A multidisciplinary approach to a patient with vulvodynia: a successful treatment and outcome

Vulvodynia is chronic vulvar pain or a burning sensation lasting for at least 3 months without a cause. We present the case of a 53-year-old postmenopausal woman that experienced vulvar and vaginal burning, and discomfort and pain during sexual intercourse for 3 years, which greatly reduced her quality of life (QOL) despite the absence of itch and genital skin lesions. Her regular gynecological exams showed no pathology, and so she was referred to a dermatologist, who initiated a multidisciplinary treatment approach involving several specialists: an anesthesiologist, gynecologist, urologist, psychiatrist, and dermatologist. Targeted psychiatric treatment (amitriptyline), together with acupuncture treatments and support by a gynecologist, led to a major improvement in symptoms and QOL, as well as a decrease in depression and anxiety measured by the Beck Depression Inventory II (BDI-II) and State-Trait Anxiety Inventory (STAI). A multidisciplinary and integrative approach was crucial for determining a diagnosis and achieving an excellent outcome.