Vulvodynia

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What is vulvodynia?

Vulvodynia is pain or discomfort when the area around the vaginal opening (vestibule) is touched, particularly when pressure is applied such as after trying to insert a tampon, wearing tight pants, or sitting for a long time. Discomfort can be limited to the vestibule (area around the opening of the vagina) or it can involve more of the vulva. The most common complaint is “burning” however the feeling can also be described as “stinging”, sharp”, and “raw.”

What causes vulvodynia?

Doctors are not sure what causes vulvodynia but they do know that it is not caused by sexually transmitted infections. Researchers think that possible causes may include:

  • Changes in the nerve endings at the opening of the vagina (vestibule)
  • Genetic factors
  • Weakness of the pelvic floor muscles
  • Injury or trauma to the nerves of the vulva that transmit pain and other feelings
  • Irritation from Candida (yeast) which can cause an area around the vulva to be very sensitive

How is vulvodynia diagnosed?

Vulvodynia is diagnosed after an exam by a health care provider (HCP). Your HCP will ask you questions about your medical and sexual history including when the discomfort started, what makes it worse/better and if you have had any recent localized infections. Next, your HCP may do a “cotton swab test.” He or she will hold a soft cotton-tipped applicator and gently touch different areas in the vestibule (the area outside and around the opening to the vagina) to help determine the location of the discomfort.

How is vulvodynia treated?

Treatment for vulvodynia can be challenging and take time and may include: medicine (topical or oral), biofeedback, counseling, sexual counseling, physical therapy, and sometimes, surgery. Treatment is often managed by a specialist who has expertise in this condition. Complementary therapies such as acupuncture have also been used. Comfort measures aimed at lowering pain and irritation may include:

  • Avoiding anything that could possibly irritate your vulva such as perfumed lotion, shampoos, and soaps or douching.
  • Using a mild soap or just water to clean your vulva
  • Using cool/packs to the vulva area for pain control
  • Rinsing the vulva with water after peeing
  • Patting the vulva dry instead of rubbing it dry
  • Switching to cotton or organic menstrual pads
  • Wearing underwear that is made out of 100% cotton
  • Using a lubricant when having sex

Additional Resources:

National Vulvodynia Association