our service.

The questionnaire was loosely based on a questionnaire developed for

patients in 1991 by the International Society for the Study of Vulval

Diseases. A total of 228 women replied which was a response rate of 45.6% of

women with vulval pain. 8 members who replied were health professionals and

therefore did not complete the questionnaire.

YOUR BACKGROUND

The average age of the group was 49 years with the youngest and oldest

member being 20 and 91 years respectively. 26% of women were less than 35

years and 20% were older than 65 years. 62% were married, 23% single, 11%

divorced and 4% widowed.

54% of women had children. Of these 121 women, 13 had had caesarean sections

and the rest had had vaginal deliveries. A total of 14 women noticed their

symptoms developing after delivery; 11 were following normal vaginal

deliveries and 3 were after caesarean sections.

50% of members had had previous health problems. The common illnesses are

listed in table 1. Of the group, 126 took regular exercise at least twice a

week.

Table 1. Common medical problems

Recurrent thrush 42

Irritable bowel syndrome 38

Previous hysterectomy 28

Recurrent cystitis 9

Endometriosis 8

Prolapse repair 6

Depression 5

PRESENT VULVAL COMPLAINTS

The Vulval Pain Society has members with a variety of different diagnoses.

Although the largest proportion were women with vulval pain syndromes

(vulval vestibulitis and vulvodynia) there were many with other diagnoses

e.g. lichen sclerosis, recurrent thrush and oestrogen deficiency (atrophic

vaginitis). A large number of member, 23%, did not have a diagnosis despite

being a member and having had seen a doctor (Table 2).

Table 2. What diagnosis do you have for your vulval symptoms?

None 23%

Vulvodynia 27%

Vulval vestibulitis 28%

Lichen sclerosis 5%

Others 17%

Not unsurprisingly, pain was the main complaint amongst women, in particular

burning and soreness (table 3). This fits in with the above diagnoses. Many

had painful sex together with a background of pain and only 5 members (all

with vulval vestibulitis) complained of painful sex only and were symptoms

free otherwise. Members with itching only were in the minority and either

had lichen sclerosis or recurrent thrush.

Table 3. What are your vulval symptoms?

Pain only 25%

Painful sex only 2%

Pain and painful sex 46%

Itching only 3%

Pain, itching & painful sex 24%

30% patients had continuous pain, whereas 70% patients described

intermittent pain with both good and bad days. The consequences of pain on

the members¹ day-to-day living was questioned; pain and inability to be

sexually active were the main concerns about symptoms. Other concerns

included relationship problems, a loss of confidence, clothing restriction,

a loss of femininity and isolation.

Table 4: What bothers you about your symptoms?

The pain 42%

Not able to be sexual 42%

Taking control 11%

Lifestyle changes 4%

The average length of symptoms was 6 years for the group as a whole. One

member had had symptoms for 2 months and the longest length of symptoms was

33 years. When asked on a score of 0 to 100 what would your average pain

level be the average score was 37. The average score for the worst symptoms

was 79.

The average length of time of symptoms was 6 years

The majority of the group used just plain water to clean the vulval area,

however, many used aqueous cream, aloe Vera soap and normal soap.

Table 5: Top 4 causes of symptoms*

Recurrent thrush

Stress

Anti-thrush creams

Previous sexual experiences

*Only vulval vestibulitis and vulvodynia

Table 6: Foods associated with vulval pain (descending order)

Coffee

Yeast containing products/wheat

Alcohol

Sugary foods

Fruit juices

Others, spicy foods, cheese, nuts, beetroot, lemons, strawberries

Table 7: My discomfort usually causes

NO interference with daily routine or

planned activities 29%

SOME interference with daily routine

or planned activities 44%

An interruption in daily routine

or planned activities 15%

Confinement to bed 2%

The pursuit of immediate medical

attention 2%

Table 8: The statement which describes the discomfort which I most often

have

Slight, I notice only when I think

about it 12%

Slight, I can ignore it by not thinking

about it 14%

Moderate, I always know it¹s there

but I can still perform most tasks

56%

Severe, it allows me to perform only

Tasks which require little concentration 12%

Severe, makes it impossible for me to do anything but seek medical attention

6%

We tried to assess the pattern of pain among women with vulval pain

syndromes. 50% of members felt their symptoms were less intense than when

they originally developed, but 23% felt symptoms were worse. Interestingly

67% had symptoms constant throughout the day, whilst 10% had pain worse in

the morning, 14% in the evening and 9% at bedtime.

The majority of women could not identify a specific cause for symptoms,

however, many regarded thrush, thrush treatments and stress as possible

factors.

30% members believed that certain foods aggravated symptoms, whilst 70%

noticed that symptoms were unrelated to food.

Of the 135 women who were pre-menopausal 62% noticed symptoms worse around

the time of a period. 4 women noticed pain worse at mid-cycle. Tables 7-10

outline the influence of symptoms on lifestyle and sexual activity. If

symptoms stopped sex from happening altogether, 42% members remained

physically close but avoided

sexual contact, 20% avoided sexual intimacy altogether, 22% concentrated on

partners¹ satisfaction and 6% had relationships as normal. For those women

with a partner the majority had a sympathetic partner, however, 8 members

had not told their partners and 11 cases partners had become hostile towards

them and sexual relationships had ended

When asked about the future, 35% remained optimistic about the future and

that the pain would go at some stage, 36% felt optimistic but that they

would have to live with the pain and 29% were not optimistic.

Table 9: My symptoms

Do not affect sexual intercourse for me

5%

Sometimes prevent me from sexual intercourse

33%

Completely prevent me from sexual intercourse

36%

Cause discomfort, but do not

prevent sexual intercourse 10%

Don¹t know, I am not sexually active

16%

RELIEF FROM SYMPTOMS

The average number of creams used which had been prescribed by a doctor was

6 with the most being 25 used by one member over a period of years. Table 5

illustrates the benefits of heat, cold, sex and underwear on vulval

symptoms. Treatments that benefited women with a diagnosis of vulval pain

syndromes varied greatly and are detailed on tables 12,13,14.

Table 10: With regards to sexual activity in the past

I used to enjoy sexual intercourse

61%

Intercourse has always been somewhat uncomfortable 22%

I have been forced to have sexual intercourse against my will 6%

I had unpleasant sexual experiences in my childhood 3%

I think my past experiences may have caused some of the problems I have now

6%

I think that my past sexual activity would be considered pretty normal

46%

Table 11 Relief No change Worsen

Heat

(hot bath) 32% 35% 33%

Cold

(like cool compress) 54% 31% 15%

Sex 3% 17% 80%

Underwear 5% 51% 44%

YOUR CARE TO DATE

The average number of doctors members had visited prior to an accurate

diagnosis was 4. One member had been to 15 doctors over a period of years!

The type of doctor varied from GPs to hospital specialists (Table 15)

Table 12: Best treatments identified by member for vulval pain syndromes and

vulvodynia

(no order)

Complimentary treatments

aloe Vera

calendula cream

geranium and lavender oil

sweet almond oil

teabags (tannic acid)

hypercal

Dr Bach rescue cream

evening primrose oil

tea tree oil

calamine lotion

vit E oil

Local anesthetics

xylocaine gel lignocaine gel

Perinal

dibucaine

anethaine cream

Emla cream

Oral antidepressants

Amitryptyline

desipramine

Dothiepin

Oral antidepressants

imipramine

Nortryptyline

Steroid creams

lotriderm

Betnovate

Triamcinolone

Hydrocortisone

Propaderm

Elocon ointment

Eumovate

Anti-thrush treatments

Nystaform

Diflucan

Nizoral tabs

Canestan Anti-thrush treatments

Gynodaktarin

Nystatin

Itraconazale

Emollients

Diprobase

Aveeno baths soaks

Aqueous cream

emulisderm bath lotion

Sudocream

zinc and castor oil

Others

lubricating gel

Replens

0estogen cream

Senselle

calcium citrate

trimethoprim (an antibiotic)

Vagisil

pimozide

Scheriproct ointment

piriton

ibuprofen

sheep¹s yogurt

physio flexible cold pads

tegretol

Prozac

olive oil cream

acigel

Dalacin cream

vaseline

progesterone suppositories

Balneum plus

morphine sulphate tablets

Astroglide

sultrin cream

27% women were satisfied with the care that they had received, however 73%

women were dissatisfied with their care mainly as they were not taken

seriously or received little information. 24% of members were receiving care

within specialized vulval clinics

Table 13: Vulval vestibulitis - top 4 best treatments

Aloe vera

Steroid creams (hydrocortisone, Trimovate,)

Amitryptyline

Local anaesthetic jelly

YOU AND THE VULVAL PAIN SOCIETY

The vast majority of you highly regarded the group and most found the

information within the newsletters adequate enough to help understand

information. For many 70% this information helped cope with pain. 79% even

felt that the Society gave e hope for the future.

Table 14: Vulvodynia - top 4 best treatments

Amitryptyline

Aloe Vera

Nortryptyline

Local anaesthetic jelly

Table 15: Type of doctor giving correct diagnosis

Dermatologist 28%

Gynaecologist 30%

Genito-Urinary Physician 19%

General Practitioner 17%

Pain clinic 5%

Psychologist 1%

DISCUSSION

The questionnaire has raised several interesting issues. It is important to

remember that all members are different and it is wrong to consider everyone

in the group as the same. This is particularly relevant with regards to

treatment. The mixture in the group is reflected in the age range. On the

whole younger women with vulval pain had vulval vestibulitis and painful sex

whereas older women had more constant pain and Dysaesthetic vulvodynia.

It is often believed that childbirth can be associated with the development

of symptoms of vulvodynia. In our survey around 10% noticed symptoms worse

postnatally. The reasons for this remain unclear, but may be related to

tissue damage following delivery or inappropriate stitches. Vulval pain can

develop even after a caesarean section. This can happen as the body¹s

oestrogen levels rapidly fall after delivery and oestrogen deficiency

postnatally can cause vaginal dryness and painful sex.

Overall, members were very health conscious with over half taking regular

exercise. Regular exercise is a vital part of managing pain and this is

crucial to controlling pain and trying to get back to normal. Sione Watts

produced a factsheet on pain management that members might find helpful

available from the VPS. The previous illnesses listed in Table 1 did not

reveal any particular Œcommon¹ illness in women with vulval pain.

Hysterectomy, prolapse repair and irritable bowel syndrome occur in women

without vulval pain and were commonly reported in the survey. Interestingly,

only 5 women declared a history of depression. Whether depression caused the

pain or whether depression was as a result of pain remains unknown. Many

doctors believe women with vulval pain are depressed, (which is

understandable for some women because pain is pain!) but this survey

questions the often held belief among doctors that depression and vulval

pain often occur together.

It was disappointing that despite the information we provide, 23% of women

still did not have a diagnosis for their symptoms. This is a concern as some

of the women had not seen a doctor and were self-treating. Having an

accurate diagnosis is essential! If your doctor is unsure then he/she should

consider referring you onto a specialist. Some women had lichen sclerosis

and Fabia at the National Lichen Sclerosis Support Group (see addresses)

continues to provide information to these women. The bulk of the group had a

diagnosis of vulval pain syndromes (vulval vestibulitis and dysaesthetic

vulvodynia). The features of these conditions are available on factsheets

from the VPS. The diagnoses often fitted the symptoms ­ pain and painful sex

were the main issues. Very few women had itching only without pain. All

these had lichen sclerosis or had not seen a doctor. Table 4 shows the

serious implications of symptoms on members¹ lifestyles. Although the

average length for member was 6 years, there were many with symptoms less

than this. It is important to remember that many women who do get better are

unlikely to rejoin the group and not therefore going to be included in the

survey. Don¹t lose hope!

Most used clean water to clean the vulval area. This is important to help

reduce contact sensitivity to the vulval skin, which can make matters worse.

Soaps, bubble baths and antiseptics can all potentially damage thin vulval

skin. Aqueous cream can be used as a soap substitute. Remember so-called Œlo

w allergy¹ soaps and shampoos can still irritate. Even though they are

perfume-free, they can still harm the vulval skin through the preservatives

which they contain.

We are still no nearer to finding the exact cause of vulval pain, but this

survey has suggested a variety of different causes (Table 5). The oxalate

theory has been covered in this newsletter several times in the past. We

asked as a part of the survey about the role of foods as a cause of pain.

Surprisingly 30% noted that certain foods listed in table 6 aggravated

symptoms. These were not necessarily high oxalate foods, but

yeast-containing foods were reported as the commonest food to make symptoms

worse. This is of interest and worthy of further study.

With regards to treatment, there were no clear benefits from heat or cold

application to the vulval area, although over half the respondent had more

relief from a cold application. Table 12 contains a long list of Œbest¹

treatment for vulval pain syndromes. It is quite a long list and the

treatments vary considerably! Complimentary treatments were commonly used

by members and were as highly rated as the prescription based treatments.

There were many prescription-based treatments used. Tri-cyclic

antidepressants were one of the most popular treatments for its benefits in

controlling pain centrally. Amitryptyline was the most common drug used

which is a surprise because many other new tri-cyclics can be used with as

much benefit and fewer side-effects e.g. Nortryptyline. Anti-thrush

treatments and steroid creams all fared well, although one would still be

very cautious in using them without the input of a doctor. Remember any

creams will give benefit because of its emollient effect. Interestingly,

nobody had had success with biofeedback therapy which probably reflects its

poor availability in this country. Many of you will want to try these

treatments. Good luck. Certainly the complimentary treatments may be

worthwhile looking at. Beware of any cream or application that irritates and

maybe prescription based could be discussed with your doctor.

OVER TO YOUŠŠŠ

Dear VPS.....

I thought other members might benefit from my experience at the dentist¹s

surgery yesterday. He asked me if I¹m taking any medications and I felt, for

my own safety, that I should tell him I take 25mg amitryptyline daily. Had I

not seen an article about low doses of anti-depressants being used to treat

chronic headaches I would have been floundered when he asked my why I¹m

taking it!

It¹s bad enough having DV and there is no need to broadcast I it, like me,

you have a ready answer. Maybe I¹m wrong, but I didn¹t think it important he

should know the real reason. I just hope that I didn¹t blush!

Incidentally, although it¹s effect has been very slow (I¹ve been on it for 9

months now) this drug does seem to be helping me (if nothing else it ensures

a good night¹s sleep ­ I go out like a light!!). It is not a miracle cure,

but it¹s worth persevering. It was 2 months before I noticed any difference

at all, then things remained static for another six months before it

improved a little more. Perhaps if I stay on amitryptyline long enough, the

problem will eventually resolve, I hope.

Mrs. Dunning, Yorkshire

PS. I still get headaches!

Dear VPSŠ

Can you let members know that if they want to hire biofeedback machines,

they can at £30/month? I also have a copy of the paper on what is required

in terms of daily exercise from the National Vulvodynia Association.

Further details tel 01942 238259 or fax 01942498491

Anne Day, Wigan

DMI Medical Ltd

Unit 1, Rosebridge Court

Ince Wigan WN13DP

Dear VPSŠŠ

I have only been recently diagnosed with vulval vestibulitis. Two small

things that have greatly helped me are soaking in a luke warm bath with 5

tablespoons of bicarbonate of soda added to the bath water. This helps with

burning or itching of the vulva. If lubrication is required for sexual

intercourse, the most natural thing is pure vegetable oil. This has made sex

once more a pleasure. It can be used in conjunction with the condom Avanti.

The only disadvantage being the price at £2 a condom. But no doubt this will

decrease, as this is new product. I was given this advice from the

genito-urinary medicine clinic. These procedures in addition to the normal

guidelines for vulval skin care have greatly helped me.

J , Glasgow

LIBRARY SERVICE

If you are interested in receiving any of the information below please send

cheque made payable to the Vulval Pain Society and send it to us at our PO

box. The price includes the cost of postage and packaging. Due to

limitations of stocks it may be necessary that you will have to wait for

your order. Sorry! We only have one or two of each copy.

Painful sex £2

Goldsmith

A book which inspired us at the VPS. Outlines most causes of painful sex

with good articles on vulval vestibulitis.

Cystitis: How to combat attacks and prevent recurrence £2

Dr Caroline Shreeve

This book explains what cystitis is, what causes it, how to recognize it and

who it affects and why. As well as explaining how orthodox medicine can

help, Dr Shreeve sets out a comprehensive self-help program, including

Œemergency¹ treatment for sudden cystitis attacks and a longer term

programme for avoiding further bouts. Her approach takes into account

various complementary therapies, such as homeopathy, herbalism and diet.

Coping with thrush £2

Caroline Clayton

This book describes thrush and explains treatment, home remedies and advises

how to prevent further attacks. There are also chapters on diets, self-help

remedies and sex.

Coping success fully with pain £2

Neville Shone

This book is directed to pain in general, but the book does apply to vulval

pain. It provides a practical guide to taking charge of pain and to handling

many situations you once dealt with automatically, but which now seen

daunting.

The Chronic Pain Workout Book £3

Ellen Mohr Catalano & Kimeron Hardin

This American book bring together the expertise of an eight-person team of

medical doctors, psychologists, educators and therapists-specialists in all

area of chronic pain management

The Pain Relief Handbook £2

Dr Wells and Graham Nown

As recommended by the Pain Society, this book has been written to help those

who suffer from all types of chronic pain. Drawn from the ground-breaking

work of the Walton pain Management Centre, it is the 'ultimate guide to

coming to terms with, coping with and overcoming pain.'

The Stress and Relaxation Handbook: A practical guide to self-help

techniques

Jane Madders £2

This book teaches numerous relaxation techniques which can help to

counteract stress. There are illustrated exercises that can manage different

types of pain and tension.

Beat Stress From Within £3

s

This package includes cassettes and books which is principally directed at

stress management. The program claims to reduce stress, protect against

stress related illness, sleep better and feel less irritable, anxious and

tense.

The Which? Guide to Complementary Medicine £2

Barbara Rowlands

This book examines a wide range of established therapies, from acupuncture

to yoga, looking at the experiences of those who have received such

treatment and, at the same time, taking into account the views of the

medical profession. As well as addressing many common consumer concerns, the

book explains what you can do if things go wrong, and provides a glossary,

bibliography and list of useful addresses.

Stress Relief for Women £1

Janet

A short book outlining types of stress management including aromatherapy,

flower remedies, self-hypnosis and many more.

Candida: The Natural Way £1

Simon

This compact guide explains the latest treatments - conventional,

complementary and alternative used to keep candida in balance.

Escape From Pain £2

Oliver Gillie

This book, published by Self-Help direct aims to provide the reader with

details on the treatment of chronic pain in general.

Cystitis £1

Kilmartin

This book, written by a former sufferer outline treatments and preventative

measure of this common problem.

Natural Pain Relief £2

Jan Sadler

This book focuses on the growing interst into alternative and natural

treatments. Written by a women with chronic backache it is divided into

different self-contained units, each one devoted to a specific aspect of

pain relief.

Vulval Vestibulitis Syndrome

SAE only

Dr Marinoff and Dr

Vulvodynia SAE only

Dr McKay

Factual review articles on vulval pain written by experts in the field

FACTSHEETS

We have complied a few factsheets taken from previous newsletters simply

outlining different aspects of vulval pain. If you would like a copy, please

send a SAE to us and we will gladly forward then onto you.

Factsheet 1: What to do with vulval pain

Factsheet 2: Vulval vestibulitis: A cause of painful sex

Factsheet 3: Dysaesthetic vulvodynia

Factsheet 4: Vulval pain and oxalates: The theory

Factsheet 5: Low oxalate diet sheets

Factsheet 6: Vulval pain and sexual dysfunction

Factsheet 7: How to set-up support group

Factsheet 8: Medical literature reference list

Factsheet 9: Vulval hygiene sheet

Factsheet 10: Treatment with amitryptyline

Factsheet 11: Cyclical vulvitis

Factsheet 12: Urethral syndrome

Factsheet 13: Vulval Intraepithelial Neoplasia

Factsheet 13: Thrush: A brief guide to diagnosis and management

SUPPORT GROUPS AND CONTACTS

There are a number of support groups for women around the country. Here are

the phone numbers of volunteer members who can be contacted

SUFFOLK AREA ­ Helen Thorpe, a member, is keen to develop contacts in the

Suffolk area. You can write to her ­ Helen Thorpe, 6 Bridgewood Road,

Woodbridge, Suffolk, IP12 4HA

LEEDS - Emma 0 (Emma also co-ordinates a support group for women

with vulval pain in the Leeds area)

SOUTHAMPTON AREA ­ Meg Hart, a member, is hoping to start a group up in the

Hampshire area. She can be contacted by post ­ Mrs MC Hart, 13 Elliot Rise,

Hedge End, Southampton, SO30 2RU.

NOTTINGHAM AREA ­ Contacts needed. Write to White, 24 Camomile Gardens,

Hyson Green, Nottingham, NG7 5GB

BRIGHTON - Do you live in the Brighton area? One of our member is interested

in setting up a group. Please write to Jay , Flat 3, 23 Brunswick

Road, Hove, East Sussex, BN3ID6 or ring G.March on 01273 465683.

LONDON VP SUPPORT GROUP

The London VP Support group is run by t. The group meets once a month

in the all female environment of The Wheels Women¹s' Centre where they rent

a room and chat about the latest issues relating to vulval pain. The

immediate aim of the group is to provide a setting in which it is possible

to talk about living with vulval pain on a confidential basis with fellow

sufferers. The long-term aim is to take positive action towards raising

awareness of this condition and eventually finding a cure.

The group invites all women with this condition to join them and welcomes

any new ideas. There is no need to make contact beforehand. Please simply

turn up at The Wheel on the last Saturday of every month between 1 and 3 pm.

The address is

The Wheel, Wild Court, Off Kingsway, London WC2B 4AU. Tel: 0

Nearest tube : Holborn

USEFUL ADDRESSES

National Lichen Sclerosus Support Group, 2 Ivy House,Wantage Road, Great

Shefford, Berkshire

RG17 7DA

Vulval Pain Foundation

Post Office Draw 177

Graham, North Carolina 27253

Pain Concern UK

PO Box 318 Canterbury Kent

CT2 OGD

National Vulvodynia Association

PO Box 4491

Silver Spring

land

20914-4491 USA

Interstitial Cystitis Society

CVS, 13 Hazelwood Road, Northampton.

Websites

www.vulvodynia.com

www.VPS/vpsintro.htm

The Vulval Pain Society aims to provide information and support to women

with vulvodynia. Vulvodynia is defined as long-standing vulvar discomfort or

pain, particularly that characterised by burning, stinging, irritation or

rawness of the vulval area. It is diagnosed by a doctor when other causes of

vulval pain such as active infection and skin diseases have been ruled out.

Women who have vulval vestibulitis form a subgroup of vulvodynia and the

society aims to support these women as well.

We do not encourage you to self-diagnose your symptoms and would encourage

you to work with your doctor (GP or specialist) to find the best treatment

for you. Before you take advice from the VPS it is best that vulvodynia and

vulval vestibulitis is diagnosed by a doctor familiar with the condition.

The Vulval Pain Society can only give general advice to women. In all cases

the Vulval Pain Society recommends that you consult a doctor regarding any

course of treatment or medication. Any products mentioned in the Newsletter

are not endorsed or recommended by the Vulval Pain Society.

LOCAL SUPPORT LISTING

Please fill in and return to the VPS if you wish to have contact with other

women near you. Tick the box which applies to you.

ú Please place my details on the county database so that my details below

can be passed onto other women

ú I have no objections for my name and address being published in the next

newsletter

ú I do not wish to have my details on the database, but would like to

receive details of other women in my area.

Name:_________________________

Address:____________________________________________________________________

__________________

County:________________________

Telno(optional)________________________________________________

Please return to VPS, POBox 514, Slough, Berkshire

>

> Reply-To: ukherbal-list

> Date: Thu, 5 Jul 2001 17:03:43 +0100

> To: <ukherbal-list >

> Subject: Fw: vulvodynia

>

>

> vulvodynia

>

>

> Dear all,

> I have a 67 yr old lady patient with vulvodynia caused by antifungal treatment

> resulting nerve damage 3yrs ago[GPs diagnosis.] being treated with

> neurontin[Gabapentin] 400mg TID and co-proxamol .She also has mild Parkinsons

> being treated with Sinemet, a dopamine precusor/dopa decarboxlase

> inhibitor.The neurontin is not working and she is very tired and constipated

> as a result of it.Her GP is willing to support her in seeking my help and will

> assist in monitoring any drug herb interactions as he says other than giving

> her spinal injections he canot help her. She has had acupunture.Emotional

> upset makes it worse, home life stressful, exercise and enjoying herself with

> her keep fit classes makes it beter,she says her husband is difficult to live

> with but she does not appear depressed just fed up with the pain which is

> burning and persitant making it difficult for her to sit down for more than a

> few minutes.She is desperate can anyone help?

> Has anyone tried using alpha lipoic acid for the pain of nerve damage?

> Would a topical approach be the most successful and safe due to the danger of

> interactions ?.She may be coming off the neurontin soon.

>

> Thanks

> watson

>

>

>

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