Table of Contents

What is Vulvodynia?

Vulvodynia is a condition characterized by chronic vulvar pain without an identifiable cause. Its symptoms may include burning, stinging, stabbing, irritation, and/or rawness, and the pain can be constant or intermittent, localized or diffuse. Upon examination, the vulvar tissue may appear inflamed and swollen, or it may appear perfectly normal. The severity of the condition varies from mild discomfort to excruciating pain.

Before diagnosing vulvodynia, other gynecological and skin conditions that cause chronic vulvar pain should be ruled out or treated. These conditions include, but are not limited to, yeast infections, bacterial infections, and dermatologic conditions like dermatitis, lichen sclerosus, and lichen planus.

Vulvodynia has two main subtypes, which may co-exist:

  • Provoked Vestibulodynia: Pain is localized in the vestibule (the area surrounding the vaginal opening) and occurs during or after touch or pressure is applied to the area, such as during sexual intercourse, tampon insertion, or prolonged sitting.
  • Generalized Vulvodynia: Symptoms occur in several areas of the vulva, including the labia, vestibule, clitoris, and perineum. Pain is relatively constant, but there may be some periods of relief. Pressure on the vulva typically exacerbates the symptoms.

Like most chronic pain conditions, vulvodynia can impair one’s quality of life, limiting the ability to work, engage in sexual intercourse, and participate in daily activities. Living with the pain and these limitations may lead to depression and anxiety.

Causes of Vulvodynia

Several contributing factors can trigger and/or promote the development of vulvodynia, including:

  • An injury to or irritation of the nerves that transmit pain from the vulva.
  • An increase in the number of “pain-sensing” nerve fibers in the vulva.
  • An abnormal response of certain cells to environmental factors, such as infection or trauma (e.g., pelvic injury).
  • Genetic susceptibility to chronic vulvar inflammation, widespread body pain, and/or an inability to combat infection.
  • Pelvic floor muscle weakness or spasm.

Diagnosis of Vulvodynia

The diagnosis of vulvodynia involves a medical history review, physical examination, and in some cases, a biopsy.

Treatment of Vulvodynia

Treatment aims to alleviate symptoms and may provide partial or complete relief. Different women may respond differently to various treatments. Some common treatment options include:

  • Discontinuation of irritants.
  • Topical medications applied to the vulva.
  • Tricyclic antidepressants (e.g., amitriptyline).
  • Anticonvulsants (e.g., gabapentin).
  • Nerve blocks.
  • Pelvic floor muscle therapy.
  • Surgery

Schedule an Appointment

If you’re interested in learning more about your treatment options for Vulvodynia, your first step is to schedule an appointment with Dr. Dubinskaya. To get started, contact our office by calling 424-210-9030 or filling out our online form.

MEET Dr. Alexandra Dubinskaya

A leader in women’s sexual health

Dr. Alexandra Dubinskaya is a board-certified, fellowship-trained Urogynecologist and Sexual Health specialist whose mission is to enhance women’s quality of life by improving their pelvic and sexual health. Dr. Dubinskaya’s focus is on making a difference in people’s lives through state-of-the-art, compassionate, and personally tailored care.

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