What Is Vulvodynia? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Vulvodynia is persistent pain of the vulva. The vulva is the area around the opening of the vagina. It includes the opening of the vagina, the pubic mound, the inner and outer labia (vaginal lips), and the clitoris.

The term typically is used to describe chronic pain of the vulva that lasts for at least three months (1) and has no identifiable cause (such as a cut or infection).

It’s not clear what causes vulvodynia.

Researchers think that one or more of the following may cause or contribute to vulvodynia:

• Damage to or irritation of the nerves that transmit pain signals from the vulva to the brain (3)
• Having a greater than usual number of pain-sensing nerve fibers in the vulva (3)
• Chronic inflammation of the vulva (3)
• Genetics (some people may be prone to chronic vulvar pain) (3)
• Hypersensitivity to yeast or other infection-causing organisms in the vagina (3)
• Pelvic floor spasms or weakness (3)
• Conditions that could affect pelvic muscles and bones (1)

Your gynecologist or other healthcare provider will ask you questions about your symptoms and carefully examine the vulva and vagina. (1)

Your doctor may try to rule out common causes of vulvar pain, such as infection, by checking a sample of vaginal fluid or discharge. (1)

Your gynecologist may apply gentle pressure to different parts of the vulva with a cotton swab and ask you to rate the severity of your pain. (4)

He or she may also take a small sample of tissue from the vulvar skin to look at under a microscope. (1) This is called a biopsy.

Prognosis of Vulvodynia

Vulvodynia is a complex condition. No single treatment works for everyone. You may need to try multiple treatments before finding one — or a combination — that helps to alleviate pain. It may take a few months before you start to experience relief. (1)

By definition, vulvodynia is chronic pain of the vulva that lasts for three months or longer. The pain may be constant for some women. For others, it may come and go. (1)

There are few medical complications associated with vulvodynia. But vulvar or vaginal pain can take its toll emotionally or psychologically. (8)

Some women with vulvodynia may benefit from psychological treatments that teach relaxation or techniques for coping with pain. (8)

Sex therapy may also help individuals or couples who are experiencing painful intercourse due to vulvodynia. (8)

Vaginal dryness This happens when the tissues of the vagina are not well lubricated. Any woman can get vaginal dryness, but it’s most common in older women. Potential causes include:

• Low estrogen (caused by menopause, perimenopause, and other factors)
• Douching, scented products, and other irritants
• Certain medications, including antihistamines and antidepressants

Vaginal pain during pregnancy (10) Many women complain of vaginal or vulvar pain during pregnancy. Causes of vaginal or vulvar pain during pregnancy include:

• Vaginal yeast infections
• Varicose (enlarged) veins in the vulva
• Increased pressure on the pudendal nerve (the main nerve that runs between the genitals and the anus)

National Vulvodynia Association

A nonprofit created to help “improve the health and quality of life of women suffering from vulvodynia — chronic vulvar pain without an identifiable cause.”

American College of Obstetricians and Gynecologists (ACOG)

ACOG is the premier professional organization for board-certified obstetrician-gynecologists. It also provides educational information on women’s health to the public.