The vexing pain of vulvodynia

By  ,  National Institute of Health
Feb 01, 2012

If you’ve never heard of the term vulvodynia, you’re not alone. You’re more likely to hear women refer to it as “the pain down there” or “feminine pain.” Although an estimated 14 million American women may have it at one point in their lives, few people are aware that the condition has a name. Even health care providers may not be familiar with it. This can lead to multiple doctor visits and delayed diagnosis and treatment for some women.


Women with vulvodynia have lasting and unexplained pain in their genitals—specifically in the vulva, the outer area around the opening of the vagina. Vulvodynia can greatly interfere with a woman’s life. It may feel uncomfortable to exercise, have sex or take part in social activities. The most common symptom is a burning feeling. Women also report stabbing pain, stinging or irritation. Symptoms are most common in women 18-25 years old. They’re less likely to appear after age 35, although older women have also reported symptoms.

No one knows for sure what causes vulvodynia, in part because it hasn’t been studied much in the past. Some researchers think it stems from irritation of the nerves around the vulva or an abnormal response to infection or injury. Medical researchers continue to investigate possible causes and treatments.

If you experience pain in the genital area, it’s important to see your doctor and discuss your symptoms. Your health care provider should ask for your thorough medical history and give you a pelvic exam. The doctor may also conduct laboratory tests to rule out bacterial and fungal infections, which can have similar painful symptoms.

Although there is no cure for vulvodynia, some of its symptoms can be treated. Experts often recommend a combination of treatments. You and your health care provider should work together to develop a treatment strategy that reduces your pain and discomfort.


Treating Vulvodynia

Health care professionals may recommend several approaches for treating vulvodynia:

Lifestyle Changes

  • Avoid using perfumed tampons and pads, bubble baths, soaps, sprays and douches that may irritate genital tissue.

  • Use laundry detergent designed for sensitive skin.

  • Rinse the vulva with cool to lukewarm water after urination and in the shower.

  • Try wearing white, 100% cotton underwear and loose-fitting pants or skirts.

  • For some women, it helps to eliminate highly acidic and sugary foods from the diet.  Talk with your doctor before making dietary changes.

Medical Approaches

  • Pain-relief cream, like lidocaine ointment, can be applied to the vulva.

  • Oral medicines, especially different types of antidepressants, sometimes help with pain relief.  Other medicines, like antiseizure drugs, are sometimes used for their pain-blocking properties, although they are not FDA-approved for treating vulvodynia.  Ask your doctor about various medications and their side effects.

  • Physical therapy, including pelvic muscle exercises, may help prevent muscle spasms and pain.

  • Complementary and alternative medical approaches—including acupuncture, hypnosis, massage therapy, relaxation techniques and biofeedback—may help with long-lasting pain.  Discuss these options with your health care provider.

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