Treatment for Vulvar Pain

Increasing numbers of women are seeking help for the treatment of vulvar pain with physical therapy.  Research has proposed certain factors as the cause of this condition, including a prolonged inflammatory response, chronic infection, nervous system dysfunction or pelvic muscle dysfunction.


Women who have vulvodynia describe the symptoms as burning or itching pain, or similar to having a chronic yeast infection.  Pelvic floor dysfunction is a common underlying symptom since the muscles attempt to guard, or protect the involved area due to the viscerocutaneous reflex and the complex neurological pathway to the area.  This often leads to inability to tolerate penetration or intercourse, bladder or bowel dysfunction, or both.


A gynecologist or urologist that specializes in vulvar disorders or pelvic floor dysfunction may be the first place to start in seeking help for vulvodynia.  Antiobiotics or antifungal cream may be prescribed.  Hormone levels may be tested as there is often an imbalance of testosterone and estrogen.  Dietary modifications may be recommended, such as replacing simple carbohydrates with complex carbohydrates, including whole grains and vegetables.  Supplementation with 1000 mg oral calcium citrate may also be helpful.  In addition, it may be recommended to discontinue potential irritants, such as certain soaps, perfumes, feminine deoderants and non-cotton underwear. Other treatment options may include anticonvulsant medication, pudendal nerve blocks, counseling and/or surgical excision of painful tissue.


Physical therapy may also be prescribed.  A pelvic floor assessment will be performed along with a complete exam of abdominal, pelvic and spinal function.  Treatment may include trigger point release of internal and/or external pelvic floor muscles and mobilization of pelvic and abdominal scar tissue (visceral mobilization). Relaxation techniques, vaginal dilators and core muscle re-education may also be utilized.


Physical therapists who treat vulvar pain have special training and are hard to find.  Women are often bounced from provider to provider before receiving a proper diagnosis and treatment.  This adds to the emotional stress of a person with vulvodynia.  Therapists at Healthy Core are here to treat vulvar pain and understand its complexity.  We will make every attempt to reduce the symptoms to encourage a return to a healthy and active lifestyle.