Burning, stinging, and soreness—oh my! If the symptoms are prolonged (and you know that it’s not a sexually transmitted infection), you might be dealing with a painful condition known as vulvodynia. Research estimates that it affects at least one in four women at some point in their lives.
Vulvodynia causes chronic pain in the skin surrounding the vagina, which can start without warning and last for weeks to months. Additional symptoms include burning, stinging, itching, throbbing, swelling, and soreness around the vulva and vaginal opening. This pain could flair when the vagina is touched—such as during sex or when putting in a tampon—or simply when a women is sitting down. This could be why you’re having painful sex, too.
Although vulvodynia affects anywhere between 200,000 and six million women in the U.S. each year, only 60 percent of them receive an accurate diagnosis.
There’s no one-size-fits-all approach to the causes and treatment of this painful condition, says Stephanie Prendergast, co-founder of the Pelvic Health Rehabilitation Center in San Francisco. Anything from hormonal deficiencies to a history of herpes or repetitive yeast infections to autoimmune diseases or even an unrelated medical procedure could cause vulvodynia. Traumatic events like genital mutilation or any associated causes such as pelvic floor dysfunction could also lead to chronic vulval pain in women.
If your pain persists, make an appointment with your provider—either a doctor or ob-gyn—who can rule out the most common causes. But be aware that many general practitioners are not trained to diagnose vulvodynia. Rachel Gelman, a physical therapist at Pelvic Health Rehabilitation Center, recommends seeing a specialist; they can often give a more accurate diagnosis if it is vulvodynia. Nonprofit societies like the International Pelvic Pain Society or the International Society for the Study of Women’s Sexual Health can help you find a nearby provider.
Thankfully, proper treatment can help manage the pain and sometimes end it entirely. The symptoms may flare up occasionally, but Gelman says that with the right treatment, she has seen plenty of patients return to their normal lives with no pain at all.
For women with this condition, the kind of treatment they receive depends on their body’s unique needs. According to Dr. Vanessa Mackay, a spokeswoman for the Royal College of Obstetricians and Gynaecologists, research has shown that low doses of antidepressants can ease the condition by treating nerve pain. That’s where the idea of a “depressed” vagina comes from (although that doesn’t mean you or your vagina are literally depressed!)
Other treatments include applying prescribed topical creams to the affected area or seeing a physical therapist or pain psychologist. To find a physical therapist near you, visit the American Physical Therapy Association’s website.
Sometimes, lifestyle changes like wearing 100 percent cotton underwear and wearing loose-fitting skirts and trousers can prevent irritation, too. You should also avoid scented hygiene products such as feminine wipes, intimate washes, bubble bath and soap. It’s one of the everyday habits that are hurting your vaginal health.
Bottom line: If you suffer persistent vulval pain, talk to your doctor or gynecologist ASAP. Whether it’s vulvodynia or not, the pain might be a sign of any number of conditions, including IBS, Crohn’s disease, or vulval cancer, and it needs to be checked out. The sooner you can treat it, the faster you can get back to your normal life—pain free.