What is vulvodynia?

Ouch.

Most of us take for granted that sex feels good. That’s kind of the point, isn’t it? Yet for the roughly one in six women who suffer from vulvodynia, sex, and even just day-to-day life, can be excruciating.

The condition, described as an unidentifiable pain or discomfort in the vulva, is particularly debilitating due to the mystery and lack of research that surrounds it. What’s more, as there’s a lingering societal shame surrounding sexual health, many people keep their suffering to themselves and are left in the dark and without a solution. 

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According to Sydney-based gynaecologist and urogynaecologist Dr Rebecca Young, experiencing pain in the vulva is more common than one might think. 

“In my experience having pain in any region of the vulva or vagina is not uncommon during the course of a woman’s life. In most cases, however, this pain will be temporary, or there will be a cause that can be identified.”

She says the diagnosis process for vulvodynia can be an arduous one, as it involves ruling out all other conditions first. As vulvodynia isn’t related to any kind of infection or injury, both diagnosis and treatment can be murky. In order to be diagnosed, one needs to experience symptoms for three months or longer, without an understandable cause. 

Dr Young tells me the condition can arise seemingly out of nowhere or can be brought about by other vaginal issues, such as an allergic reaction, a bad case of thrush or childbirth. Research shows most people start to develop symptoms between age 18 and 25 and the condition is far less common after the age of 35.

“Some women describe pain with sitting, touching of the vulva, placing tampons, during sex or when riding a bike.” Some people describe the sensation as rawness, stinging, itching or sharp pain, and it can be localised or move to different areas of the vulva. It can also be constant or recurring. 

Because vulvodynia can cause such intense pain with sex, it can wreak havoc on people’s relationships with their own bodies and with their partners. Some may even decide to give up on sex entirely. In relationships, this can lead to a loss of intimacy and closeness, especially if partners aren’t communicating well. But that’s not even the worst of it. 

Beyond the bedroom, it’s been reported that the pain can even get bad enough that people are unable to hold down jobs, give up on physical exercise or are left bedridden. 

For those who are suffering from vulvar pain, Dr Young recommends first seeking out a gynaecologist to ensure it’s not related to any other condition. Once a diagnosis has been reached, the road to recovery can be long. 

“Vulvodynia is a challenging condition to manage as it requires long-term treatment with the aim being to reduce pain and improve quality of life,” says Dr Young. 

“Having daily pain can cause other health issues such as anxiety and depression and can cause issues with sleep. It can also result in problems with having sex due to discomfort that is present all the time or that occurs during or after sex.”

When it comes to treatments, the options are wide-ranging and varied, including antidepressants, topical anaesthetics, oral pain medications, physical therapy, diet changes and counselling. Patients often try out multiple different doctors and treatments before settling on something that works for their specific needs. 

As vulvodynia has only been widely acknowledged by the medical community in recent years, much more research is now being done to attempt to uncover the causes and treatments. 

While the condition is deeply unpleasant for many, luckily, there is a bright side. Perplexingly, for roughly 40 per cent of people who experience vulvodynia, it’ll go away on its own, leaving as mysteriously as it arrived. 

For more information on vulvodynia, head here.