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Vulvodynia

Vulvodynia is chronic vulvar pain, most often described as a burning discomfort, whose specific medical cause cannot be found. It can occur over the entire vulvar area or just be limited to a small spot on the vulva or vaginal opening.

Vulvodynia is often associated with pain conditions such as low back pain, irritable bowel, interstitial cystitis, and fibromyalgia. It is not an uncommon problem, and may affect up to 15 percent of the female population.

Many women will feel constant burning throughout the day. Others, however, will feel pain only when there is pressure to the vaginal opening, which can occur with sex, tampon use, tight clothing, or physical activity such as bicycle riding or horseback riding. This is known as vestibulodynia, because the affected area is located at the vestibule, or vaginal opening. Vestibulodynia can occur in all age groups.

To determine if you have vulvodynia, we will perform an evaluation that includes a complete history and physical exam, to exclude any treatable vaginal or vulvar conditions that could be causing the pain.

Treatment includes support and education. Vulvar hygiene is crucial to avoid any irritants to sensitive skin.

Other treatments

  • Topical medications such as estrogen or lidocaine ointment to numb the area
  • Oral medications to help calm overactive nerves, which may be contributing to the problem
  • Physical therapy to improve pelvic floor dysfunction
  • Referral to a pain clinic if necessary
  • Counseling for depression or sexual dysfunction
  • Surgery, as a last resort when conservative therapy does not help women with vestibulodynia
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