What is vulvodynia?
If you’ve been experiencing burning, stinging, or rawness in your vaginal area, and keep hearing “everything looks normal”, you’re not alone. The truth is, up to 16% of women experience ongoing vulvar pain at some point, but many never get a diagnosis.
My story
For years, I searched for answers while navigating pain that no one seemed able to explain. Every practitioner I saw stopped at the usual suspects: yeast infections, UTIs, BV. But test after test came back “normal,” even though nothing about what I was feeling felt normal.
Eventually, I had to do what so many women do when the healthcare system fails them. I started researching on my own. That’s when I stumbled onto Reddit threads, blog posts, and stories from other women that finally made me feel seen. I learned about vulvodynia for the first time, not from a doctor, but from another woman just trying to make sense of her body.
What is vulvodynia?
Vulvodynia is chronic pain in the vulva (the external part of your genitals) that lasts for three months or longer, with no obvious cause. When I first learned about vulvodynia, it almost felt like a placeholder diagnosis, like a fancy way of saying, “We don’t know what’s going on”. Which felt very defeating in that moment of realization.
Wondering what symptoms come with vulvodynia?
If you’ve been dealing with symptoms like these for months (or even years) without clear answers, vulvodynia could be the reason:
Burning
Stinging
Irritated or raw
Sharp or throbbing
Painful during sex (dyspareunia), sitting, or even wiping
It’s also good to keep in mind that there are different forms of vulvodynia:
Generalized: pain is widespread across the vulva
Localized: pain is concentrated in a specific area, often the vaginal opening
Provoked: pain is triggered by touch or pressure
Unprovoked: pain occurs spontaneously, even without contact
If you’ve been living with ongoing pain and no clear answers, this might be what you’ve been dealing with all along. Just having a name for it can be the first step toward healing.
Why doctors often miss it.
Many women spend months or even years searching for answers, only to be told over and over again that nothing’s wrong. Trust me, I’ve been there. It’s one doctor after another, repeating the same story, hoping this time someone will listen. It’s hitting dead end after dead end, and wondering if you’re the only one.
Here’s why doctors are missing it:
It’s often mistaken for recurrent yeast infections, UTIs, or skin conditions
Many OB/GYNs aren’t trained to recognize it
There’s no standard test, it’s a diagnosis of exclusion
The pain is invisible, and unfortunately, that means it’s often dismissed
Possible root causes (emerging theories)
Vulvodynia doesn’t have a single clear cause, but researchers and practitioners are uncovering possible contributing factors. For many, it’s a combination of the following:
1. Nerve hypersensitivity or injury
Sometimes vulvodynia starts after a specific event, like a yeast infection, childbirth, a fall, or even rough sex. These can irritate or damage vulvar nerves, creating long-term sensitivity even after the original trigger has healed.
Repeated inflammation or trauma can make nerves overly reactive
Pain may persist even when there’s no visible issue
For some, nerves misfire simply from sitting or wearing tight clothes
2. Pelvic floor muscle dysfunction
When the pelvic floor is too tight (hypertonic) or uncoordinated, it can cause pain, pressure, or burning, especially during sex or while sitting.
How it starts:
Holding tension from chronic stress, trauma, or anxiety
After childbirth or surgery
Guarding behavior after pain or infection (unconscious muscle clenching)
Sometimes, you won’t realize your muscles are involved until you work with a pelvic floor therapist trained to assess internal tension.
3. Chronic yeast or microbial imbalance
Many women with vulvodynia have a history of recurrent yeast infections or bacterial imbalance.
Why it happens:
Antibiotics that wiped out good bacteria and allowed yeast to overgrow
High sugar or low-fiber diet
Hormonal birth control altering pH and flora
Hidden imbalances like low lactobacillus, high Gardnerella, or aerobic vaginitis
Even if standard tests say you’re “clear,” subtle microbial imbalances can still be driving symptoms. It’s also worth noting that PCR tests, like Evvy or Juno, detect a wider range of microbes than a typical yeast or BV swab. Understanding your full microbiome picture can bring you closer to real answers.
4. Hormonal changes
Hormones affect tissue health, moisture, and your microbiome. Drops in estrogen (or major shifts in other hormones) can lead to pain, dryness, or increased sensitivity.
How it starts:
Stopping or starting birth control
Postpartum recovery
Perimenopause or menopause
Chronic stress alters hormone levels
If your symptoms started after a life change or med adjustment, hormones may be part of the picture.
5. Gut + vaginal microbiome dysbiosis
Your gut and vaginal microbiomes are closely connected. When gut bacteria become imbalanced, it can impact digestion, inflammation, and vaginal flora.
Triggers can look like:
Antibiotics or medications
Processed foods, low fiber, alcohol, sugar
Chronic bloating, constipation, or IBS symptoms
High stress, which impacts gut-brain signaling
6. Inflammation & mast cell activation
Some women have an overactive immune system response in vulvar tissues, often tied to mast cell activation (which releases histamine and other pain-producing chemicals).
It may be linked to:
Chronic stress
Hidden food sensitivities
Past trauma or high cortisol levels
Other inflammatory conditions like interstitial cystitis, eczema, or fibromyalgia
How it’s diagnosed
Diagnosis usually starts by ruling other things out. You may need to:
Undergo a cotton swab test to identify pain areas
Rule out infections, STIs, skin conditions, or dermatologic issues
See a specialist, often a pelvic floor physical therapist or vulvar pain clinic
Many people are diagnosed only after being persistent and advocating for themselves. If you haven’t gotten answers yet, it’s not the end of the road. Keep going.
Treatment & relief options
While vulvodynia has no one-size-fits-all solution, many women have found powerful relief, and even full recovery, through consistent, root-cause approaches. These aren’t quick fixes, but they are deeply healing when applied with intention.
Here’s what worked most often, based on real stories and science-backed insights:
Conventional treatments
Some find relief through clinical treatments like:
• Topical lidocaine for numbing the area
• Low-dose antidepressants or anticonvulsants to calm nerve pain
• Pelvic floor physical therapy to release tension and restore coordination
• Nerve blocks in more severe cases
Holistic & at-home approaches
1. Vitamin D3 + K2: Supporting Your Body’s Natural Balance
One of the most surprising recoveries came from supplementing Vitamin D3 (5,000–10,000 IU/day) alongside K2. For some, pain began to ease within a week.
Why it helps:
• Regulates immune and inflammatory responses
• Supports vaginal and gut microbiome balance
• Especially effective for those with low sun exposure or known deficiencies
2. Vaginal Microbiome Testing (Evvy, Juno, etc.)
Like mentioned about, many women shared that microbiome testing was the turning point. As they had other issues going on that weren’t picked up with traditional testing.
Common findings included:
• Low Lactobacillus
• High levels of Candida, Gardnerella, Strep, or E. coli
• Hidden infections like aerobic vaginitis or chronic UTIs misdiagnosed as vulvodynia
Once identified, targeted treatments like oral/vaginal probiotics, antifungals, or antibiotics led to major symptom improvement. But if everything still comes back “normal” and you’re still in pain, it’s a sign that something deeper may be at the root of your symptoms.
3. Pelvic Floor Physical Therapy: Releasing Tension, Restoring Ease
A tight pelvic floor can feel like constant resistance. Pelvic Floor Physical Therapy (PFPT) is one of the most commonly cited tools for real, lasting relief.
What it can include:
• Breathwork (like “Umbrella Breathing”) to reset tension patterns
• Pelvic stretches like “The Pelvic Clock”
• Internal release work with a trained specialist
• Gradual use of dilators or gentle vibrators to reintroduce comfort
4. Nourishment + Gut Support: Treating the Root
A healthy gut often leads to a calmer pelvis. Supporting digestion and reducing inflammation can ease pressure, balance hormones, and soothe nerve sensitivity.
What helped:
• Magnesium citrate for muscle relaxation and nerve calm
• Omega-3s and anti-inflammatory foods
• Plenty of fiber and water to relieve tension from constipation
• Reducing irritants like caffeine, sugar, and alcohol
Healing is holistic, and your body knows how to come back into balance when it’s nourished well.
5. Removing Irritants: Protecting a Sensitive System
Your vulva is delicate by design. Many women found major relief simply by eliminating external stressors.
Changes that made a difference:
• Switching to 100% cotton or no underwear
• Skipping soaps, wipes, or any fragranced products on the vulva
• Ditching pads, thongs, tight pants, or synthetic fabrics
• Pressing pause on shaving, waxing, or aggressive grooming
• Using lidocaine only as a temporary aid when recommended
6. Calming the Nervous System: Rewiring the Pain Loop
Pain is a full-body experience. For many, addressing nervous system regulation and past emotional stress was a turning point, not because it was “all in their head,” but because their body was stuck in protection mode.
Helpful practices:
• Somatic therapy or trauma-informed coaching
• Daily breathwork or mindfulness
• Grounding routines that help signal “you’re safe now”
7. When Other Methods Don’t Work
In more persistent or severe cases, some women found relief through:
Gabapentin, amitriptyline, or SNRIs to calm nerve signaling
Topical lidocaine for temporary symptom relief
Vestibulectomy, a surgical option in rare cases
These approaches are typically explored after trying more foundational healing methods.
Healing from vulvodynia isn’t always linear—but it is possible.
Sometimes relief looks like the first pain-free day in months. Sometimes it looks like finding a provider who actually listens. Sometimes it looks like reading someone else’s story and realizing you’re not broken. Your body is wise. Your instincts are valid. And your healing matters.
For me, I haven’t fully healed. But I’ve found relief, and even that small shift changed everything. That ounce of ease gave me the strength to keep going. It reminded me that healing isn’t about perfection. It’s about progress and about reconnecting with a body that deserves care and compassion.
Your body is wise. Your instincts are valid. And your healing matters.
But here’s the truth: you shouldn’t have to fight this hard to be heard.
It’s time we demand more from our healthcare systems, more research, more training, more answers, for a condition that affects so many and is still too often dismissed. Vulvodynia deserves the same urgency and attention as any other chronic pain condition.
So keep listening. Keep searching. Keep going.
