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From: Arts and Lifestyle | Women | Thursday, June 07, 2001 No Laughing Matter A joke on the season premiere of 'Sex and the City' is not so funny in real life By SUSAN FERRARO Charlotte had a prickly problem last Sunday. The "Sex and the City" character was suffering from burning and itching "sort of like a yeast infection," she told her friend Carrie. The diagnosis: vulvodynia. "It's not serious, mostly just uncomfortable," said Charlotte's doctor, who prescribed an anti-depressant. "I'm not depressed!" protested Charlotte. "It's not for you, it's for your vagina," the doctor insisted. When Charlotte relayed the news to her friends over lunch, they couldn't help but joke about it. "So your vagina is depressed?" asked Carrie. Very funny — if you're in a sitcom. In real life, vulvodynia is not curable. It also can ruin a woman's life. "We hope the show helps raise awareness," says Phyllis Mate of the National Vulvodynia Association. "But its frivolous portrayal offended many, and the comment by the gynecologist that it is easy to treat was absolutely incorrect." Not an infection, but ceaseless burning and stinging in the outer vaginal tissue, vulvodynia may affect 8% of women — many too embarrassed to ask about it — and makes sex so painful that most avoid intimacy. The pain varies day to day, and can hurt all over the outer vaginal tissue or confine itself to a raw irritation at a specific spot that hurts if touched — during sex or when inserting a tampon. The problem "couldn't be more serious" for patients, says Dr. Howard Glazer, a New York neurophysiologist and sex therapist who works with biofeedback to treat the disease. "The stories women tell you make your hair curl," says Lynn W., 38, who lives in New Jersey and has had vulvodynia for 12 years. She has used low-dose antidepressants, which interrupt pain messages. These days she fights it with biofeedback that strengthens and relaxes her pelvic floor muscles. "I was able to have two children the old-fashioned way, and most of the time I feel pretty good," Lynn says. "But I can't wear tight pants, jeans or sit for long periods of time. I can't ride a bicycle." Causes are hard to pin down, says Dr. Gae Rodke at the New York Center for Vulvovaginal Pain. They range from injury to constant yeast infections, soap allergies, certain crystals in the urine and spasms of the pelvic floor muscles. Yet often, the first hurdle most women face is doctors who ignore or dismiss them. "Many women are told they are crazy, which is not true," says Rodke. She sees as many as six new patients a week. On average, they have spent four years and seen nine doctors searching for help. Care starts with a very thorough history, says Rodke. "Usually, whatever started the problem is long gone," she says. Treatments that work together or alone include: Eliminating irritants like fragrances in soaps and laundry detergent that might aggravate the condition. Clearing up problems like cystitis or real yeast infections. Trying low doses of older antidepressants, like Elavil, which interrupt pain messages. Drinking lots of water, to dilute urine. Retraining the pelvic floor muscles with a specific form of biofeedback. For carefully selected patients, surgery. To find out more, contact the National Vulvodynia Association at (410) 686-7011, go to www.nva.org or click on Glazer's Web site: www.vulvodynia.com
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