Vulvar Sores

Etiology

The causes of vulvar sores, also known as Yin Chuang in Chinese medicine, may include:

• Invasion of external Dampness
• Irregular diet
• Emotional strain
• Excessive use of Yang tonics

Pathology

The Chinese pathology of vulvar sores includes Fire, Damp-Heat, and Cold, with the first two being the most common. The pathology is often characterized by invasion of "parasites".

Identification of patterns and treatments

When treating vulvar sores, it is important to differentiate between deficiency and excess conditions. Excess conditions may include Damp-Heat, Toxic-Heat, Fire, and parasites, and common treatment principles include resolving Dampness, clearing Heat, resolving Toxic-Heat, draining Fire, and killing parasites. The relationship between the external genitalia and internal organs and channels should be studied, with the main channels involved being the Directing Vessel and the Liver channel.

Deficiency patterns may involve the Liver and Kidneys, and treatment principles may include tonifying the Liver and Kidneys, resolving Dampness and clearing Heat.

Clinical manifestations and treatment principles

The clinical manifestations of vulvar sores may include vulvar swelling, pain, itching, erosion, lumps, discharge of pus, and excessive vaginal discharge. These local symptoms may be accompanied by systemic symptoms and signs such as shivers, fever, lassitude, abdominal distension, dark urine, thirst, constipation, a Slippery or Wiry and Rapid pulse, and a Red tongue with a thick, sticky yellow coating.

Treatment principles may include resolving Dampness, clearing Heat, resolving Toxic-Heat, draining Fire, and killing parasites, as well as tonifying the Liver and Kidneys.

Prognosis and prevention

The prognosis for vulvar sores varies depending on the underlying cause and the severity of the condition. In general, the prognosis is better for those with excess patterns and those who receive early treatment. Prevention measures may include avoiding exposure to Dampness, maintaining a healthy diet, managing emotional stress, and avoiding excessive use of Yang tonics.

Western viewpoint

In Western medicine, vulvar sores may correspond to various diseases of the genitalia such as vulvitis, vaginitis, boils or ulcers of the external genitalia, inflammation of the Bartholin’s glands, cancer of the external genitalia, or genital herpes. Treatment may include antibiotics, anti-inflammatory medications, or surgery, depending on the underlying cause.