Overview
Vulvodynia is long-lasting pain or discomfort of the vulva for at least 3 months without a clear cause such as infection or skin disease.
When to get urgent help
Not usually urgent.
Causes and risk factors
The cause is not fully understood. Nerve sensitivity, pelvic floor muscle tension, past infections, hormonal changes and stress may contribute.
How it develops (pathophysiology)
Pain nerves in the vulva become overactive and sensitised, so normal touch or pressure is felt as pain. The pelvic floor muscles can tighten protectively, adding to the pain.
Signs and symptoms
Burning, stinging or raw pain, which may be constant or triggered by touch, sex, tampons or sitting.
How it is diagnosed
Examination, including a cotton-swab test, after excluding infections and skin conditions.
Possible complications
Difficulty with sex and relationships, anxiety and low mood.
Medicines
Lidocaine gel, low-dose amitriptyline or other nerve pain medicines.
Other treatments
Pelvic floor physiotherapy, psychosexual therapy and avoiding irritants such as perfumed products.
Living with it and prevention
Not preventable.
Outlook
Many people improve with a combination of treatments.
