Vestibulodynia & Pelvic Floor Control: Why Neuromotor Research Is Changing the Conversation

Inline with the London Vulva Pain Clinic bringing readers up to date with the latest breakthroughs and news on various pain conditions, our Vulva Doctors would like to tell you about a new neurophysiological study which suggests that pelvic floor control could hold the key to understanding and treating vestibulodynia.

The Low-Down on Neuromuscular Studies & Vulvodynia

Research within these fields indicate that vulvodynia incorporates neurological transformations. These comprise:

  • Elevated nerve density
  • Functional alterations within brain pain pathways
  • Possible neuro-inflammation as a result of suboptimal pelvic ligaments arousing specific nerves

As our Vulva Consultants regularly explain: this aforementioned neurological dysregulation is frequently entangled with dysfunction of the pelvic floor. In this scenario, heightened muscular tension has been shown to aggravate symptoms of vulvodynia. However, there is light at the end of the tunnel. – A multidimensional approach (as facilitated by our Vulva Doctors who provide patients with a Holistic Personalised Treatment Plan), combines treatments such as trigger point injections, nerve blocks, pelvic floor physical therapy, and if required, solutions to address ligamentous laxity.

Did You Know?

“Chronic pelvic pain (CPP) affects 26% of the female population all over the world. Due to its complex etiology, it poses a major challenge to health care providers [unless they are Vulva Pain Doctors]. Many times, due to limited availability of neurodiagnostic tests, patients with neurological cause of pelvic pain are often missed” [1].

Understanding Neuromotor Functioning

The interconnected workings of PFMs (pelvic floor muscles) and their connected organs, serve as a crucial pre-requisite that ensures females can:

  • Experience orgasm
  • Micturate
  • Defecate
  • Be continent of urine, and
  • Be continent of faeces [2]

However, the aforementioned points are reliant on intricate neurological control. The latter of which involves genetically-ascertained patterns of activation involving voluntary reflexes and muscle actions – thus empowering a precise interaction of autonomous and skeletal muscle structures and linked organs [2].

So What Are the Neuromotor Facets of Vulvodynia?

  • Central Sensitization – brain imaging reveals transformation in brain activity and connectivity in regions linked to pain processing
  • Neural Sensitization – research indicates elevated nerve density and vulva tissue containing higher than optimal sensitive nerve endings
  • Neuroinflammation – it is thought by some Vulva Doctors and others, that vulvodynia may be a neuro-inflammatory pain syndrome caused by weakened uterosacral ligaments. – The latter of which drive the mechanical stimulation of pelvic nerves – a scenario which results in heightened sensitivity and the proliferation of nerve fibres [2]

Research Backs Trigger Point Injections, Nerve Blocks & Pelvic Floor Therapy

A recent important study concludes: “results indicate that a six-week treatment consisting of once-weekly ultrasound-guided pelvic floor musculature trigger-point injections & peripheral nerve blocks combined with once-weekly pelvic floor physical therapy was very effective at relieving pain & improving function for patients with Vulvodynia. Significant reductions in opiate use, emergency room visits, & pain interference at work were observed following treatment” [3]. And this along with other research studies is why all of these treatments (which are conducted by our Vulva Doctors), have such a good success rate

Getting Your Vulva Pain Sorted

Our world-class Vulva Pain Doctors can be consulted either in-person at our Harley Street London Vulva Clinic, or via an online appointment.

References

[1]. Gupta et al.,(2025). “The role of Pelvic neurophysiology testing in evaluating a neurological cause for Chronic Pelvic Pain in Females.” ICS.

https://www.ics.org/2025/abstract/515

[2]. Vodušek, D.B. (2008). Neural Control of Pelvic Floor Muscles. In: Baessler, K., Burgio, K.L., Norton, P.A., Schüssler, B., Moore, K.H., Stanton, S.L. (eds) Pelvic Floor Re-education. Springer, London.

https://doi.org/10.1007/978-1-84628-505-9_2

[3]. Shrikhande et al., (2024). “Significant Improvement Noted in Vulvodynia when Pelvic Neurogenic Inflammation is Addressed.” Auctores. https://www.auctoresonline.org/article/significant-improvement-noted-in-vulvodynia-when-pelvic-neurogenic-inflammation-is-addressed

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