Editing Vulvodynia (section)

==Treatment==
There are a number of possible treatments with none being uniformly effective.<ref name=Stock2013/> Treatments include:

===Medications===
A number of medications have been used to treat vulvodynia.<ref name=Stock2013/> Evidence to support their use, however, is often poor.<ref name=Stock2013/> These include creams and ointments containing [[lidocaine]], [[estrogen]] or [[tricyclic antidepressant]]s.<ref name=Stock2013/> Antidepressants and anticonvulsants in pill form are sometimes tried but have been poorly studied.<ref name=Stock2013/> Injectable medications included [[steroid]]s and [[botulinum toxin]] have been tried with limited success.<ref name=Stock2013/>

===Physical therapy===
Many patients who have vulvodynia also have high-tone pelvic floor, meaning that their pelvic floor muscles are too tight. This may contribute to their pain in the area. [[Pelvic floor physical therapy]] may help treat the [[pelvic floor dysfunction]] and help the patient gain greater control over their pelvic floor muscles.

===Surgery===
[[Vestibulectomy]] is a surgery to remove the [[vulval vestibule]], and it may be recommended for certain patients. It has been suggested as a first-line treatment for neuroproliferative [[vestibulodynia]].<ref>{{cite journal |last1=King |first1=Michelle A. |last2=Mitchell |first2=Leia S. |last3=Belkin |first3=Zoe |last4=Goldstein |first4=Andrew T. |title=Vulvar Vestibulectomy for Neuroproliferative-Associated Provoked Vestibulodynia: A Retrospective Analysis |journal=Journal of Gynecologic Surgery |date=April 2018 |volume=34 |issue=2 |pages=58–62 |doi=10.1089/gyn.2017.0030 |url=https://www.liebertpub.com/doi/pdf/10.1089/gyn.2017.0030 |access-date=29 March 2024 |language=en |issn=1042-4067}}</ref> It has successful long-term outcomes,<ref name="Longterm">{{cite journal |last1=Arik |first1=David |last2=Bornstein |first2=Jacob |title=Evaluation of Long-Term Surgical Success and Satisfaction of Patients After Vestibulectomy |journal=Journal of Lower Genital Tract Disease |date=October 2020 |volume=24 |issue=4 |pages=399–404 |url=https://oce.ovid.com/article/00128360-202010000-00013/HTML |doi=10.1097/LGT.0000000000000552|pmid=32569021 }}</ref> but is often only offered after conservative measures have failed.

===Lifestyle===
A number of lifestyle changes are often recommended such as using cotton underwear, not using substances that may irritate the area, and using [[personal lubricant|lubricant]] during sex.<ref name=Stock2013/> The use of alternative medicine has not been sufficiently studied to make recommendations.<ref name=Stock2013/>

===Counseling===
Gynaecologist-led educational seminars delivered in a group format have a significant positive impact on psychological symptoms and sexual functioning in women who have provoked (caused by a stimulus such as touch or sexual activity) [[vestibulodynia]] (pain localized in the [[vulvar vestibule]]).<ref>{{cite journal |pmid=20181314 |year=2010 |last1=Brotto |first1=L. A. |title=Impact of educational seminars on women with provoked vestibulodynia |journal=Journal of Obstetrics and Gynaecology Canada |volume=32 |issue=2 |pages=132–8 |last2=Sadownik |first2=L |last3=Thomson |first3=S |doi=10.1016/s1701-2163(16)34427-9}}</ref>