17878 Vulvodynia

Overview

Vulvodynia is a condition that causes ongoing pain in the vulva — the external part of the female genital area — without a clear cause. The pain may feel like burning, stinging, or rawness, and it can happen even when there is no infection, injury, or visible skin problem.

It is not rare. Research suggests that around 1 in 6 women will experience vulvar pain at some point in their lives.

Vulvodynia can affect women and people assigned female at birth of any age, but it is most often diagnosed during the reproductive years and around menopause.

Symptoms

Common symptoms

• Burning, stinging, or raw pain in the vulvar area
• Itching or aching that does not go away
• Pain when touched — such as during sex, when inserting a tampon, or when wearing tight clothing
• Soreness that may come and go or be constant
• A feeling of swelling or throbbing, even though the area looks normal

Symptoms in children

• In children and teens, the pain may make it hard to ride a bike, use a tampon or pad, or wear tight underwear.
• They may avoid swimming, sports, or activities that involve sitting for a long time.

Symptoms in older adults

• In older adults, the skin around the vulva can become thinner and drier with menopause, which may make pain more noticeable.
• Pain may also be triggered by rubbing, tight clothes, or urinary irritation.

Causes

Main causes

• The exact cause is not known.
• Nerve overactivity in the vulvar area (the nerves send pain signals too easily)
• Hormonal changes, especially around menopause
• Tightness or spasm in the pelvic floor muscles
• A history of vaginal infections or trauma

Risk factors

• Previous yeast infections or other vaginal infections
• Skin conditions such as psoriasis or lichen sclerosus
• Chronic pain conditions, like fibromyalgia or irritable bowel syndrome
• High levels of stress or anxiety

When to see a doctor

See a doctor urgently if:

• If you have vulvar pain along with a fever, unusual discharge, or an open sore
• If the pain is so severe that you cannot sit, walk, or pass urine normally

Book a routine appointment if:

• If you have vulvar pain that lasts for 3 months or more
• If pain affects your daily life, sex, or tampon use
• If you have noticed any changes in the skin of the vulva, such as colour changes, cracking, or sores

Diagnosis

Your doctor will ask about your symptoms, medical history, and anything that triggers the pain. They will also do a gentle physical examination of the vulva to check for visible skin changes. A simple cotton-swab test helps identify the exact painful spots.

Tests that may be done

• Swabs of the vagina or vulva to check for infections such as yeast, bacteria, or herpes
• A small tissue sample (biopsy) if the skin looks unusual
• Blood tests if hormone levels or immune conditions might be involved

What to expect at your appointment

The examination can feel uncomfortable, but it is usually quick and you are in control. You can ask the doctor to stop at any time, to use a smaller speculum, or to explain what they are doing before they do it.

Treatment

Treatment focuses on reducing pain and helping you get back to normal life. There is no single best approach — many people improve by trying a combination of self-care, medical treatments, physiotherapy, and emotional support.

Self-care at home

• Wear loose, cotton underwear and avoid tight trousers or thongs
• Use a cool compress or ice pack wrapped in a cloth to soothe burning
• Wash the vulva with water only — avoid soaps, scented wipes, or bubble bath
• Use a generous amount of plain lubricant when having sex or inserting a tampon
• Use a soft cushion or inflatable donut ring when sitting for long periods

Medical treatments

Medical options include topical creams, gels, or ointments that numb the pain; oral medicines that calm nerve-related pain; pelvic floor physiotherapy to relax tense muscles; and hormone creams if the pain is linked to menopause. Some doctors may also recommend counselling or cognitive behavioural therapy to help with the emotional impact. Your healthcare provider will discuss the options and help choose what is safe and suitable for you.

When is surgery considered?

Surgery is very rarely needed and is not a first-line treatment. It may only be considered in severe, difficult-to-treat cases after all other options have failed, and only after a specialist consultation.

Living with this condition

Pain can come and go. Keep a diary of what makes your pain worse and plan your activities around better days. It is okay to ask for a short break or adjust how you sit during work or school. You do not have to push through the pain.

Lifestyle tips

• Avoid scented menstrual pads, panty liners, and feminine sprays
• Change out of wet swimwear or sweaty clothes as soon as you can
• Use a plain, unperfumed soap substitute or just water for washing
• Choose gentle, breathable fabrics for underwear and clothes

Diet and exercise

There is no special diet that cures vulvodynia, but eating a balanced diet and getting regular gentle exercise can help your body manage pain. If cycling or sitting on a hard exercise bike worsens your symptoms, try other activities like walking or swimming.

Mental health and emotional wellbeing

Living with chronic pain can be exhausting and can affect your mood, sleep, sex life, and self-esteem. Feeling frustrated, anxious, or down is completely normal. Talking with a counsellor or psychologist — alongside other treatments — can make a real difference.

Prevention

Because the cause is not fully understood, vulvodynia cannot always be prevented. However, avoiding known irritants, managing stress, and getting early help for vaginal infections may lower the chance of developing the condition or having flare-ups.

Vaccines

There is no vaccine specifically for vulvodynia.

Screening programmes

There is no routine screening test. The best step is to see a doctor early if you notice any unusual pain or skin changes in the vulvar area.

Complications

If left untreated

• Long-term pain can lead to poor sleep, anxiety, and depression
• Pain can make sexual intimacy difficult and cause relationship strain
• Some people avoid seeking help, which can delay finding effective treatment

Long-term outlook

With the right support, most people see a clear improvement over time. It may take patience to find the treatment that works for you, but it is realistic to expect a better quality of life. You are not alone, and you deserve help.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.