What Is Vulvodynia?
Sex and gender exist on spectrums. This article will use the terms “female” and “women” when discussing people assigned female at birth to reflect language that appears in source materials.
Vulvodynia causes chronic pain or discomfort in the vulva area. The vulva is the external area of female genitals that includes the labia, the clitoris, and the vaginal opening.
There are many reasons you may experience pain in the vulva area. The pain from vulvodynia often lasts for 3 months or longer and is not the result of an underlying cause like an infection.
Doctors often place vulvodynia into categories that include:
- Generalized vulvodynia: You can typically feel this pain in the entire area of the vulva.
- Localized vulvodynia: This pain is in one particular area of the vulva.
- Provoked vulvodynia: The contact or activity within the area causes this pain. This may include using a tampon, having a gynecological exam, having sexual intercourse, and wearing tight-fitting pants.
- Spontaneous vulvodynia: In this case, the pain happens without a trigger.
- Provoked vestibulodynia: This pain is due to a trigger and occurs around the entry point to the vagina.
Pain in your vulva area does not always mean it is vulvodynia. There are many things that can cause pain in that area. These include:
- vaginal infections
- sensitivity to products like soap or medicated creams
- hormone changes that cause vaginal dryness
- herpes that reoccurs
- conditions like lichen sclerosis or lichen planus
If you experience pain in your vulva area, contact your doctor.
The main symptom of vulvodynia is chronic pain or discomfort in the vulva area.
People experiencing vulvodynia describe the pain in different ways. You may experience:
- sensation of burning, stinging, or throbbing
- constant or intermittent pain
- pain that worsens when you sit
- widespread pain, including in the anal area
Typically, the vulva still looks as it usually does.
The pain from vulvodynia generally starts suddenly. It may last for months or even years. Sometimes, the pain can interfere with your daily activities and relationships.
The exact cause of vulvodynia is unknown.
Some experts believe vulvodynia may be the result of nerve damage in the area. Possible causes for this damage include:
- history of chronic yeast infections
- nerves that are trapped
- past sexual trauma
Vulvodynia is not contagious, and it is not the result of your personal hygiene. It is also typically not a symptom of cancer.
It is often unlikely that vulvodynia will get better on its own. If you experience persistent pain in your vulva area, contact your doctor.
Your doctor will generally ask you questions about the type of pain you have. They may also ask about your medical history, sexual activity, and any treatments you may have already tried.
They will likely want to perform a physical exam. During the exam, they will typically touch the vulva area and may take a swab to rule out other causes of the pain. They may also perform a biopsy of the skin in the area.
The goal of the exam is to determine how severe your pain is and if there are other underlying conditions causing it.
It is not uncommon for females to experience vulval pain for an extended period of time, even years, before they receive a diagnosis of vulvodynia.
If your pain is persistent, your doctor may refer you to a specialist.
Some people feel embarrassed talking about vulval pain. However, it is important for you to discuss any issues with your doctor so they can help you to develop a treatment plan and rule out any underlying conditions.
There are many possible treatments for vulvodynia. Not every treatment can work the same for everyone. You may need to work with your doctor and try different options to find the right combination for you.
Gels and lubricants
There are over-the-counter gels and lubricants you can get to help treat vulvodynia.
It is a good idea to always discuss any treatments with your doctor before using them.
These treatment options include:
- Lidocaine ointment: This is an anesthetic gel that you can apply to your vaginal area 20 minutes before having sex. The ointment can help make sex more comfortable. Be sure to wipe it off before sex or have your partner use a condom so that the ointment does not get on them. If you have constant pain, you can apply the gel throughout the day.
- Vaginal lubricants: If you experience dryness, these might moisturize the vulva.
Your doctor may recommend prescription treatments for your vulvodynia. Because the cause of vulvodynia is unknown, these treatments are meant to help manage the symptoms and ease your pain.
These treatments include:
- seizure medications
- hormone creams
Each of these treatments can help to block the pain. Typically, your doctor starts you on a lower dose of the antidepressants or seizure medications. They can then gradually increase the dose until they find one that helps relieve your pain.
Your doctor may recommend injections of steroids or anesthetics if other medications are ineffective for you.
You can also talk with your doctor about alternative treatments and physiotherapist to help relax and strengthen your pelvic muscles.
These other treatments include:
- biofeedback treatment
- physical therapy
- transcutaneous electrical nerve stimulation
In rare cases, your doctor may recommend surgery to remove part of the vulva.
Certain lifestyle changes can help to reduce your symptoms of vulvodynia.
These changes include:
- Wear cotton underwear and pants or skirts that fit loosely.
- Avoid products with scents, like soaps and bubble baths.
- Try lowering your stress.
- Use a donut-shaped cushion if you have pain when sitting.
- Apply petroleum jelly before swimming to protect your vulva from chlorine.
- Place a cool gel pack on the area to ease pain.
It is a good idea not to avoid sexual intercourse or touching the vulva. This can actually increase your vulva’s sensitivity. You may need to try different positions to find one that is more comfortable for you. If penetration is too painful, you might also want to try other sexual activities until you can get advice from your doctor.
Vulvodynia is a chronic condition. It causes persistent pain in the area of the vulva.
The exact cause of vulvodynia is unknown. However, treatments can help manage your pain. Lifestyle changes like wearing looser clothing can also help ease the symptoms.
If you have persistent pain in your vulva area, contact your doctor.