What Is Vulvodynia?

Vulvodynia is a condition of chronic pain, of three months or more in duration, affecting a women’s vulva, or vaginal opening. This pain can be severe, and has been described as stinging, throbbing, and burning. Vulvodynia often occurs without an apparent cause or reason. It can affect women at any age, though it is more common in women younger than 35, and is not linked to a particular race or ethnicity. Vulvodynia can have a major impact on a woman’s quality of life, making sexual intercourse, normal physical activity, or even sitting for long periods too painful to be endured. 

To learn more about vulvodynia, including ways to manage and reduce symptoms, see a Baptist Health gynecologist.

What Are Vulvodynia Symptoms?

The primary symptom of vulvodynia is a persistent pain of the external genitalia, described as: 

• Burning
• Itching
• Rawness
• Soreness
• Stinging
• Throbbing

Vulvodynia can manifest in a number of ways. Among these are:

• Localized vulvodynia: With localized vulvodynia, pain is limited to a single location in the vulvar region. Included are vestibulodynia, or pain of the vestibular tissues at the vaginal opening, and clitirodynia, a pain of the clitoris. 
• Provoked vestibulodynia (PVD): Provoked forms of vestibulodynia are triggered by pressure on the vestibule, for example, during sexual intercourse, tampon placement, or a medical exam. If pain results from the first attempt to penetrate the vestibule, the condition is known as primary PVD. If the pain only develops over time, the condition is called secondary PVD. 
• Generalized vulvodynia: With generalized vulvodynia, pain occurs throughout the vulvar region, though sometimes with periods of relief. 

What Causes Vulvodynia? 

The exact cause of vulvodynia is unknown to science. Possible contributing factors are:

• Vaginal infection
• Nerve damage
• Hormonal imbalances
• Allergies or skin sensitivities
• Spasms in the pelvic floor muscles, which support the organs of the lower abdomen

Risk factors for vulvodynia include anxiety, depression, post-traumatic stress syndrome, and physical or psychological abuse. This condition has also been linked to other common medical issues, including fibromyalgia, temporomandibular joint disorder, and irritable bowel syndrome. 

How Is Vulvodynia Diagnosed?

Diagnosing vulvodynia requires eliminating other possible explanations for vulvar pain. It typically relies on the following steps:

• Physical examination: Your physician will ask about your symptoms and record your medical history. He or she will want to know the location, intensity, and frequency of the pain that you’re feeling.
• Pelvic exam: The second step is a pelvic exam. Your physician will check your external genitals for evidence of injury or infection. He or she will also make contact with those areas that you report as painful, using a gloved hand or cotton swabs. 
• Sample collection and analysis: If there is evidence of infection, your physician might also collect a fluid sample from the vagina. This will be analyzed in a lab to identify the pathogen causing the infection. 
• Biopsy: In rare cases, your physician may also collect a tissue sample for biopsy in a medical lab. This will be done only if he or she sees evidence of a serious medical condition, for example, a possible cancerous lesion. 

The diagnosis of vulvodynia will be made if no other cause for vulvar pain can be identified. 

How Is Vulvodynia Treated?

Treatment of vulvodynia involves finding an optimal combination of methods for decreasing symptoms and limiting pain:

• Topical anesthetics: Ointments and cremes for curtailing nerve sensitivity are available for applying directly to the vulvar area. These are sometimes applied prior to sexual intercourse. 
• Medications: Prescription anticonvulsants and antidepressants can be effective in reducing pain. Antihistamines are useful for addressing itchiness. 
• Nerve blocks: Nerve-block injections reduce pain by interrupting communication between the brain and the genital nerves. 
• Physical therapy: Physical therapy can strengthen the pelvic floor muscles, reducing spasms and providing relief to the vaginal neural environment. 
• Biofeedback: Biofeedback is a second technique for relaxing muscles and diminishing spasms in the pelvic floor. 
• Surgery: The surgical removal of pain-sensitive tissues is possible, in cases of vestibulodynia and other forms of localized vulvodynia. 

Vulvodynia is not life-threatening but it is quality-of-life threatening. Women suffering from this condition can experience a variety of complications, including loss of physical intimacy with a loved one, lack of sleep, and even job loss, when the pain overwhelms the ability to concentrate at work. If you develop symptoms of vulvodynia, it is important to be properly diagnosed, so you can adopt a treatment plan that helps you get on with life. 

Can Vulvodynia be Prevented?

Vulvodynia may not be preventable but there are steps you can take to lessen its impact:

• Wear loose-fitting clothes, to avoid pressure on sensitive areas
• Wash painful zones with plain water only; avoid soaps and douches
• Use a special support cushion when sitting for long periods
• Apply a lubricant prior to sexual intercourse
• Watch your stress level
• Avoid exercises and other physical activities that would irritate sensitive locations
• Get sufficient sleep