Vulvodynia, which literally means “painful vulva,” is a condition characterized by pain, burning and irritation around the opening of the vagina. Because the cause of vulvodynia has not been established, treatment for the condition is often difficult. One popular treatment method for vulvodynia is a low-oxalate diet, which reduces the amount of a waste product called oxalate in the urine. Before making changes in your diet, consult your physician.
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Evidence For and Against
A case report published in "The Journal of Reproductive Medicine" in 1991 found that a woman who experienced chronic pain from vulvodynia had extremely high levels of oxalate in her urine. After following a low-oxalate diet combined with calcium citrate supplements, the woman was able to reduce her levels of urinary oxalate, as well as her vulvodynia symptoms. After one year of treatment, symptoms disappeared entirely.
A study by Dr. Barbara Reed of the University of Michigan Medical School, Ann Arbor, published in the “American Family Physician” in 2006, reported that a low-oxalate diet can decrease the amount of oxalate in the vulvar tissue. However, this same study reported that the use of such a diet remains controversial. In fact, a study in the March 2008 issue of "The Journal of Reproductive Medicine" reports that high intake of oxalates in diet have nothing to do with an increased risk of vulvodynia.
Low-Oxalate Diet Details
A low-oxalate diet generally limits intake of oxalate to 40 to 50 grams per day, although your specific diet plan may be more or less restrictive based on your individual condition. When following a low-oxalate diet, high-oxalate foods, such as nuts, nut butters, soy, soy foods, whole wheat, bran cereal, blackberries, blueberries, raspberries, spinach, celery, beets, eggplant and beans, are not permitted. You may consume small amounts of medium-oxalate foods, such as yogurt, apples, oranges, pears, bagels, brown rice, white bread, broccoli, carrots, corn and tomatoes.
Most of your diet should consist of low-oxalate foods, which contain less than 2 milligrams of oxalate per serving. These foods include cheese, milk, avocado, bananas, mangoes, pork, poultry, beef, shellfish, pasta, white rice, cabbage, cucumber, peas and mushrooms.
In addition to cutting out high-oxalate foods and limiting medium-oxalate foods, it is also important to increase your fluid intake. The University of Pittsburgh Medical Center recommends 8 to 13 cups of fluid per day. Water is best, but you may also meet your fluid needs through other low-oxalate beverages such as herbal tea, apple juice, green tea, soda and grapefruit juice.
Things to Consider
When taken in conjunction with a low-oxalate diet, calcium citrate supplements may help decrease the amount of oxalate that deposits in the tissues of the vulva and promote excretion of any excess oxalate. Treatment with calcium citrate generally begins with two tablets twice per day and then increases to 4 tablets twice per day in combination with a low-oxalate diet. Specific dosage recommendations will differ based on your condition. Reed notes that although many women report improvement in symptoms while taking calcium citrate supplements, there is only anecdotal evidence to support the use of this supplement.
- American Congress of of Obstetricians and Gynecologists: Vulvodynia
- American Family Physician: Vulvodynia: Diagnosis and Management; Barbara Reed; April 2006
- Vulval Pain Society: The Low-Oxalate Diet
- University of Pittsburgh Medical Center: Low Oxalate Diet
- The Journal of Reproductive Medicine: Calcium Citrate for Vulvar Vestibulitis. A Case Report
- The Journal of Reproductive Medicine: Influence of Dietary Oxalates on the Risk of Adult-Onset Vulvodynia