Vulvodynia

Definition

Vulvodynia is a pain disorder of the vulva. This is the outside area of a woman's genitals. Vulvodynia causes severe pain, burning, and stinging of the vulva.

Causes

The exact cause of vulvodynia is unknown. Researchers are working to learn more about the condition. Causes may include:

Sexually transmitted infections (STIs) do not cause this condition.

Symptoms

There are two main types of vulvodynia:

The vulvar pain is often:

You may feel symptoms all the time or just some of the time. At times, you may feel pain in the area between your vagina and anus (perineum) and in the inner thighs.

Vulvodynia may occur in teens or in women. Women with vulvodynia often complain of pain during sexual activity. It may occur after having sex the first time. Or, it may occur after years of sexual activity.

Certain things may trigger symptoms:

Exams and Tests

Your health care provider will perform a physical exam and ask questions about your medical history. Your provider may do a urinalysis to rule out a urinary tract infection. You may have other tests to rule out a yeast infection or skin disease.

Your provider also may perform cotton swab test. During this test, the provider will apply gentle pressure to different areas of your vulva and ask you to rate your pain level. This will help identify specific areas of pain.

Vulvodynia is diagnosed when all other possible causes have been excluded.

Treatment

The goal of the treatment is to reduce pain and relieve symptoms. No one treatment works for all women. You also may need more than one type of treatment to manage your symptoms.

You may be prescribed medicines to help relieve pain, including:

Other treatments and methods that may help include:

LIFESTYLE CHANGES

Lifestyle changes may help prevent vulvodynia triggers and relieve symptoms.

SURGERY

Some women with localized vulvodynia may need surgery to relieve pain. The surgery removes the affected skin and tissues around the vaginal opening. Surgery is done only if all the other treatments fail.

Support Groups

You can ease the stress of illness by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

More information and support for people with vulvodynia and their families can be found at:

Outlook (Prognosis)

Vulvodynia is often a complicated disease. It may take weeks to months to achieve some pain relief. Treatment may not ease all symptoms. A combination of treatments and lifestyle changes may work best to help manage the disease.

Possible Complications

Having this condition can take a physical and emotional toll. It can cause:

Working with a therapist can help you better deal with having a chronic condition.

When to Contact a Medical Professional

Contact your provider if you have symptoms of vulvodynia.

Also contact your provider if you have vulvodynia and your symptoms get worse.

References

American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice; American Society for Colposcopy and Cervical Pathology (ASCCP). Committee Opinion No 673: persistent vulvar pain. Obstet Gynecol. 2016;128(3):e78-e84. PMID: 27548558 pubmed.ncbi.nlm.nih.gov/27548558/.

Bornstein J, Goldstein AT, Stockdale CK, et al. 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. J Low Genit Tract Dis. 2016;20(2):126-130. PMID: 27002677 pubmed.ncbi.nlm.nih.gov/27002677/.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Pruritus and neurocutaneous dermatoses. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 4.

Stenson AL. Vulvodynia: diagnosis and management. Obstet Gynecol Clin North Am. 2017;44(3):493-508. PMID: 28778645 pubmed.ncbi.nlm.nih.gov/28778645/.

Waldman SD. Vulvodynia. In: Waldman SD, ed. Atlas of Uncommon Pain Syndromes. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 96.



Review Date: 7/2/2022
Reviewed By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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