What should you know about provoked vulvodynia?

Pain may be burning, stinging, rawness or sharp discomfort at the vaginal opening. It can begin with touch and settle when pressure stops, although some people develop pain that lingers. Provoked vulvodynia is diagnosed after conditions such as infection, skin disease, injury or hormonal causes have been considered. The pain is real; it is not explained by poor hygiene or a lack of desire.

A clinician may examine the vulval skin gently and use a light cotton-swab touch to map tenderness. Avoid fragranced washes, deodorants and unnecessary antiseptics; choose breathable underwear and use a lubricant for sexual activity. Treatment may combine education, pelvic floor physiotherapy, pain-focused medicines, counselling and gradual desensitisation. Some people are offered vaginal dilator therapy, introduced slowly and only within a personalised plan.

Seek assessment for new, persistent or worsening vulval pain, especially with sores, bleeding, unusual discharge, fever, a lump or urinary difficulty. Urgent care is appropriate for severe pain with fever, rapidly spreading swelling, or inability to pass urine. A sudden change in symptoms after a new product or sexual contact also merits review, because irritation and infection can need different treatment.

What other causes should be checked? Could pelvic floor tension be contributing? Would pelvic floor physiotherapy or vaginal dilator therapy suit me? How can we protect comfort during examination and intimacy?