What is vulvodynia?

Vulvodynia is pain in the vulva which is persistent and unexplained. The vulva is the female genital area, and it includes the skin surrounding the vaginal opening. 

Vulvodynia can affect women of all ages and can become a long-term problem which affects quality of life. However, treatment can provide relief and, it can go away itself.

What are the symptoms of vulvodynia?

Vulvodynia has several symptoms but the main one is pain that persists in and around the vulva and vagina. This pain can:

• be constantly in the background
• sting, throb, burning or sore
• be triggered by touch, for example during sex or when inserting a tampon
• be widespread, and can spread over the whole genital area and the anus
• be limited to one part of the vulva like the opening of the vagina
• be worse when you're sat down

Other symptoms can include:

• Vaginismus
• Irritable bowel syndrome
• Painful periods
• Interstitial cystitis

Vulvodynia pain can also lead to mental health issues such as low mood and depression, because it reduces sex drive and can affect relationships.

Is vulvodynia an STI?

No. It isn't caused by an sexually transmitted infection or an active infection. 

Does vulvodynia hurt all the time?

When a person experiences vulvar pain, it can either be constant, or come and go. 

It can last for weeks, months, and for some people years.  

What causes vulvodynia?

There is no clear cause for vulvodynia. However, factors that may contribute to vulvar pain include:

• Hormonal changes
• Allergies to feminine hygiene products
• Previous vaginal infections
• Vulval nerves being injured or irritated
• Inflammation
• Muscle weakness in the pelvic floor
• Some genetic conditions

Can low oestrogen lead to vulvodynia?

Yes. When oestrogen levels fall, which is a symptom of the menopause and perimenopause, this can cause vaginal dryness which can lead to vulval pain.

What can happen if vulvodynia is left untreated?

The impact of untreated vulvodynia can mean that you experience a lower quality of life. Vulvodynia can lead to a disturbed sleep and anxiety and depression around sex and body confidence. 

How is vulvodynia treated?

Vulvodynia is treated in a combination of ways. 

Prescribed medication

• Antidepressants amitriptyline and nortriptyline
• Anti-epilepsy medicines gabapentin and pregabalin

You should speak to your doctor about possible side effects, dosage and the amount of time they will take to be effective

Local anaesthetic and steroids into a nerve nearby may provide pain relief temporarily if you have pain in a specific area of your vulva. 

Physiotherapy

• Pelvic floor exercises can help the muscles around the vagina relax. 
• Vaginal trainers, which are smooth cones of increasing size and length can be inserted into your vagina to help relax the muscles. 
• Transcutaneous electrical nerve stimulation (TENS), where a machine is used to deliver a mild electrical current to the painful area that reduces pain

Gels and lubricants

Anaesthetic gels such as lidocaine can assist in making sex more comfortable. If you use condoms, it's advisable to use latex-free ones because latex condoms can get damaged by lidocaine. 

This gel can also be regularly applied if the pain is more constant. 

Cognitive behavioural therapy (CBT)

The impact that vulvodynia can have on your psychology can be assisted with this therapy. It focuses on problems and difficulties you have in your day-to-day, looking for practical ways to improve your state of mind on a daily basis. 

Psychosexual counselling

This therapy can help when intimacy is affected between you and your partner. It can address problems such as fear and anxiety about sex and assist in restoring a physical relationship. 

Can you heal vulvodynia naturally?

Changes to your lifestyle may contribute to a reduction in symptoms. These changes include:

• Applying cool gel packs to your vulva to soothe the pain
• Before swimming, use petroleum jelly to protect your vulva from chlorine
• Avoiding scented hygiene products like feminine wipes, bubble baths and soap
• Wearing cotton underwear, loose-fitting skirts or trousers
• Reduce general stress, as it can increase vulval pain
• Using a doughnut-shaped cushion for pain when sat down
• Not avoiding sex and finding other positions that are more comfortable, or other sexually-intimate activities that avoid penetration
• Seeking advice if penetration is painful
• Touching your vulva completely. This may increase sensitivity in your vulva.

Does vulvodynia ever go away?

Vulvodynia often goes away by itself, but treatments and lifestyle changes can help to manage symptoms while you have it. A sexual health or gynaecological specialist can provide expert advice if you experience persistent pain or have flare ups.