What should you know about generalised vulvodynia?

The discomfort may be described as burning, stinging, rawness, aching, or tenderness. It can vary across the day and may be triggered by touch, sitting, clothing, movement, or sexual activity; some people also feel pain without contact. The visible skin may look normal, so appearance alone does not measure the severity of symptoms.

Vulvodynia is diagnosed after a clinician considers the history and examines the vulval skin, pelvic floor muscles, and possible infections or skin conditions. A symptom such as vulval pain can have several explanations, so assessment helps guide the right treatment.

Arrange an appointment with a gynaecologist, sexual health clinician, or clinician familiar with vulval pain. Keep a brief record of triggers, cycle timing, products used, urinary symptoms, and pain during sex. Loose cotton underwear, fragrance-free washing, and avoiding unnecessary creams or douching may reduce irritation.

Treatment is tailored to the pattern of pain. Options can include pelvic floor physiotherapy, topical or oral medicines, pain-focused counselling, and gradual desensitisation approaches such as vaginal dilator therapy. Progress may involve several appointments, and a plan should be adjusted if an approach increases pain.

Book a review for vulval pain that persists, returns, affects sleep, limits sitting, or makes sexual activity difficult. Seek prompt care for new sores, blisters, bleeding, foul-smelling discharge, fever, rapidly increasing swelling, or severe pain with difficulty passing urine.

Ask what conditions should be ruled out, whether the pelvic floor is contributing, what tests are useful, how to protect the skin, which treatment should be tried first, and how progress will be reviewed if pain during sex continues.