The condition of Vulvodynia has perplexed gynecologists for over a century. It is known as one of the most distressing gynecologic conditions next to cancer that a woman can experience. It manifests as spontaneous or provoked burning, stinging and rawness of the vulvar tissues. The burning pain can be so intense that it controls every lifestyle decision from the type of activities able to be engaged in, to the types of clothing tolerated, to the loss of desire and/or inability to have intimate relations. Also, it can make it difficult to focus and concentrate in the work place. Only sleep can lead to escape from being conscious of the vulvar pain. Countless relationships, marriages and job positions have been thrown in havoc and/or disrupted over the problem.
Support groups, societies and conventions have been organized throughout this country to draw attention to the condition and entice researchers to find the etiology. To the present date, the medical literature and most authorities, Dr. Fowler not included, state that the cause of vulvodynia is “idiopathic” or of unknown etiology. In fact, for a patient with vulvar pain to be diagnosed with “vulvodynia” some experts boldly claim that there can be no associated finding other than variable redness of the vestibule or the condition is not vulvodynia. Dr. Fowler finds this absurd, inferring that an underlying aberration at whatever microscopic or biochemical level for vulvodynia does not exist.
The first case suggestive of vulvodynia was reported in a London address by J. Marion Sims, MD in 1861. Thereafter, a number of reports appeared during the Victorian Era in the United States. Nearly a century passed with less than a handful of articles published. Then a resurgence of cases manifest in the 1980’s prompting Dr. A. W. Young to report these occurrences to the International Society of the Study of Vulvovaginal Disease (ISSVD) task force in 1984.
The first-ever national awareness campaign was launched by the National Institutes of Health in October of 2007 at the National Press Club in WashingtonDC. This campaign was spearheaded by the NIH Office of Research for Women’s Health in consultation with the National Vulvodynia Association, a non-profit organization and was joined by 30 governmental agencies and health organizations. The topic has been a matter of discussion on the Oprah Winfrey Show as well as Dr. OZ. Twenty-nine years from the first report to the ISSVD, the general medical community is no closer to understanding the etiology then it was at that time. Looks like researchers perused the wrong leads.
Dr. Fowler has been a member of the International Society for the Study of Vulvovaginal Diseases (ISSVD) since 1996. Having actively participated in the World Congress meetings, he has had privy to the latest research and discussions. He has noted that physicians around the world have been mislead by the location of the pain in trying to determine its etiology. It’s not so much being shortsighted as it is a lack of advanced diagnostic equipment and skills to determine other significant contributing factors. At the offices and laboratory of Fowler Gyn International in PhoenixArizona, Dr. R. Stuart Fowler uses advanced microscopic diagnostic techniques and treatment protocols that consistently result in marked to total resolution of symptom in the majority of women with vulvodynia; lack of response is the exception to the norm. When Dr. Fowler polled the audience of the world’s experts at the World Congress XVIII meeting of the ISSVD in New Zealand, only 4 other providers affirmed they even had the equipment to diagnose with the same capability as Dr. Fowler. Given the expense of the equipment, the discipline needed to master the skill set, the unpopularity of dealing with vulvar pain by general gynecologists, and the poor reimbursement rates for office microscopy, it’s no surprise that few gynecologists have a working knowledge of vulvodynia let alone how to effectively treat the condition. Testimonies of women with vulvodynia successfully treated by Dr. Fowler can be found at FowlerGynInternational.com. The large number of testimonies is an indicator that Dr. Fowler may well have solved the mystery of this perplexing condition i.e. what is the underlying etiology. After all, this needs to be understood before effective treatment can be directed towards the inciting factor/s.