Chronic vulvar pain: It can be helped.

Pain is not a sensation most of us want to face. But chronic vulvar pain--persistent pain in the area around your vaginal opening--can be especially hard to deal with. Not only have societal norms made it an awkward subject to talk about, but science so far hasn't found an exact cause for the pain. Misunderstanding and lack of diagnosis have led many women to believe that unexplained vulvar pain is all in their heads, or that it's a condition they simply must live with.

Nonetheless, understanding of chronic vulvar pain is growing. With patience, persistence and the help of an experienced doctor, chronic vulvar pain can be helped.

Your vulva

Your vulva is your external genital area. It consists of the hair-covered pad of tissue at the base of your abdomen (mons pubis), outer lips (labia majora) and inner lips (labia minora) that enclose the clitoris, hymen, vaginal opening and vestibule. The vestibule is the area around the vaginal opening. The perineum is the area between your vaginal opening and your anus.

Two types of pain

Doctors usually classify vulvodynia, the medical term for chronic vulva rain, into two categories: generalized or localized. Both types often start abruptly but may last for months or even years.

Generalized vulvodynia is a chronic pain or burning around the vulva, although there may be periods when you're symptom-free. In some women, the pain radiates to the perineum and inner thighs. Urination, prolonged sitting and sexual intercourse may cause discomfort. Generalized vulvodynia is more common in menopausal and postmenopausal women.

Localized vulvodynia (vulvar vesticulitis) is pain that results when pressure is applied to the vestibule, such as during sexual intercourse or tampon insertion, or when riding a bicycle or horse. Just wiping or touching your vulvar area may hurt. Typically, pain is absent when no pressure is applied.


Doctors aren't sure what causes vulvodynia, but most agree that it's likely a result of multiple factors. Sometimes, the onset of localized vulvodynia is associated with an infection, injury or trauma, or a medical procedure involving the vulva. There also appear to be more nerve fibers in the area than normal, which may make the vestibule more sensitive to pressure.

Generalized vulvodynia may be associated with damaged or irritated nerve endings in the vulva that send abnormal pain messages to the brain.

Women with vulvodynia may have a genetic predisposition for increased vulvar...

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