Vulvodynia Q & A

Vulvodynia is a chronic condition where women experience pain on the vulva. The reasons for vulvodynia vary widely as well as a women’s individual response to therapy and relapse making it difficult for doctors to treat. UT Health Austin gynecologist Margaret Whitney, MD shares information about Vulvodynia in this Q & A.

What is vulvodynia and what are the risk factors?

Vulvodynia is a condition where women experience pain on the vulva, which is the area outside the vagina between the mons pubis and the anus. It can include the labia, clitoris, vaginal opening and other areas. Some women have constant pain, while others may only have pain when provoked by certain activities, such as sex or wearing tight clothing. It is generally considered to be a chronic condition but many women will have resolution of their symptoms with appropriate therapy and relapse varies from person to person.

Known risk factors include young age, Hispanic ethnicity, being married and having co-existing conditions such as depression, post-traumatic stress disorder, sleep dysfunction and other pain syndromes like irritable bowel or bladder pain syndromes and fibromyalgia. However, this is an area of medicine that is poorly understood and there are likely other risk factors and associated conditions that we have yet to identify.

How many women are affected and at what ages?

Surveys suggest that 3-16% of women report pain suggestive of vulvodynia. It is more common in younger women but can occur in women of all ages such as around the time of menopause. Vulvodynia can occur early in life, such as with the first tampon use, or it can occur later in life after a pain-free period.

Why is it important to treat vulvodynia?

Many women with vulvodynia have seen multiple medical providers before they are given a diagnosis of vulvodynia and even fewer can find effective treatment. The condition can have a significant impact on self-esteem, relationships, quality of life and ability to work. There is still much to be learned about this condition and by treating more women, we can begin to learn more about the disease and hope to continue to offer better and more effective treatment options.

What is the most difficult aspect of vulvodynia that patients struggle with most?

Many of our patients have been told there is nothing wrong or have been misdiagnosed. This seems to be a common hardship than many have endured. They often feel they have been disregarded and have not been heard.

What treatment options are available?

Treatment can vary depending on the severity, duration and associated conditions. There can be an initial period of trial and error and most women benefit from a multidisciplinary approach to care.

Explain how the Women’s Health Institute uses their team approach for patients with vulvodynia?

We approach vulvodynia using the biopsychosocial model of care. This means that we treat the whole person and keep in mind the complex issues that can arise when a patient is living with a painful condition. Our team includes associate providers such as physician assistants and nurse practitioners, pelvic floor physical therapists, sex counselors, social workers and behavioral health specialists, nutritionists and physicians. All members of the team play a critical role in the treatment of our patients. We meet as a team in the morning to review patient treatment plans so that we can receive input from all of the team members.

What is one thing that you want women to know who are suffering with vulvodynia?

You are not alone, we can help you, there is hope for a better quality of life with appropriate treatment.

About the Women’s Health Institute

Margaret Whitney, MD, NCMP, is a gynecologist at the UT Health Austin Women’s Health Institute. The Institute focuses specifically on complex women’s pelvic conditions, such as urinary incontinence, pelvic floor and vulvar disorders. For more information or to schedule an appointment visit UTHealthAustin.org or call 1-833-UT-CARES.