Symptoms, Causes, and Treatments
What is Vulvodynia?
Vulvodynia is chronic pain or discomfort of the vulva (the external female genital area) lasting 3 months or longer without a clear identifiable cause such as infection or skin disorder. The pain may be localized (in one area, like the vestibule) or generalized (affecting the entire vulva), and it can be constant or triggered by touch, pressure, or sexual activity.
Common Symptoms Include
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Burning, stinging, irritation, or rawness in the vulva
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Pain during or after sexual activity (dyspareunia)
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Pain when inserting tampons or during pelvic exams
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Discomfort with prolonged sitting, tight clothing, or exercise
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Pain localized to the vestibule (entry point of vagina) or generalized across the vulva
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Pain that fluctuates in intensity, sometimes worsening with stress or hormonal changes
What causes it?
The exact cause of vulvodynia is not fully understood. It is considered a multifactorial condition involving nerve dysfunction, pelvic floor muscle tension, and heightened pain sensitivity.
Possible mechanisms include:
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Overactive or irritated vulvar nerve fibers
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Pelvic floor muscle dysfunction (tightness, spasm, weakness)
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Nerve injury or irritation (e.g., after infection, surgery, or trauma)
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Altered immune or inflammatory response
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Hormonal influences
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Nervous system hypersensitivity (central sensitization)
Possible contributors include:
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Past yeast or bacterial infections
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Pelvic surgery, childbirth, or trauma
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Hormonal changes (e.g., oral contraceptives, menopause)
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Pelvic floor dysfunction or tension
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Chronic inflammation or irritation from soaps, chemicals, or tight clothing
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Psychological stress, anxiety, or history of trauma
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Genetic predisposition to nerve hypersensitivity
A Neuroplasticity-Based Approach
In vulvodynia, the pain often persists even when there is no ongoing tissue damage. This suggests that the brain and nervous system are misinterpreting normal sensations as painful. A neuroplasticity-based approach works to retrain the nervous system, calm pelvic hypersensitivity, and restore a sense of safety in the vulvar region.
At Menda, we use therapies that help retrain the brain and calm the nervous system. Approaches such as Pain Reprocessing Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy can help reduce the brain’s fatigue signals and restore balance. By teaching the nervous system new, safer patterns, people can gradually rebuild their energy, resilience, and quality of life.
You don’t have to keep living with these symptoms. Explore Menda’s evidence-based therapies designed to rewire the brain and restore balance.
Key Neuroplasticity-Informed Strategies
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Breathwork and pelvic relaxation: Reduces pelvic floor tension that aggravates pain.
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Gentle sensory retraining (desensitization): Gradually reintroducing safe touch or pressure to teach the brain that vulvar sensations are not threatening.
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Mindfulness and grounding techniques: Calms the autonomic nervous system and reduces stress-driven pain amplification.
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Visualization and guided imagery: Reinforces safe, comfortable associations with pelvic sensations.
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Cognitive reframing: Shifting from “damage” thinking to an understanding of nervous system hypersensitivity.
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Graded exposure: Rebuilding tolerance to sitting, intimacy, or clothing without reinforcing avoidance patterns.
Why Neuroplasticity Works
Vulvodynia often results from central sensitization, where the nervous system amplifies pain signals from the vulva. Neuroplasticity techniques teach the brain to form new, safe neural pathways, reducing the overactive “danger” response. Over time, this retraining decreases hypersensitivity, restores comfort, and supports confidence in daily activities and intimacy.
When to Seek Care
Seek medical care if you experience:
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Vulvar pain lasting more than 3 months
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Pain that interferes with sexual activity, sitting, or daily life
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Severe burning or stinging without clear cause (such as infection)
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Pain accompanied by new skin changes, sores, or discharge
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Emotional distress (anxiety, depression, or relationship difficulties) linked to vulvar pain
Specialists who may help include gynecologists, vulvar pain specialists, pelvic floor physical therapists, and pain or neurology professionals. A multidisciplinary approach—combining medical care, pelvic therapy, and neuroplasticity strategies—often brings the best results.
