Dr. med. Federica Brunetti (I)

Dr. Federica Brunetti (I)

Federica Brunetti, MD, is a specialist in gynecology and obstetrics; since 2020, she has mainly dealt with gynecological problems of chronic pelvic pain, vulvodynia and endometriosis. She works at Casamedica Medical Center in Bergamo, Italy, in the team of Dr. Chiara Marra, who specializes in chronic pelvic pain and women's health care with an integrated approach. Dr. Brunetti has been a doctor-in-training at the Ayurveda Point School in Milan for two years under the direction of Professor Antonio Morandi and Carmen Tosto. By studying Ayurvedic medicine, she hopes to find a new way to treat women's health in its entirety and complexity, where Western medicine often fails.

Vulvodynia and Ayurveda: an integrated approach

Year: 2023

Introduction and objective
It is estimated that one out of four women in Western Countries suffers from vulvodynia, greatly impacting sexual function and quality of life.
According to the 2015 Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, vulvodynia is defined as idiopathic vulvar pain of at least three months duration without a clear, identifiable cause. Although many potential associated factors exist, a precise aetiology is still undetermined.
Vulvodynia is challenging for the physician because of difficult diagnosis, lack of awareness of the pathology and sub-optimal response to any treatment, even surgical.
Vulvodynia also presents with many comorbidities, such as bowel and other pelvic disorders (recurrent or postcoital cystitis, endometriosis) and other neuropathic pain syndromes (i.e. pudendal neuralgia).
Āyurveda, the traditional Indian medicine, divides patients into different groups according to their constitution (Prakriti) and the current imbalance (Vikriti) of the three main governing principles of the organism, known as Vāta, Pitta and Kapha.
Our aim is to identify the pathogenesis (called samprapti in ayurvedic terms) of the disease and divide patients into four groups: Vataja, Pittaja, Kaphaja and Sannipata, on the basis of Prakriti and Vikriti in order to find specific treatments for each group.

We designed a questionnaire to investigate the main lifestyle habits of patients, their physiological features (digestion, bowel movements,menstrual cycle, sleep) and symptoms of vulvodynia. Survey was submitted to 600 patients with vulvodynia who attended gynaecological evaluation for pelvic pain in Casamedica clinic in 2022 and were already on some conventional intervention.

To date 208 patients answered; preliminary results show that 79% of patients suffer from chronic bloating, 64% has digestive problems with abdominal pain, 60% has painful or forced evacuation, 50% has chronic costipation. 83% has menstrual pain, severe in 43% of cases. 90% of patients has no restful sleep, with multiple wakings at night, especially between 2 and 6 am (when Vāta accumulates). Vulvar pain is like burning in 50% of cases and cutting in 37%.

These preliminary results show a hypothesis of samprapti: vulvodynia results from Vata and/or Pitta imbalance and at the end aggravation of Vāta dosa locates in vulvar region. With a bigger sample and further analysis, we will be able to divide women into the four groups mentioned above and treat each group with a specific ayurvedic approach, to improve quality of life and change the natural course of this challenging disease.