Vulvodynia is pain in the outer part of the female genitals (vulva). The vulva is made up of the:
- Labia majora and labia minora
- Vaginal opening
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The exact cause is not known. It may be due to:
- Injury from things like an infection or an allergy
- A problem with how the body responds to pain
- Emotional or mental stress
This problem is more common in women who are 20 to 40 years of age.
Other things that may raise the risk are:
- Mood or anxiety disorders, such as posttraumatic stress disorder
- Sleep problems
The main symptom is vulvar pain that lasts more than three months.
A woman may have:
- Pain after pressure is applied to the vaginal opening
- Pain with sex or inserting tampons
The doctor will ask about symptoms and health history. A physical exam will be done. A pelvic exam may also be done. This is often enough to make the diagnosis.
Tests may be done to rule out other causes for the pain.
The goal of treatment is to ease pain. Options are:
- Supportive care, such as mild soaps, cold packs, and using lubrication during sex
- Medicines to ease pain, such as:
- Topical medicines that are put on the skin, such as corticosteroids, estrogen, or anesthetics
- Antiseizure medicine
- Physical therapy to strengthen and relax the pelvic muscles to ease pain
- Counseling to learn how to cope with the pain
- Procedures, such as:
- Botulinum toxin injections
- Nerve stimulation
- Surgery to remove painful tissue
There are no known guidelines to prevent this health problem.
- ACOG Practice Bulletin Summary, No. 224: Diagnosis and management of vulvar skin disorders. Obstet Gynecol. 2020 Jul;136(1):222-225.
- Tam T, Levine EM: Female sexual dysfunction in women with pelvic pain. Semin Reprod Med 2018;36(5):1-7.
- Vulvodynia. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html.
- Vulvodynia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vulvodynia.
- Vulvodynia. National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/vulvodynia.
- What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/what-is-vulvodynia.
- Elizabeth Margaret Prusak, MD
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