Vulvodynia

Overview

Definition

Vulvodynia is pain in the outer part of the female genitals (vulva). The vulva is made up of the:

  • Labia majora and labia minora
  • Clitoris
  • Vaginal opening
Vulva
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Causes

The exact cause is not known. It may be due to:

  • Injury from things like an infection or an allergy
  • A problem with how the body responds to pain
  • Emotional or mental stress

Risk Factors

This problem is more common in women who are 20 to 40 years of age.

Other things that may raise the risk are:

  • Mood or anxiety disorders, such as posttraumatic stress disorder
  • Sleep problems

SymptomsandDiagnosis

Symptoms

The main symptom is vulvar pain that lasts more than three months.

A woman may have:

  • Burning
  • Stinging
  • Soreness
  • Aching
  • Pain after pressure is applied to the vaginal opening
  • Pain with sex or inserting tampons

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. You may also have a pelvic exam. This is often enough to make the diagnosis.

Tests may be done to rule out other causes for the pain.

Treatments

Treatment

The goal of treatment is to ease pain. Options are:

  • Supportive care, such as mild soaps, cold packs, and using lubrication during sex
  • Medicines to ease pain, such as:
    • Topical medicines that are put on the skin, such as corticosteroids, estrogen, or anesthetics
    • Antidepressants
    • Antiseizure medicine
  • Physical therapy to strengthen and relax the pelvic muscles to ease pain
  • Counseling to learn how to cope with the pain
  • Procedures, such as
    • Botulinum toxin injections
    • Nerve stimulation
    • Surgery to remove painful tissue

Prevention

There are no known guidelines to prevent this problem. The cause is not known.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

The American Congress of Obstetricians and Gynecologists http://www.acog.org 

National Vulvodynia Association http://www.nva.org 

CANADIAN RESOURCES

Canadian Women's Health Network http://www.cwhn.ca 

Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org 

References

ACOG Practice Bulletin Summary, No. 224: Diagnosis and management of vulvar skin disorders. Obstet Gynecol. 2020 Jul;136(1):222-225.

Tam T, Levine EM: Female sexual dysfunction in women with pelvic pain. Semin Reprod Med 2018;36(5):1-7.

Vulvodynia. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html. Accessed October 15, 2020.

Vulvodynia. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/vulvodynia  . Accessed October 15, 2020.

Vulvodynia. National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/health/topics/vulvodynia/Pages/default.aspx. Accessed October 15, 2020.

What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/what-is-vulvodynia. Accessed October 15, 2020.