Understanding Vulvodynia: How Physical Therapy Can Help

Vulvodynia is a chronic pain condition that affects the vulva – the external part of the
female genitalia and can have a profound impact on a person’s quality of life. Often
misunderstood, misdiagnosed, or dismissed, vulvodynia can feel like a frustrating
mystery for those living with it. Fortunately, awareness is growing, and one of the most
effective, non-invasive treatment options is pelvic floor physical therapy.

What is vulvodynia?

Vulvodynia is defined as vulvar pain lasting three months without an identifiable cause.
The pain can be constant or intermittent, provoked by touch (like during intercourse,
tampon use, or even sitting), or occur spontaneously. Common symptoms include:
- Burning, stinging, or rawness
- Throbbing or aching sensation
- Irritation or itching
- Pain during intercourse

While the cause of vulvodynia isn’t fully understood, potential contributing factors
include:

- Nerve injury or irritation
- Pelvic floor muscle dysfunction
- Inflammatory conditions
- Hormonal changes
- Past infection or trauma
- Psychological factors like stress or anxiety

What is the role of the pelvic floor?

The pelvic floor is a group of muscles that support the pelvic organs and help control
bladder, bowel, and sexual function. When these muscles are too tight, weak, or not
functioning in a coordinated way, they can contribute to pain, including vulvar pain.
In vulvodynia, the pelvic floor muscles often become overactive or tense in response to
chronic pain or to protect the area. This creates a cycle of pain and muscle guarding
that worsens symptoms.

How can physical therapy help?

Pelvic floor physical therapy can focus on the muscles, ligaments and tissues in the
pelvic region. For people with vulvodynia, this can be a game-changer. PT can help with
muscle relaxation and re-training, reducing overactivity or tension in the pelvic muscles.

Techniques such as manual hands-on therapy, biofeedback, and breathing exercises
teach the muscles to relax and function normally. Trigger point release can assist with
relaxing any tension in these areas, as well as reduce referred pain. Desensitization
techniques and graded exposure exercises reduce hypersensitivity in the vulvar area.
This can help retrain the nervous system and decrease pain response over time.

A physical therapist can also guide you through posture, movement patterns, and daily
habits that might be aggravating your symptoms, such as prolonged sitting, clothing
choices, or hygiene products. Strengthening based exercises can create stability for the
body and promote long term longevity. Empowering patients with knowledge and
comprehensive home exercise programs are a key part of the healing process.
Because vulvodynia can be complex, physical therapists often work as part of a
multidisciplinary team, including gynecologists, pain specialists, psychologists, and
dermatologists. Pelvic floor physical therapy fits seamlessly into this holistic approach.

What should you expect during a session?

Your first visit will typically include a detailed history, discussion of symptoms, and an
assessment that may include internal and external examination of pelvic floor muscles
(always with your consent). Treatment plans are tailored to your needs and comfort
level and progress at a pace that feels safe for you.

Final Thoughts and Resources

Living with vulvodynia can be isolating, but you are not alone, or without options. Pelvic
floor physical therapy offers a safe, evidence-based approach that addresses the root
causes of pain, rather than just the symptoms. With time, patience, and a supportive
care team, many people with vulvodynia experience significant relief and a renewed
sense of control over their bodies and their lives.

- National Vulvodynia Association (NVA) – www.nva.org
- International Pelvic Pain Society – www.pelvicpain.org

Book with one of our pelvic health specialist