Vulvodynia

Vulvodynia is defined as persistent vulvar pain for at least three months with no clear underlying infection, skin disease, or neurological disorder, and is considered a diagnosis of exclusion. The pain may be burning, stinging, raw, or sharp and can be localized to the vestibule or generalized across the vulva, occurring spontaneously or when provoked by touch, intercourse, tampon use, or prolonged sitting. Although the exact cause is unknown, proposed mechanisms include vulvar nerve injury or hypersensitivity, chronic inflammation, hormonal changes, pelvic floor muscle dysfunction, genetic susceptibility, and abnormal response to past infections or irritants.?

Management is multidisciplinary, aiming to reduce pain and improve function rather than “cure” a single cause. Options may include vulvar care measures, topical anaesthetics, low?dose tricyclic antidepressants or anticonvulsants for neuropathic pain, pelvic floor physiotherapy, cognitive behavioural therapy, and, in selected localized cases, vestibulectomy. Early recognition, empathetic counselling, and individualized treatment plans help limit sexual distress, relationship strain, and psychological comorbidities such as anxiety and depression.