Vulvodynia

What Is Vulvodynia?

Vulvodynia is chronic pain of the vulva lasting three months or more without an identifiable cause. It affects an estimated 8-16% of women at some point in their lives. Despite being common, it's often underdiagnosed and undertreated. The pain can significantly impact quality of life, relationships, and sexual health.¹

Types²

Localized

Pain in specific area (often vestibule)
Vestibulodynia most common type
Often provoked by touch or pressure

Generalized

Pain throughout vulvar area
May be constant or intermittent
Provoked or unprovoked

Symptoms

Burning sensation
Stinging or rawness
Soreness or throbbing
Pain with intercourse
Pain with tampon use
Pain with sitting
Pain with tight clothing

Possible Contributing Factors

Nerve damage or irritation
Pelvic floor muscle dysfunction
Inflammation
Genetic factors
Previous infections
Hormonal changes
Central sensitization

Diagnosis³

Detailed history
Physical examination
Q-tip test (cotton swab testing)
Ruling out other causes
Often delayed diagnosis

Treatment Approaches

Self-Care

Avoid irritants (soaps, douches)
Wear cotton underwear
Use preservative-free lubricants
Cold compresses for relief

Physical Therapy

Pelvic floor physical therapy
Often essential component
Internal and external work

Medications

Topical lidocaine
Tricyclic antidepressants
Anticonvulsants
Topical estrogen (if appropriate)

Other Options

Nerve blocks
Biofeedback
Cognitive behavioral therapy
Surgery (vestibulectomy) - last resort

Finding Help

Seek specialist familiar with condition
Gynecologists, pain specialists
National Vulvodynia Association
Multidisciplinary care often best

References

Pukall CF, Goldstein AT, Bergeron S, et al. Vulvodynia: definition, prevalence, impact, and pathophysiological factors. J Sex Med. 2016;13(3):291-304.
Bornstein J, Goldstein AT, Stockdale CK, et al. 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain. J Sex Med. 2016;13(4):607-612.
Goldstein AT, Pukall CF, Brown C, et al. Vulvodynia: assessment and treatment. J Sex Med. 2016;13(4):572-590.