Case Study: Chronic Vulvar Pain

I recently received great news from a patient I had been working with for over a year. One of the lines read,

“I wanted to let you know that I am feeling 100%. I don’t have any vaginal symptoms for the first time since I was 18 years old. I wanted to thank you for everything you have done. I can’t tell you how grateful I am.”

When I first met this patient, she had worked with a number of providers without success and was seeking relief for chronic vulvar and vaginal pain that started following a misdiagnosed and mistreated vaginal infection when she was 18 years old- almost 20 years prior to us meeting.

She had been given the diagnosis of vulvodynia and described the sensation as pain and burning at the entrance of the vagina. She had been to a number of experts and tried a number of treatments, including pelvic floor therapy, hormone therapy and various medications and supplements with fluctuating success. Most recently she had undergone surgery at the entrance of the vagina, which seemed to make everything worse, prompting her to come and see me.

We tried a number of treatments and work ups aimed at reducing inflammation with moderate success. After working together for a few months, I recommended testing the vaginal microbiome and gut microbiome.

Identifying and treating the cause

One of my favorite aspects of naturopathic medicine is the philosophy of treating the underlying cause. I have seen over and over again, that there is often an underlying imbalance that is contributing to a patient’s presenting symptoms. I love working with patients on getting to the root of what is ailing them.

Microbiome testing was not a part of our initial work up because she did report many gut symptoms, but after months without much response to treatment, I thought it was worth our time to re-evaluate.

Her results came back positive for dysbiosis in both the gut and vaginal microbiome. We immediately treated both systems with a combination of botanicals and antibiotics. Very quickly after we started treated she reported an improvement in her vaginal symptoms. Her pelvic floor physical therapist even shared that she was noticing less guarding and hypertonicity in the pelvic floor.

Let me repeat that- treating bacterial imbalances in the gut and vagina IMPROVED THE TONE OF HER PELVIC FLOOR.

She also acknowledged that previously she didn’t think she had any digestive issues, but after changing her diet slightly and addressing dysbiosis, she began feeling better and recognized that she had in fact been dealing with gas and bloating and other digestive issues for a long time.

Within 3 months of successfully and identifying what the underlying issue was causing inflammation in her gut and vagina, I received an email stating she was feeling 100% better. I couldn’t believe it.

I love helping womxn optimize their health. This always starts with correctly identifying the root of what is causing the imbalance. Sometimes it takes a few tries to correctly identify it, but I will always keep working with patients until we find it because once we do and take the appropriate steps to treat it, incredible healing happens.