VULVODYNIA

curvy separator line

Vulvodynia is chronic pain or discomfort in the vulva, the outer region of the female genitals, lasting three months or longer without a clear identifiable cause. It can affect women of any age, from teenagers to women in their seventies, and often disrupts daily activities, intimacy, and quality of life.

At Singapore Paincare, our specialists provide minimally invasive treatments that aim to relieve pain safely and effectively, offering an alternative to long-term medication or surgery, often with little to no downtime. Our goal is to help you get back to your daily life with comfort and confidence.

Female Genital Pain Vulvodynia

How Common Is Vulvodynia in Singapore?

Vulvodynia is more common than most women realise. A large US population-based study estimated that up to 16% of women may experience vulvar pain consistent with vulvodynia at some point in their lives (Harlow & Stewart, American Journal of Obstetrics and Gynecology). Despite how common it is, the condition remains under-discussed and under-diagnosed. Research shows that about half of women with symptoms never seek treatment, often because they are unsure whether their pain is “normal” or because previous doctors have found nothing wrong on examination.

There is no large-scale local prevalence study specific to Singapore. Women here are encouraged not to rely on regional estimates alone and to have persistent vulvar pain assessed by a doctor, since early evaluation makes management easier.

What Causes Vulvodynia?

Information about the causes of vulvodynia is still limited. Suspected contributing factors include:

  • Inflammation
  • Nerve injury or irritation (neuropathic problems)
  • Hormonal changes
  • Musculoskeletal problems, such as pelvic floor muscle tension
  • Genetic factors

Hormonal creams applied to the vulva have been tried by some patients, with limited success. Vulvodynia is also not uncommon among women going through menopause.

What Are the Symptoms of Vulvodynia?

Pain

Vulvodynia usually develops gradually. It may start as mild pain during sexual intercourse and progress into constant discomfort that interferes with daily life. Patients describe the pain as burning, soreness, stinging, throbbing, or a general rawness in the area. Many cases have nothing to do with intercourse at all — everyday activities like sitting or walking can trigger significant pain.

Redness or swelling

Some women show visible signs on physical examination, such as redness or swelling of the vulva. In many cases, however, there are no visible physical signs at all, even though the pain is real.

Other symptoms

Pain may also be localised to one specific spot, triggered only when the area is touched, or occur specifically during intercourse.

How Is Vulvodynia Diagnosed?

At Singapore Paincare, our primary care doctors and pain specialists work together with a gynaecologist to conduct a thorough diagnosis. This typically includes:

  • A physical examination
  • A detailed discussion of your symptoms
  • A review of your medical history

What Treatment Options Are Available for Vulvodynia?

In many cases, non-surgical treatment can help manage vulvodynia effectively. At Singapore Paincare, our specialists focus on identifying the exact cause of your pain before recommending a treatment plan, since vulvodynia can stem from different underlying factors in different patients. Once the likely cause has been identified, our approach is to start with the least invasive option appropriate for each patient. Treatment may combine targeted injections and minimally invasive procedures with pharmacological treatment and rehabilitative therapy, with the aim of improving function and reducing the chance of pain returning.

Non-Surgical Treatments for Vulvodynia

Pelvic floor therapy

This approach helps release tension in the muscles that support the uterus, bladder, and bowel. Techniques such as Kegel exercises and superficial perineal massage may help reduce vulvodynia-related pain for some patients.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) may help with nociceptive vaginal pain. However, many cases of vulvodynia do not have an inflammatory component, so NSAIDs may not improve symptoms for every patient.

Pharmacotherapy

Beyond NSAIDs, other medications used to manage vaginal pain include anticonvulsants, antidepressants, antivirals, and antifungals. Alpha-blockers and antibiotics may also be considered if a bacterial cause is suspected. Antihistamines or lidocaine ointments may be used to help reduce sensitivity.

Estrogen replacement therapy

For perimenopausal and postmenopausal women with vulvodynia, treatments that support estrogen levels may offer short-term relief of menopausal symptoms alongside potential benefit for vulvodynia.

Biofeedback psychotherapy

This approach uses relaxation techniques, sometimes with the aid of electric leads, to guide patients into a relaxed state. Combined with psychotherapy, it may help reduce heightened attention to pain in the vulva over time.

Desensitisation of the pelvic nerve plexus

Pulsed radiofrequency desensitisation of the sacral plexus nerves (S2 to S4) has been used to help “quieten” the nerves supplying the vulva, reducing transmission of pain signals. This may help break the pain cycle and reduce central sensitisation over time.

Surgical Treatment for Vulvodynia

If non-surgical methods have been fully explored without sufficient relief, surgery may be considered for suitable candidates. As with any surgery, there are associated risks, potential complications, and recovery time to weigh carefully.

Vestibulectomy

This procedure removes the specific area of tissue causing localised pain and may be an option for patients who have not responded well to other treatments. The decision should be made only after carefully weighing the risks and potential benefits with your specialist.

How Can I Manage or Reduce Vulvodynia Symptoms?

There is currently no known way to fully prevent vulvodynia, since the causes are not completely understood. However, the following steps may help reduce discomfort:

  • Avoid tight clothing and pantyhose
  • Wear 100% cotton underwear
  • Avoid activities that put pressure on the vulva, such as cycling or horseback riding
  • Manage stress levels
  • Get adequate sleep
  • Wash the area with plain water only

A Message About Vulvodynia From Our Pain Specialist

Vulvodynia is a painful condition that many women live with in silence. After a physical examination and scans such as MRI or CT, results often come back normal, with no visible abnormality. Because of this, some women are told their pain is psychological or that they are being overly sensitive.

In most cases, vulvodynia is a neuropathic pain condition: the nerves in the area become hypersensitive due to causes ranging from hormonal changes to nerve impingement or muscle spasm. A useful comparison is a sensitive tooth that causes pain despite no decay, crack, or gum disease being present on examination.

Loading...

Frequently Asked Questions 

There is no dedicated local prevalence study, but international research suggests vulvar pain consistent with vulvodynia may affect up to 16% of women at some point in their lives. It affects women of all ages, not just older women.

No. Vulvodynia is chronic vulvar pain without a clear identifiable cause, typically lasting three months or more. A yeast infection is a specific, treatable infection. A doctor can help distinguish between the two through examination and history.

Some women experience improvement over time, particularly with treatment. Because the underlying cause varies from person to person, it’s best to consult a pain specialist to understand what may be contributing to your symptoms.

No referral is required. You can consult our pain specialists directly to discuss your symptoms and possible next steps.

No. While pain during intercourse is a common symptom, many women with vulvodynia experience pain during everyday activities such as sitting or walking, unrelated to sexual activity.

References

  1. Reed BD, et al. Prevalence and demographic characteristics of vulvodynia in a population-based sample. American Journal of Obstetrics and Gynecology. Available via PMC (National Institutes of Health).
  2. Harlow BL, Stewart EG. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from two geographic regions. American Journal of Obstetrics and Gynecology. Available via PMC (National Institutes of Health).
  3. Ministry of Health / Health Sciences Authority — Advertisement Controls of Health Products, and Singapore Medical Council Ethical Code and Ethical Guidelines (2016 Edition) — used as compliance references for this content.

Last Updated July 2026