Dr. Oz and Dr. Ashton discuss vulvodynia in the no-embarrassment zone. Learn what causes vulvodynia by watching the video, but some common treatments are:

Self-Care Measures


Many women who have vulvodynia will develop personal strategies that help to control the pain. Here are some tips for everyday living.

  • Wear 100% cotton underwear during the day and wear nothing at night and avoid using panty liners or wearing pantyhose
  • Don't use harsh soaps or douche but instead cleanse with natural emollients such as olive oil and sweet almond oil or just plain water
  • Use non-propylene glycol lubricants during intercourse to improve elasticity of tissue
  • Dab the vulva with cool water after urinating
  • Apply cool ice or gel packs before engaging in a triggering activity
  • Eat a low-oxalate diet (also prevents kidney stones) to reduce the calcium oxalate crystals in urine that might irritate vulvar tissue
  • Use a soft "donut" pillow if you need to sit for a long time

Blocking Pain Signals

The goal of pharmaceutical approaches is to desensitize or block pain signals. Medications can be applied topically, directly on the vulva, taken orally or injected. Here are a few options that interrupt pain signals.

  • Topical anesthetics that contain lidocaine or capsaicin applied 30 minutes prior to activating activity to numb affected area (avoid cortisone topical steroids)
  • Estradiol cream if low is estrogen is low
  • Antidepressant and anti-seizure medications that are known to have pain-reducing qualities
  • Trigger-point injections of steroids or Botox

Practitioner-based Therapies

Patients who see an a physical therapist experienced in treating women with vulvodynia can see marked improvement in symptoms after a series of sessions. The therapist works on stabilizing muscle tone to improve contraction strength and structure of pelvic floor muscles, a potential trigger for pain.

Biofeedback, cognitive and behavioral therapies (CBT) and supportive talk psychotherapy can help patients develop self-regulation strategies to cope with the pain and psychosocial distress that can accompany a diagnosis.

And as a last resort, surgical procedures (perineoplasty or vestibulectomy) removes tissue that is causing the pain.

For more information visit the National Vulvodynia Association.

Your Parent Has Dementia: What to Talk to Their Doctor About

Make sure all their doctors are aware of all the medications she is taking.

Q: My mom is 94 and has dementia. She is taking a whole medicine cabinet-full of medications and I think they actually make her fuzzier. How should I talk to her various doctors about what she is taking and if she can get off some of the meds? — Gary R., Denver, Colorado

A: Many dementia patients are taking what docs call a "polypharmacy" — three or more medications that affect their central nervous system. And we really don't know how that mixture truly affects each individual person.

A new study in JAMA Network that looked at more than 1 million Medicare patients found almost 14% of them were taking a potentially harmful mix of antidepressants, antipsychotics, antiepileptics, benzodiazepines such as Valium and Ativan, nonbenzodiazepine benzodiazepine receptor agonist hypnotics such as Ambien or Sonata, and opioids. And almost a third of those folks were taking five or more such medications. The most common medication combination included an antidepressant, an antiepileptic, and an antipsychotic. Gabapentin was the most common medication — often for off-label uses, such as to ease chronic pain or treat psychiatric disorders, according to the researchers from the University of Michigan.

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