For some time now I have been working on fibromyalgia, so I can calmly state, on the basis of scientific documentation (medical records, first visit) that about three out of five women patients I meet every day on first visit – which lasts roughly an hour – suffer from vulvodynia .
All, or almost, have the same clinical history, the same anamnestic account, it seems really a “copy and paste”!
What is it about?
Vulvodynia is a syndrome of unclear etiopathogenesis, which causes immense pain to the vulva, associated with very strong burning, in addition to dryness, burning sensation, pinpricks … Symptoms sustained by a painful hypersensitivity of the vulvar vestibule which, moreover, makes the relationship complete sexual very painful and impossible and / or disabling penetration.
It is not an easy topic to deal with, because initially the patient is reluctant to talk about it, even for culture. But after having established an atmosphere of empathy and seizing the obvious non-verbal messages, with simple words the help to remove the weight, to free themselves, to “spit the toad”.
Sometimes you can talk about it even in the presence of the partner, other times it is necessary to invite him to wait in the waiting room to allow the patient to communicate freely. In my opinion, the presence of the partner during the interview is fundamental, as the latter plays an important role in the therapeutic path. Initially, the reaction of the partner is understanding, is close to her, thoughtful, convinced that everything will pass, will heal, and everything will return as before. But this is not always the case, or at least not immediately. With the passage of time, things get complicated, pain increases, the absence of sexual relations feeds imaginary suspicions of infidelity in men and depression in women. Couple problems thus arise.
All professionals, at least those who believe in the disease, agree on the multifactoriality of the etiopathogenesis.
From the casuistry of Never more pain is a curious fact that led me to deepen the topic, namely:
not all patients suffering from fibromyalgia develop vulvodynia , as not all patients suffering from vulvodynia develop fibromyalgia.
From recent studies and research conducted at the University of Boston by Prof. Theoharis Theoharides together with Prof. Pio Conti and published on PubMed, we highlight the fundamental role of mast cells and their degranulation with the production of inflammatory factors – hypersensitivity and pain – in onset of symptoms and how, by blocking the degranulation of mast cells, this can lead over time to clear improvements up to even healing.
It is scientifically proven that cannabis therapy is very effective in these cases, because it adheres perfectly to the sites exposed on the surface of the mast cells, effectively interrupting their activation and therefore the degranulation.
As for fibromyalgia, vulvodynia also requires a multidisciplinary therapeutic pathway.
The Multidisciplinary Therapeutic Path adopted by Mai Più Dolore includes:
Gynecological examination , to exclude organic and / or infectious diseases – referents Dr. Luigi Selvaggi and Dott.ssa AnnaMaria Stammitti
Psychological visit and psychotherapy , also for couples – referent Dr. Benedetta Stivaletta
Physiatric visit and pelvic floor rehabilitation – referring to Dr. Serena Columbo
Cannabis therapy – referent Dr. Ali Younes
Adjuvant medical therapy with antidepressants in addition to the application of a topical cream based on local lubricant anesthetic and CBD cannabis, whose formula and production I am working with our galenic pharmacist Dr. Federico Dalla Montà.
In life everything is shareable, except pain! Because it is subjective.