What is vulvodynia? What is vestibulodynia? How do you treat them?


What is vulvodynia?

Vulvodynia is a term used to describe pain on or around the vulva (external genitals), generally without an identifiable cause. You may have also heard it referred to as vestibulodynia, which is pain on or around the entrance of the vaginal opening (called the vestibule). The location, consistency and severity of the pain varies among individuals. People will often describe the pain as burning, itching, raw, or stinging, particularly during urination or sexual intercourse.


How is it diagnosed? 

Vulvodynia or vestibulodynia can be diagnosed by a medical professional specialising in pelvic health such as a GP, Gynaecologist or Pelvic Floor Physiotherapist. Typically, a diagnosis may be made if there is vulva pain present for at least 3 months duration without clear identifiable cause (like a skin condition, UTI, thrush, etc) which may cause similar symptoms. Vulvodynia can be either provoked or spontaneous in nature. Provoked Vulvodynia is pain that occurs in response to physical touch (there is no pain present until you initiate penetration or touch the vulva). Spontaneous vulvodynia is when you experience vulva pain even when there is no obvious touch occurring (e.g. when sitting on a chair or wearing jeans). 


What causes it?

There is not always a known cause of Vulvodynia. Sometimes it may occur in response to sexual trauma, thrush, childbirth or a skin condition, but often the cause is unknown. It is more commonly found in individuals who already have a chronic pain condition such as Painful Bladder Syndrome (PBS), endometriosis, or fibromyalgia. Studies have shown that hormonal contraception use significantly increases the risk of developing vulvodynia (up to 11x more likely).


What are the symptoms:

  • Pain at the entrance of the vagina or vulva with touch, pressure, wearing tight clothing or with sexual intercourse
  • Pain that is burning or stinging in nature
  • Pain with urination


What are the treatment options?

Pelvic Floor Physiotherapy is often one of the first treatment options recommended to individuals. This often involves addressing the following:

  • Pelvic Floor tightness and relaxation (please log in to view this video)
  • Improving breathing mechanics, hip, lower back, and abdominal mobility
  • Improving an individual’s understanding of their pain and condition
  • Retraining the CNS and nerves to be less sensitive to things like penetration
  • Dilator therapy to reintroduce penetration
  • Electrical stimulation (TENS) to decrease nerve sensitivity

Other options may include steroid treatment, medications, and topical creams. In more extreme cases surgical interventions may be sought.