Vulvodynia is a condition characterised by chronic pain, burning, or discomfort in the vulvar area — the external female genitalia — that lasts three months or longer without an identifiable infection, skin condition, or other obvious cause. It is far more common than most women realise, affecting approximately 1 in 6 women at some point in their lives, yet it remains significantly underdiagnosed. Many women are dismissed, told the pain is psychological, or cycle through multiple providers before receiving an accurate diagnosis. At THE FIT CLINIC, we take this condition seriously and offer a structured, specialist approach to assessment and care.
Vulvodynia presents in two main forms. Generalised vulvodynia involves pain spread across the entire vulvar region and may be constant or intermittent, triggered by touch or occurring spontaneously. Localised vulvodynia, particularly vestibulodynia, affects a specific area — most commonly the vestibule, the tissue at the vaginal opening — and is typically provoked by pressure, penetration, tampon insertion, or prolonged sitting. The pain itself is often described as burning, stinging, rawness, or a feeling of irritation that does not resolve. Many women with vulvodynia also experience secondary effects including difficulty with intercourse, reduced sexual desire, anxiety around intimacy, and impact on daily activities and quality of life.
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WhatsAppLINEThe exact causes of vulvodynia are not fully understood, but research points to a combination of contributing factors. These include alterations in nerve density or sensitivity in the vulvar tissue, hormonal influences particularly related to changes in oestrogen levels, a history of recurrent yeast infections or other inflammatory episodes, pelvic floor muscle dysfunction where the muscles are overactive or in chronic spasm, genetic predisposition, and in some cases, prior trauma or psychological factors that sustain the pain response. Crucially, vulvodynia is not caused by sexual activity, poor hygiene, or any behaviour of the patient — a misconception that causes unnecessary shame and delays in seeking care.
Diagnosis at THE FIT CLINIC begins with a thorough consultation including a detailed history of your symptoms, pain patterns, and any previous treatments. A careful physical examination — including a standardised cotton-tip test to map the location and severity of vulvar sensitivity — confirms the diagnosis and identifies whether pelvic floor dysfunction is a contributing factor. This assessment guides a personalised treatment plan. Management of vulvodynia is multifaceted. Depending on your presentation, options may include topical lignocaine or compounded oestrogen cream to reduce localised nerve sensitivity, pelvic floor physiotherapy to release chronic muscle tension, low-dose tricyclic antidepressants or anticonvulsant medications that act on pain pathways, trigger-point injections including botulinum toxin for vestibulodynia, and psychological support to address pain-related anxiety. For carefully selected cases with vestibulodynia that has not responded to other treatments, minor vestibulectomy may be discussed.
If you have been living with unexplained vulvar pain, burning, or discomfort that makes intimacy, daily activities, or gynaecological examinations difficult, you deserve a proper evaluation and a compassionate plan of care. Vulvodynia is not in your head — it is a recognised medical condition, and care is available. Book a consultation at THE FIT CLINIC Bangkok and take the first step with an assessment.