Vulvodynia

What is vulvodynia?

Vulvodynia is a condition when you have pain in your vulva (AKA vulvar pain) that isn’t from an infection or other medical problem, and it lasts for 3 months or more.

Vulvodynia symptoms include pain and irritation like burning, stinging, rawness, aching, soreness, throbbing, and swelling. This may affect your whole vulva, or only one specific area. If your vulvar pain is in the tissue at the opening of your vagina (called the vestibule), you may have a type of vulvodynia called vestibulodynia, also known as vulvar vestibulitis.

You can have vulvodynia symptoms all the time, or they can come and go. Symptoms can happen randomly or only when something touches your vulva or goes inside your vagina. Things that put pressure on your vulva — like sex, using a tampon, getting a pelvic exam, wearing tight pants, or sitting for a long time — can trigger vulvodynia symptoms or make them worse. 

What causes vulvodynia?

Vulvodynia often doesn’t have a specific cause. It likely has lots of different causes working together, including things like:

• Nerve irritation or nerve damage in your vulva

• Inflammation (swelling) in your vulva

• Some genetic disorders, like chronic pain or problems fighting infections

• Problems with your pelvic floor muscles

• Reactions to certain infections

• Food sensitivities 

• Conditions that impact the muscles or bones near your vulva

• Sexual abuse or trauma in your past

Are there vulvodynia treatments?

If you have vulvar pain, make an appointment with a doctor or nurse, like the ones at your local Planned Parenthood health center. They’ll give you an exam and ask you questions about your symptoms and medical history to try to help figure out what’s causing your vulvar pain. The nurse or doctor may take a sample of your vaginal discharge, and touch parts of your vulva with a cotton swab to see where you have pain and how badly it hurts. In some cases they may also do a biopsy of a small amount of skin from the area.

There are lots of treatments for vulvodynia, but everyone’s different. So there’s not one treatment that works for everyone. You might need to try more than one treatment, and it can take a few months before you start to feel better.

Vulvodynia treatment can include:

• Medicines like anesthetics (creams that numb pain), antidepressants, anti-seizure medicines, and hormone creams.

• Physical therapy that helps to relax your pelvic floor tissues or strengthen your pelvic muscles (the muscles around your vulva/vagina).

• Trigger point therapy that uses massage and/or shots that have a combination of painkillers and steroids to treat a small area where your muscles are tight.

• Other shots like a nerve block (painkillers for the nerves that make you feel pain) or botox (a shot of medicine that relaxes your pelvic floor muscles). 

• Using ultrasound or electrical stimulation to help ease pain.

• In some cases, surgery to remove tissue from the vestibule (the area right around your vaginal opening), if that’s the only place you have pain and other treatments haven’t worked.

Dealing with vulvodynia can be hard both physically and emotionally. It may help to get mental health counseling like cognitive behavioral therapy or sexual therapy, which can help you deal with the emotional effects of chronic pain and the impact vulvodynia may have on your sex life and relationships.