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Vulvodynia

Vulvodynia is vulvar pain without a clear cause. It may occur anywhere in the vulva, or external female genital area. This includes the vaginal opening, labia and clitoris.

There are two main types of vulvodynia:

  • Localized vulvodynia: Pain that occurs in a specific area of the vulva, such as right at the vaginal opening.
  • Generalized vulvodynia: Pain that affects multiple areas of the vulva.

Vulvodynia symptoms

Vulvodynia has no visible signs, and the way it feels differs from person to person. People with vulvodynia have described the following sensations in the vulva:

For some people, this pain is present continuously. Others experience it only in response to pressure on the vulva, such as during sexual intercourse, insertion of a tampon, sitting for long periods, riding a bicycle or wearing tight clothing.

How can I get help for vulvodynia?

If you have one or more of the above symptoms and they don’t go away, speak with your primary care doctor or OB-GYN. If necessary, your doctor may refer you to a specialist. 

At Rush, you also have the option of contacting the Program for Abdominal and Pelvic Health, which is designed to address the full range of issues related to pelvic pain. The program has a coordinator who will help you navigate the multiple specialists you might need to see to find relief.

Care for vulvodynia at Rush

Comprehensive evaluation

  • Pelvic gynecologic exam: Because vulvodynia is defined as vulvar pain with no known cause, your doctor will arrive at that diagnosis after eliminating other possible causes. This may involve testing for infections, skin problems or other issues.
  • Pelvic floor nerve and muscle exam: Your doctor will examine your pelvic area externally and internally to see if your muscles are tight, painful and/or weak.  He or she may touch different areas with a cotton swab to determine precisely where the pain is located (and whether you have generalized or localized vulvodynia).

Nonsurgical treatments

Different people find that different treatments help with vulvodynia. Because the cause of vulvodynia isn't known, treatment focuses on relieving symptoms. Your doctor at Rush will work with you to find the combination of treatments that provides the most relief from your symptoms.

These treatments may include one or more of the following:

  • Physical therapy: A physical therapist who specializes in treating people with pelvic floor conditions will develop a rehabilitation program designed to manage your pain and address your functional problems.
  • Exercise prescription: A doctor or physical therapist may teach you specific exercises that can help reduce your pain.
  • Biofeedback: Your health care provider may use electrical sensors to give you feedback about activity in your muscles and nerves. This feedback can help you learn to relax certain muscles in response. This helps you control your body’s reaction to pain or other stressors.
  • Psychological counseling: Stress, depression and other psychological problems are sometimes at the root of vulvodynia. Vulvodynia can also cause some of these issues. For some women, counseling to address these problems may lead to less pain.
  • Medications: Antidepressants, pain relievers, estrogen therapy and other topical and oral medications sometimes help reduce vulvar pain.
  • Nerve block: Your doctor may offer an injection to block the nerves that may be at the root of your pain.

Surgery

In most cases, people with vulvodynia do not need surgery. But if you have had pain for an extended period of time and it shows no signs of lessening, your doctor may recommend surgical removal of part of the vulva.

Why choose Rush for vulvodynia care

  • Pioneering care for pelvic and abdominal health: More than a decade ago, Rush became the first academic medical center in Chicago to create a pelvic health program focused exclusively on providing care for patients with incontinence, vulvodynia, cystocele and other pelvic and abdominal conditions.
  • Coordinated, individualized care: At Rush, a team pelvic floor experts will individualize your treatment program based on your goals.

Departments and programs that treat this condition