Vulvodynia is a condition characterized by chronic pain or discomfort in the vulva, which can greatly impact a person’s quality of life. It is estimated that up to 16 percent of women will experience this at some point in their lives, making it a relatively common condition. The exact causes of vulvodynia are not well understood and may vary from person to person. In this lesson from the handbook on vulvodynia, we will explore some of the possible causes of vulvodynia and the factors that may contribute to its development. Understanding the underlying causes of vulvodynia is crucial in developing effective treatment strategies and improving the quality of life for those affected by this condition.

What Are the Causes Of Vulvodynia?

Vulvodynia is a complex condition that can have multiple underlying causes. It is often difficult to identify a single cause, and many individuals with vulvodynia may have a combination of factors contributing to their pain.

  1. Nerve Damage or Irritation: One of the most common causes of vulvodynia is nerve damage or irritation. This can occur due to injury, surgery, or an underlying medical condition such as diabetes. When the nerves in the vulvar area are damaged or irritated, they can send pain signals to the brain, even in the absence of an actual injury or inflammation.

  2. Hormonal Changes: Hormonal changes can also play a role in the development of vulvodynia. Fluctuations in estrogen levels, such as those that occur during menopause or pregnancy, can cause changes in the vulvar tissues that make them more susceptible to pain and irritation.

  3. Inflammation: Inflammation of the vulvar tissue can also contribute to the development of vulvodynia. This can be caused by infection, injury, or an autoimmune disorder.

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  4. Musculoskeletal Issues: Musculoskeletal issues, such as muscle tension or spasms in the pelvic floor, can also lead to vulvar pain. This can occur due to injury, overuse, or chronic stress.

  5. Genetics: Some research suggests that there may be a genetic component to vulvodynia. Studies have found that women with a family history of chronic pain conditions, such as fibromyalgia or irritable bowel syndrome, may be more likely to develop vulvodynia.

  6. Pelvic Pain: One of the contributing factors to vulvodynia is dysfunction or tension in the muscles of the pelvic floor. The pelvic muscles play an important role in supporting the organs in the pelvis, controlling bladder and bowel function, and regulating sexual function.

What Are The Symptoms Of Vulvodynia?

The primary symptom of vulvodynia is chronic pain or discomfort in the vulvar area, which makes up the external female genital area. The pain may be constant or intermittent, and it can range from mild to severe. Other symptoms of vulvodynia can vary from person to person and may include:

  • Burning or stinging sensation in the vulvar area

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  • Itching or irritation in the vulvar area

  • Unexplained vulvar pain 

  • Soreness or rawness in the vulvar area

  • Painful intercourse (dyspareunia)

  • Pain or discomfort during tampon insertion

  • Chronic vulvar pain or discomfort in the vulvar region during prolonged sitting or activities that put pressure on the vulva, such as cycling or horseback riding.

  • Muscle spasms in cases of provoked vestibulodynia (PVD) such as touch or sexual activity, which is a type of vulvodynia that affects the vulvar vestibule, the area surrounding the entrance to the vagina.

  • Psychological distress. The pain and discomfort associated with vulvodynia can cause anxiety, depression, and feelings of frustration or hopelessness. It can also affect a person’s self-esteem and sexual functioning.

  • Sexual dysfunction. The pain and discomfort associated with vulvodynia can make sexual activity difficult or even impossible, leading to decreased sexual desire, arousal, and satisfaction.

Symptoms of vulvodynia can be localized to a specific area of the vulva or may affect the entire vulvar area. The pain may be constant or may come and go over time. The severity of symptoms can also vary, and some women with vulvodynia may experience only mild discomfort, while others may experience severe pain that affects their daily activities and quality of life.


However, the symptoms of vulvodynia can be similar to those of other conditions, such as infection or skin conditions. If you are experiencing any of the symptoms of vulvodynia, it is important to consult a health care provider to determine the underlying cause and receive appropriate treatment.

How Can You Confirm That It Is “Vulvodynia”?

doctor explaining to the woman about the confirmation Of Vulvodynia

Vulvodynia is a chronic pain condition that affects the vulva, which is the external female genital area. If you are experiencing pain or discomfort in this area, you can determine whether or not you meet the diagnostic criteria for vulvodynia using the following steps:

  1. Consult with a healthcare provider: The first step in confirming whether or not you have vulvodynia is to consult with a healthcare provider. They will ask about your symptoms and medical history and perform a physical examination to rule out other potential causes of vulvar pain, such as infection or injury.

  2. Rule out other potential causes: In addition to a physical exam, your healthcare provider may recommend additional tests or procedures to rule out other potential causes of vulvar pain. This may include a pelvic exam, blood tests, or a biopsy.

  3. Keep a pain diary: If your healthcare provider suspects that you may have vulvodynia, they may recommend that you keep a pain diary. This involves recording your pain levels, triggers, and other symptoms over a period of time. This can help your healthcare provider better understand your symptoms and develop an effective treatment plan.

  4. Referral to a specialist: In some cases, your healthcare provider may refer you to a specialist, such as a gynaecologist or pain management specialist, for further evaluation and treatment.

Treatment Options

The treatment for vulvodynia typically involves a combination of medical, self-care, and lifestyle interventions. The goal of treatment is to relieve pain and improve quality of life. Here are some of the common treatment options for vulvodynia:

  • Medications: Your healthcare provider may prescribe medications to help relieve pain and reduce inflammation in the vulvar area. This may include topical creams or ointments, oral medications such as antidepressants or anticonvulsants, or nerve blocks.

  • Physical therapy: Physical therapy can be an effective treatment for vulvodynia. This may involve exercises to strengthen the pelvic floor muscles, manual therapy to relieve muscle tension, or biofeedback to help you learn to control muscle tension.

  • Counselling or psychotherapy: Counseling or psychotherapy can help address the emotional impact of vulvodynia and help you develop coping strategies to manage pain and reduce stress.

  • Self-care measures: There are several self-care measures you can take to manage vulvodynia symptoms. This may include avoiding tight clothing, using fragrance-free and dye-free products, using lubricants during intercourse, and avoiding activities that put pressure on the vulva.

  • Complementary therapies: Some individuals with vulvodynia find relief through complementary therapies such as acupuncture, yoga, or meditation. However, it is important to discuss these options with your healthcare provider before starting any new treatment.

  • Surgery: In rare cases, surgery may be recommended for vulvodynia that is not responding to other treatments. This may involve removing tissue or nerve endings in the vulvar area.

There is no one-size-fits-all treatment for vulvodynia, and finding the most effective treatment for your symptoms may take some trial and error. Working closely with your healthcare provider and following their recommended treatment plan can help you manage your symptoms and improve your quality of life.

Early diagnosis and appropriate treatment can often lead to successful outcomes in addressing vulvodynia, and there are various treatment options available depending on the underlying cause. Remember, seeking help is the first step towards overcoming the barriers to physical intimacy and regaining control over your sexual and emotional health. You can also seek support from qualified professionals such as gynaecologists, pain specialists, therapists, counsellors, or sexual health experts, who can guide you through your queries and treatment options to establish a healthy and fulfilling sexual relationship with your partner.

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