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Vulvodynia is defined by the National Vulvodynia Association ( as chronic vulvar pain without an identifiable cause.

Translation: it is pain at the entrance to the vagina. It isn't caused by an infection, STI/STD (sexually transmitted infection/disease), diet, genetics or anything else that we know of. It is a diagnoses by exclusion, meaning, everything else has been ruled out as a cause of pain by the medical doctor. It is important to meet with your medical provider to make sure to rule out infections and medical causes.

Treatment, therefore, is to help with symptoms, and pelvic floor therapy is one of the recommended treatments. There are a few medications that may provide short term relief that a medical doctor can prescribe.

Early in my career, in the early 2000's, the thought was it was a skin irritation and different diets were prescribed, but that is no longer a common thought for how to treat vulvodynia, yet 15 years later this diagnosis still remains mostly a mystery.

Wearing tight clothes, tampons and sexual activity may increase symptoms and often these are the things we help the body to tolerate with physical therapy treatment.

Often in response to pain, the muscles of the pelvic floor will tighten because they think the body needs to protect the area. This is a normal biological response, however, in chronic conditions like vulvodynia, the initial threat is gone, but the muscles can remained in a tightened state of protection. Physical therapy can help break that cycle.

We also teach the client things they can do at home to help with the symptoms. This may include desensitization techniques for the vulvar tissues, stretches, etc. If sexual activity is painful or uncomfortable and a goal to have pleasurable sex, then we can teach techniques to help decrease the tissue sensitivity pre-sexual activity.

As in all physical therapy issues, there is no "one-size-fits-all" prescription. It is all based on individual symptoms and assessment.

Vulvodynia sometimes is never "cured" but rather "managed" and many of the clients we see manage it quite well. They go on to have pleasurable intercourse, pregnancy and vaginal delivery. These are often quite huge fears that we have to work through, but I want you to know there is hope and there is help.

Call or email the office if you would like help for this condition. Also, check out the National Vulvodynia Association for more information (

PS: If you don't have an official diagnosis of vulvodynia, but suspect this is what you have, PT can help. I'm not into labels and names and diagnoses because no matter what name is or isn't given to your symptoms and condition, we will do our own examination and treatment based on what we find.

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