Vulvodynia (burning vulva syndrome, vulvar vestibular syndrome or vulvar vestibulitis) is a painful condition affecting the external genitals (vulva) of sexually active women due to inflammation of the tiny lubricating glands in the skin of the vulva. The cause is unknown, but attacks sometimes follow a vaginal thrush infection.
The vulva appears normal, but there is intermittent tenderness and pain of the vulva and opening into the vagina, which is worse with pressure or friction (e.g. during sex, inserting a tampon, bike riding or tight clothing) and persists for an hour or more once triggered.
Muscle spasms in the vagina triggered by fear of pain occurring may cause vaginismus and make sexual intercourse impossible.
Patients should apply heat to the area (hot bath, warm water bottle) when pain occurs. Steroid creams may reduce inflammation and amitriptyline tablets my relax the woman and help her cope. Patients should avoid using soap in the area.
Sex can be assisted by an understanding partner, applying local anaesthetic ointment, adequate foreplay and the use of lubricants.
The condition often persists for months or years before settling spontaneously.