Vulvodynia Medications: Why Nothing Has Worked, and Every Option That Actually Might

Vulvodynia just means pain in the vulva. It is not a diagnosis - and Dr. Maria Uloko argues that is why treatment so often fails. Maria is a urologist trained in comprehensive sexual health, one of seven in the world doing this work. We go type by type: what causes each one, what treats it, who it will not help. SPONSORSPelva: the HydroSlix liner, a cushioning insert for more comfort during insertion. pelva.com, code TWTC10 for 10% off your first order.Origin: the largest in-network pelvic floor PT provider in the US, most patients pay under $36 a visit. theoriginway.com/TWTC, code TWTC for your first month of OnTrack free. Connect with Dr Uloko:instagram.com/mariaulokomdinstagram.com/vulvai.co Connect with Mathilde:IG: @theworldstightestcommunityWeb: theworldstightestcommunity.comNewsletter: https://tinyurl.com/4h4snzzdSupport: https://tinyurl.com/mtxnzhsd 00:00:00 Introduction, Dr. Maria Uloko00:02:24 Medication, Trial and Error00:03:35 Sexual Health Training00:04:25 Curable Conditions, No Diagnosis00:05:24 Chest Pain Analogy00:08:22 Symptoms vs Diagnoses00:09:20 Success Rates, 13-67%00:10:14 Root Cause, Burnout, VULVAi00:11:17 Mathilde's Diagnosis, Dismissal00:12:45 Crisis in Plain Sight00:13:37 Anatomy Study, 75% Gap00:14:37 Pelvic vs Vulvar Exam00:16:28 Cost of Misdiagnosis00:18:47 Sponsor: Origin00:21:12 Sponsor: Pelva00:22:44 Topicals, Systemics; a 10100:23:24 Vulvodynia, Parts of the Vulva00:24:48 Vestibule, 90% of Pain00:26:34 Hormonally Mediated Vestibulodynia00:27:44 Recurrent BV, Yeast; Q-Tip Test00:28:35 Birth Control, Acne, Hair Loss00:29:28 Tool: Estrogen, Testosterone00:30:06 Premenopausal Triggers, 99%00:30:44 IUDs, Rings, Implants00:31:24 Oral Pill, Testosterone, SHBG00:33:03 Staying on Birth Control00:34:50 Tool: Check Hormone Labs00:35:57 Recovery Timelines00:37:39 Neuroproliferative Vestibulodynia00:38:20 Congenital vs Acquired00:39:26 Gabapentin, Lyrica; Pudendal Nerve00:40:41 Wrong Drug, Wrong Diagnosis00:41:17 Vestibulectomy, 96% Success00:42:30 Partial vs Complete Surgery00:45:29 Europe vs US Practice00:46:54 When Surgery Is Indicated00:48:28 Nerve Medication Success Rates00:49:44 Hormonal and Nerve Pain00:50:36 Anesthesia Test, Nerve Blocks00:52:18 Living at a Four; Side Effects00:53:43 Pelvic Floor Dysfunction00:55:13 Primary vs Secondary Tension00:59:26 Pelvic Floor Physical Therapy01:00:00 Kegels, Why to Stop01:00:47 Tool: TENS, Acupuncture, Breath01:01:20 Muscle Relaxants, Suppositories01:01:52 Botox, Resetting the Muscles01:03:22 Clitorodynia, Clitoral Adhesions01:04:37 Clitoral Nerve Pain01:06:47 Lidocaine01:08:50 Compounded Topicals, ABG Cream01:10:44 Systemic vs Topical, Duration01:11:56 Emerging Treatments01:13:43 Endometriosis, Fibroids01:14:44 Mast Cells, Antihistamines01:16:11 VULVAi, Pre-Seed Round01:16:54 Instagram, Reviews, Support