We know vulvar pain can feel isolating and exhausting – but the fact that you’ve made it here means you haven’t given up, and that persistence is the first step toward real healing.
The term vulvodynia simply means “pain of the vulva.” It is not a single disease, but a symptom-based diagnosis describing chronic or recurrent vulvar pain that has no clear infectious, dermatologic, or malignant cause. The vulva includes the mons pubis, clitoris, labia majora, labia minora, vestibule (the entrance to the vagina), urethral opening, vaginal opening, and the Bartholin’s and Skene’s glands.
A common subset is vestibulodynia, where pain is confined to the vulvar vestibule (the tissue immediately surrounding the vaginal opening). This is often described as burning, stinging, or sharp pain at the point of penetration or even with light touch.
Vulvodynia and vestibulodynia are often called “diagnoses of exclusion”—meaning they are diagnosed once other possible causes have been ruled out. Research and clinical experience show that many cases involve pelvic floor muscle hypertonicity (overactivity), nerve sensitization, and comorbid conditions such as lichen sclerosus or inflammatory vaginitis (Goldstein et al., When Sex Hurts).
Because symptoms overlap, it’s important to distinguish these conditions from related diagnoses such as vaginismus, dyspareunia, hypertonic pelvic floor, or pudendal neuralgia (each of which we cover on their own dedicated pages).
Women with vulvodynia may experience pain that is provoked (triggered by intercourse, tampon use, tight clothing, wiping, sitting, or medical exams) or unprovoked (pain arising spontaneously without direct touch). Symptoms may include:
Vulvodynia is complex and usually multifactorial. Possible contributors include:
Many women with vulvodynia have overlapping issues – pelvic floor overactivity often develops as the body’s protective response to pain, creating a cycle that perpetuates discomfort.
At Sarton Physical Therapy, we begin with a comprehensive evaluation to ensure your symptoms are accurately understood. Vulvodynia and vestibulodynia are usually multifactorial—there isn’t always a single cause. Instead, pain can develop from a mix of influences such as pelvic floor tightness, hormonal changes, nerve sensitivity, or skin conditions.
Finding the true origin of your pain can take time and careful exploration. Think of it as detective work: together, we look at all possible contributors, rule in what’s relevant, and rule out what isn’t. Our assessments may include:
Pelvic floor physical therapy has been at the forefront of vulvodynia and vestibulodynia treatment for decades. As early as the 1990s, researchers identified pelvic floor muscle hypertonicity (overactivity) as a key driver of chronic vulvar pain. Early studies showed that techniques such as biofeedback and pelvic floor retraining could significantly reduce pain and improve sexual function (Hartmann & Sarton, 2014).
Since then, the field has advanced dramatically. Today, pelvic floor physical therapists don’t just address the muscles—we take a whole-body, multifactorial approach that considers nerves, fascia, connective tissue, and the way your pelvic floor interacts with the rest of your body.
At Sarton Physical Therapy, every plan is individualized, but common treatment strategies may include:
While we collaborate with gynecologists, dermatologists, and pain specialists when needed, our unique role is to serve as the muscle experts—identifying and treating the pelvic floor dysfunction that so often underlies vulvar and vestibular pain.
“Before starting at Sarton Physical Therapy, I had been struggling with pain for so long that I didn’t even fully realize the extent of it because it had become normal to me.
Self-referring to Sarton was a complete shot in the dark for me. I’m in my 20’s and knew nothing about pelvic floor physical therapy, but I was too nervous to go to the gynecologist and not be understood and I was desperate for answers and hoping Sarton could at least point me in the right direction. Instead, they’ve gone above and beyond. From the very beginning, I felt heard, supported, and safe.
I’ve primarily worked with Dr. Niki, who has been incredible. She listens, problem solves, and tailors care specifically to what I need. Her support and understanding have been truly life changing. I have also worked with Megan on strengthening, and she has been amazing at not only helping me exercise properly but also ensuring my pelvic floor is being strengthened and cared for in the process.
If you’re struggling with pelvic pain and feeling unsure about where to turn, I can’t recommend Sarton enough. I know how scary that first appointment can seem, but this is a place where you will be listened to, understood, and supported every step of the way. I’ve learned so much about my body and have made real progress in my healing journey, which I never thought was possible before.”
You deserve answers and relief from your pelvic pain. Our experienced team is here to guide you in reclaiming your confidence and quality of life.
