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Women's Health

Vulvodynia

Vulvodynia is persistent pain or discomfort affecting the vulva without an obvious underlying cause. Symptoms may include burning, stinging, irritation or increased sensitivity.

Vulvodynia is persistent pain or discomfort affecting the vulva (the external female genital area) that lasts for three months or longer, without an obvious cause such as infection or a skin condition.

The pain can range from mild irritation to severe discomfort and may have a significant impact on everyday life, exercise, relationships and emotional wellbeing.

Many women live with vulvodynia for months or even years before receiving a diagnosis. It can be frustrating when symptoms are difficult to explain or when investigations do not identify a clear cause. However, the pain is very real, and with the right assessment and treatment, many women experience significant improvements in their symptoms and quality of life.

Pelvic health physiotherapy is recognised as an important part of the multidisciplinary management of vulvodynia, helping to address the muscles, tissues and nervous system that may be contributing to ongoing pain.

What are the symptoms of vulvodynia?

Symptoms vary between individuals but commonly include:

  • Burning, stinging or raw sensations around the vulva
  • Sharp or aching pain
  • Pain during or after sexual intercourse
  • Pain when inserting tampons
  • Discomfort during cycling or prolonged sitting
  • Irritation when wearing tight clothing
  • Increased sensitivity to touch
  • Symptoms that fluctuate throughout the day

Some women experience pain only when the area is touched (provoked vulvodynia), while others have pain even when sitting or resting (generalised vulvodynia).

What causes vulvodynia?

The exact cause is not fully understood, and there is rarely a single reason why symptoms develop. Instead, vulvodynia is thought to result from a combination of factors that affect the tissues, muscles and nervous system.

These may include:

  • Pelvic floor muscle overactivity
  • Increased nerve sensitivity
  • Previous infections such as recurrent thrush
  • Hormonal changes
  • Previous childbirth or pelvic surgery
  • Previous painful sexual experiences
  • Persistent pelvic pain conditions

For many women, ongoing pain causes the pelvic floor muscles to become increasingly tense, which can further contribute to discomfort and sensitivity.

How is vulvodynia diagnosed?

Vulvodynia is usually diagnosed after other causes of vulval pain, such as infection or skin conditions, have been excluded.

A pelvic health physiotherapy assessment focuses on understanding how the condition is affecting your body and your daily life.

Your physiotherapist will discuss:

  • Your symptoms and medical history
  • Previous investigations or treatments
  • Activities that aggravate or relieve symptoms
  • Bladder, bowel and sexual function
  • Your personal goals

Assessment may include a pelvic floor examination (with your consent) to assess muscle tension, coordination and tissue sensitivity. Your comfort is always the priority, and any examination is entirely optional.

How can pelvic health physiotherapy help?

Treatment is tailored to your individual symptoms and progresses at a pace that feels comfortable for you.

Pelvic floor muscle rehabilitation

Many women with vulvodynia have pelvic floor muscles that are overactive or unable to fully relax.

Treatment may focus on:

  • Reducing muscle tension
  • Improving relaxation
  • Restoring normal muscle coordination
  • Gentle rehabilitation where appropriate

Pain management and education

Understanding how persistent pain develops can often reduce anxiety and help you feel more in control of your symptoms.

We will explain how the muscles, nerves and pain system work together and provide practical strategies to help manage flare-ups.

Manual therapy

Gentle hands-on techniques may help improve tissue mobility and reduce muscle tension where appropriate.

Returning to normal activities

Together, we will develop a gradual plan to help you return to:

  • Exercise
  • Cycling
  • Intimacy
  • Everyday activities
  • Hobbies and social activities

The aim is to help you regain confidence without fear of worsening your symptoms.

What other treatments may be recommended?

Management of vulvodynia often involves a multidisciplinary approach and may include:

  • Medical assessment by your GP or gynaecologist
  • Topical medications
  • Pain management services
  • Psychological support where persistent pain is affecting wellbeing

Pelvic health physiotherapy works alongside these treatments to improve movement, muscle function and overall quality of life.

You don't have to manage vulvodynia alone

Persistent vulval pain can feel isolating, but effective support is available.

Our specialist pelvic health physiotherapists provide a confidential and compassionate environment where you can discuss your symptoms openly and receive personalised care.

Here for you

Ready to take the first step?

Book a one-to-one pelvic health assessment to explore how physiotherapy can help you manage vulvodynia and regain confidence in your daily life.
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