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Wednesday, August 17, 2016

Chronic vulvodynia, cured with elimination diet

This patient (a 28-y-old athletic woman) reported vulvovaginal pain dating back to when she began menstruating and using tampons. Initially the pain was ignored. In the subsequent decade, she noticed an itching and a burning pain slightly inside of the vaginal canal that would come and go several times per year. At age 21 years, she became sexually active and experienced increasingly painful intercourse, which was eventually present with every sexual encounter.

In the summer of 2014, a gynecologist obtained a vaginal biopsy, diagnosed vulvodynia, and suggested that the local removal of the vaginal mucosa was one potential treatment for vulvodynia. Her gynecologist prescribed 4 medications: gabapentin and lidocaine ointment nightly, and hydrocortisone and estradiol suppositories alternating nightly.


The nutritionist recommended an individualized, vegetarian elimination diet to this patient (who had been a vegetarian since age 12 y) to assess potential connections between food sensitivities and her vulvodynia. Her diet eliminated meat, fish, dairy, soy, all grains (except quinoa), peanuts, corn, sugar, and artificial sweeteners. She also eliminated caffeine and limited alcohol to 1 drink per day or less with food. She continued to eat eggs and legumes (except for peanuts). Patient was instructed to not limit calories and to eat when she felt hungry.


Patient Perspective
My pain has been incredibly decreased overall since I started this program and my irritable bowel symptoms are much better! 
I am not presently using any vaginal creams and I did not feel an increase in pain. I think soy was a major trigger and since eliminating it from my diet, my pain level has significantly decreased. Now when I get a flare, the worst it gets is about 3 out of 10, whereas before it could be an 8 or 9 out of 10. 
I have started physical therapy (PT) again and am working on reducing the tension in the pelvic floor. I was able to jump back into the PT with more ease and bring in
new breathing techniques and stretches now that we don’t have to spend as much time on the muscles. Everything is going in a good direction! 
The elimination diet is definitely a challenge. However, it is completely worth trying if it means it can help heal your body after so many years of pain. In order to really
receive the benefits of the elimination diet, you definitely need to be committed to the plan, which can be hard (especially for very active, busy women). But it is really all possible with the help of a knowledgeable and patient nutritionist, advice from a team of other medical professionals who care about you, and support from your friends and family. And finally, the most important part of successfully completing the elimination diet, is giving yourself permission to focus on yourself, because you deserve to live a happy, healthy, and pain-free life.

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