People with vestibulodynia experience pain at the entrance of their vagina (vestibule). It’s a form of vulvodynia, which causes chronic pain in the vulva. Pressure on the vulva from sex, tampons or a pelvic exam causes provoked vestibulodynia, the most common type of localized vulvodynia. Medications and nonmedicinal treatments can ease pain.
Vestibulodynia is pain that occurs at the entrance (vestibule) to your vagina. Pain may also occur in other external parts of your genitals or vulva. Vestibulodynia is a form of vulvodynia or serious and long-lasting (chronic) vulvar pain that occurs for no known reason. Your healthcare provider may also use the term vulvar vestibulitis syndrome or VVS.
Your vulva is the outer part of the female reproductive system. It protects your internal reproductive organs, such as your vagina, uterus and ovaries. It also protects your urethra, the tube in your urinary system that carries pee out of your body.
Your vulva is key to your sexual response cycle and ability to achieve orgasms. It includes your:
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Vestibulodynia is a type of vulvodynia. With both conditions, you experience vulvar pain that doesn’t have an apparent cause.
There are two types of vulvodynia:
Provoked vestibulodynia refers to pain that occurs when there’s pressure on your vaginal vestibule. The pressure “provokes” or brings on chronic pain that lasts for at least three months. This pressure or provoked pain may occur from:
Types of provoked vestibulodynia include:
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As many as 1 in 4 women and people assigned female at birth experience a type of vulvodynia or unexplained vulvar pain at some point in their lives. In most cases, the pain comes from outside pressure or touch (provoked).
The actual incidence of vulvodynia may be higher as some people may be too embarrassed to talk about the problem with their healthcare providers. Others may not seek care because they think the problem is untreatable and something they must live with.
Experts aren’t sure why certain people experience vestibulodynia. It’s possible that some people have a greater number of pudendal nerves in the vulva area. Your pudendal nerves send messages of pain and pleasure to your nervous system.
Some people experience neuroproliferation (also called neuroproliferative vestibulodynia). Their pudendal nerves are hypersensitive to sensations of light touch (allodynia) and pain (hyperalgesia). Neuroproliferation may be congenital or develop as the result of nerve injuries or irritation (acquired).
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Anyone with a vagina can develop vestibulodynia, although the condition is most common among sexually active white and Asian people between the ages of 20 and 40. The condition is also more common among people in menopause who experience vaginal dryness and vaginal atrophy.
You may be more prone to vestibulodynia if you have:
Vestibulodynia causes neuropathic (nerve) pain that lasts for at least three months. The pain may be constant or it may come and go (intermittent).
Symptoms of vestibulodynia include:
Some people with vestibulodynia also have:
There isn’t a diagnostic test for vestibulodynia. Your healthcare provider will assess your symptoms. During a pelvic exam, your provider may use a cotton swab to apply gentle pressure to various areas of the vulvar area while you rate your level of pain or discomfort.
You may also get one or more of these tests to diagnose or rule out other problems:
Although vestibulodynia affects your genitals, it isn’t necessarily a gynecologic problem. You may see various specialists for treatment, including:
Treatments for vestibulodynia focus on easing pain and managing symptoms.
Nonmedicinal treatments for vestibulodynia include:
Medicinal treatments for vestibulodynia include:
Some people with provoked vestibulodynia who don’t respond to treatments benefit from surgery to remove sensitive skin and tissue. This surgery (a vestibulectomy) provides permanent symptom relief in many cases.
These steps for vulvar care can prevent and ease vulvar pain:
Chronic pain from vestibulodynia can be extremely uncomfortable and life-disrupting. The condition can affect your ability to exercise and even do things like sit for an extended period of time.
Vestibulodynia can also lead to sexual dysfunction. It can affect your ability to enjoy sex and may negatively impact your relationships and self-confidence. You and your partner may benefit from talking to a therapist, such as a couples therapist or sex therapist.
Vestibulodynia often improves over time (remission). Unfortunately, the vulvar pain also tends to come back (relapse). It’s important to follow your healthcare provider’s recommendations to prevent and minimize vulvar pain.
You should call your provider if you experience:
You may want to ask your healthcare provider:
No. There’s no known link between vestibulodynia and STDs. However, some STDs like chlamydia and gonorrhea cause similar symptoms like a painful, burning sensation. You should see your healthcare provider to determine the cause of these symptoms and get proper treatment.
A note from Cleveland Clinic
Vulvar pain from vestibulodynia is very real. Painful vaginal penetration or persistent pain in the vulvar area isn’t something you should be embarrassed to discuss with your healthcare provider. You may have vestibulodynia, a type of vulvodynia that causes chronic pain at the opening of your vagina (the vestibule). This vestibular pain often occurs spontaneously for no apparent reason. Medications and nonmedicinal treatments can help.
Last reviewed on 07/21/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy