Vulvodynia is a chronic pain condition affecting the vulva, the external part of the female genitalia. It is defined as vulvar pain that lasts for at least three months without an identifiable cause, making it a complex and often misunderstood condition.
Despite an estimated 18% of women being impacted at some point in their lives by the condition in the UK1, vulvodynia remains underdiagnosed and under-discussed, leaving many individuals to suffer in silence.
Understanding the Symptoms
The main symptom of vulvodynia is persistent pain in the vulva, which may be described as burning, stinging, rawness, or soreness. The pain can vary in intensity and location and may be constant or intermittent.
Some individuals experience pain only when the area is touched, for example, during sexual intercourse, using tampons, or sitting down for a long time, known as provoked pain, while others may feel discomfort without any trigger, or spontaneous pain.
There are two main types of vulvodynia:
- Localised Vulvodynia: Pain is confined to a specific area, often the opening of the vagina, known as the vestibule). This subtype is commonly referred to as vestibulodynia, and pain is often more likely to occur during activities that apply pressure to the area, this is known as provoked vestibulodynia.
- Generalised Vulvodynia: Pain is more widespread across the vulva and is more likely to occur spontaneously. It can affect multiple areas or the whole of the vulva, including the labia, clitoris.
- In both cases the pain associated can even extend to the perineum and inner thighs.
One survey of people living with vulvodynia found that 43.9% had localised and 32.1% had generalised, and the remaining 24% had both2.
What Causes Vulvodynia?
The exact cause of vulvodynia is unknown, but researchers believe it may result from a combination of factors. These include:
- Nerve injury or irritation
- Past vaginal infections
- Inflammation
- Hormonal changes
- Genetics
- Pelvic floor muscle dysfunction.
Psychological factors such as stress, anxiety, and a history of trauma may also contribute to the development or exacerbation of symptoms.
Importantly, vulvodynia is not caused by an active infection, skin disorder, or other identifiable medical condition. This makes diagnosis challenging, requiring healthcare providers to rule out other potential causes, such as Sexually Transmitted Infections (STI’s) through physical exams and tests.
Impact on Daily Life
Vulvodynia can significantly affect quality of life. The pain may interfere with basic activities such as sitting, exercising, or wearing certain clothing. It can also lead to difficulties with sexual intimacy, contributing to emotional distress, relationship strain, and reduced self-esteem. Many individuals with vulvodynia report feelings of isolation, frustration, and depression.
Research has shown a strong link between mental health and vulvodynia. Women who screened positive for PTSD were found to be more than twice as likely to also screen positive for vulvodynia. Additionally, those experiencing depression or symptoms suggestive of PTSD had a 50% higher likelihood of reporting this chronic pain condition3.
Seeking Help and Treatment
If you suspect you may have vulvodynia, it’s important to consult a healthcare provider, ideally a gynaecologist, sexual health clinic, who can begin to rule out other causes. Treatment options vary and may include topical medications, oral pain relievers, physical therapy, nerve blockers, and, in some cases, surgery. Psychological support through counselling or sex therapy can also be beneficial.
For many, however, treatments for vulvodynia may not provide relief or may negatively impact a person’s sex life, for example, numbing cream.
MAC Clinical Research is looking for volunteers with a diagnosis, or are experiencing symptoms, of vulvodynia to take part in a new clinical trial. You could help yourself and generations to come, plus you will receive up to £1730 for your time and commitment if you are suitable and complete the trial.
For more information and to register your interest, please visit our vulvodynia research webpage. You can also find additional information on the NHS website – Vulvodynia (vulval pain) – NHS.
1 NIHR – The silent and widely impacting cost of Vulvodynia: lessons learned and future recommendations
2 Journal of Pain Research – Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings
3 Journal of Women’s Health – Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study
