Vulvodynia and Diet

Can there be a connection between what we eat and how we feel? Absolutely! Today, I'm talking about vulvodynia and its complex relationship with food. 

What is Vulvodynia

Vulvodynia refers to pain (burning, stinging, irritation, and rawness) at the vulva. The vulva is known as the external female genital area (and is often thought as the vagina). Vulvodynia is pain that lasts longer than 3 months, and is not caused by an infection, skin disorder, or other medical condition.

Vulvodynia is often seen in combination with two conditions: interstitial cystitis and irritable bowel syndrome. Because of this, I wanted to discuss which diets are often used in these conditions, how they may apply to vulvodynia, and why food sensitivity testing may be the best way to proceed. 

Interstitial Cystitis and Diet 

I'll be writing a post on IC in the future, but generally it's pain, discomfort, burning of some kind (in urethra, pelvis, or low back). It's thought that a leaky gut may be a contributing factor to this condition. 

Leaky gut happens when there is damage to the gut lining, making it more permeable. It can be due to stress, certain medications, environmental toxins, nutritional deficiencies, microbiome dysbiosis, and food sensitivities. Permeability of the lining can lead to unwanted digestive system symptoms like gas, bloating, constipation, loose stools. Other symptoms like fatigue, mood changes, or rapid heart beat can also occur.

If you've followed my work for a while, then you know that I like focusing on food as medicine. We may not always be able to take supplements and get acupuncture, but we're usually always able to eat. With IC, there have been specific foods known as potential triggers for this condition. Women often find relief by avoiding these foods. 

While this specific diet has not been studied in women with vulvodynia, it would be interesting to see if any relief is felt by avoiding these foods.  

Irritable Bowel Syndrome and the FODMAPs Diet

I've mentioned this particular diet on the blog before, especially as it's being considered for the relief of digestive symptoms associated with endometriosis. 

A quick recap on IBS:

You may have IBS if you have recurrent abdominal pain on average at least one day/week in the last three months, associated with two or more of the following criteria:

• related to defecation

• associated with a change in frequency of stool

• associated with a change in form (appearance) of stool

Studies have shown that a FODMAPs diet may be helpful in relieving symptoms associated with IBS. Similar to the IC diet, it would be interesting if women with vulvodynia experience similar relief. 

Vulvodynia and the Diet

Low Oxalate Diet

If you're familiar with vulvodynia, you've probably heard about the low oxalate diet. Oxalates are organic acid found in plants, and bind minerals within the body. In some individuals oxalates may cause kidney stones, and has been proposed as a trigger for vulvodynia. Unfortunately there are only 2 studies looking at oxalates and vulvodynia. 

A 1991 study concluded that urinary oxalates may be nonspecific irritants that aggravate vulvodynia, but they are unsure if oxalates are the true instigators. And a 2008 study concluded that dietary oxalate consumption does not appear to be associated with an increased risk of vulvodynia. 

Elimination Diet

One case study looked at the elimination diet in the treatment of vulvodynia and found it to be helpful, as the woman noticed a relief of symptoms.

An elimination diet is when you avoid all foods containing allergens for at least 3 weeks (although it should be 4-6 weeks), and reintroduce foods one by one to see if they cause any distressing effects. 

When to consider Food Sensitivity Testing

As you can see, there are at least 4 diets on the table for vulvodynia. If you have this condition, and are looking to see if food can make a difference, you can certainly try each of these diets and see if they help. This may, however, take a couple of months with the avoidance and reintroduction periods. One of the benefits of doing this, is that you are able to experience the effects of a particular food. 

A faster way to determine which foods may not jive well with your system is through food sensitivity testing. This is an IgG test, which is a delayed reaction (in this case, to food). Collected via a blood draw, an IgG test can tell you how reactive you are to 120 or 200 foods and herbs. Once you have the results you can stay away from the ‘elevated’ foods, or you can test how exactly they affect you through a diet challenge (where you would consume a serving of food twice in a day, and wait 48 hours to see which symptoms present).

Next Steps

Whether you choose to go the diet or blood test route, having support is always helpful. Book an appointment with a Naturopathic Doctor who is well versed in pelvic health, so you can finally achieve relief! 

References

Baggish M, Sze E, Johnson R. Urinary Oxalate Excretion and Its Role in Vulvar Pain Syndrome. Obstet Gynecol Surv. 1998;53(2):80. doi:10.1097/00006254-199802000-00012.

Harlow BL et al. Influence of dietary oxalates on the risk of adult-onset vulvodynia. J Reprod Med. 2008;53(3):171-8.

Drummond J, Ford D, Daniel S, Meyerink T. Vulvodynia and Irritable Bowel Syndrome Treated With an Elimination Diet: A Case Report. Integrative Medicine. 2016;15(4):42-47.

Friedlander J, Shorter B, Moldwin R. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int. 2012;109(11):1584-1591. doi:10.1111/j.1464-410x.2011.10860.x.