Healing Beyond Medicine: How Group Interventions Could Change the Game for Vulva Pain
Here at the London Pain Clinic, our Vulva Doctor’s ethos, is that: “effective management requires an inter-professional approach that prioritises the patient’s reported pain and its severity. Many women endure symptoms in silence or consult multiple clinicians without achieving pain relief. [Aside from a Vulva Pain Doctor, who orchestrates a multi-discipline approach], care for patients often involves a team of other specialists” [1].
The ‘V’ Team
This may include: “a gynaecologist with expertise in vulvovaginal health, a dermatologist, a neurologist, a urologist, and a physiotherapist specialising in women’s health” [1], a sex therapist, and psychological counselling with a cognitive behavioural therapist (who helps the patient manage their pain and distress by addressing thoughts and behaviours).
Here at the London Pain Clinic, our world-class Vulva Pain Team have always advocated and practised a multidisciplinary group intervention approach. In addition to this, we are renowned for our multi-faceted Holistic Personalised Treatment Plans. These are provided by our Pain Specialists as soon as they have established an accurate vulva pain diagnosis.
Consultations with our Pain Doctors are available both in-person and online, and once they have reviewed your medical and sexual history, and undertaken any necessary examination, scan, and tests, you can get started on your Holistic Personalised Treatment Protocol, right away. This will be regularly reviewed and adjusted according to your progress and the success of particular treatments. The latter include conventional treatment along with the latest state-of-the-art cutting-edge therapies and injectables (including pain blocker and Botox).
Top Evidence-Backed Treatments
The interventions that have the highest degree of evidence for pain reduction and/or dyspareunia (on the basis of randomised controlled or comparative effectiveness trials), include the following options:
- Multimodal physical therapy (this includes: vaginal dilators, manual therapy, education, and pelvic floor muscular exercises with or without biofeedback)
- Acupuncture
- Intravaginal TENS treatment (which is used as a single therapy)
- 5% Lidocaine ointment which is used overnight (by placing on a gauze and applying to the vulvar vestibule)
- Oral desipramine which incorporates 5% lidocaine cream
- Intravaginal diazepam tablets coupled with intravaginal TENS treatment
- Botox type A (50 units)
- Subcutaneous injection of enoxaparin sodium (low-molecular-weight heparin) [2]
As our Pain Consultants regularly explain: group interventions are providing an optimistic pathway towards the management of vulva pain. This is being achieved by decreasing emotional distress, offering educational information and guidance, and promoting patients’ coping ability via shared experiences. Moreover, such initiatives have been shown to be highly beneficial for vulva pain sufferers who are not very amenable to traditional therapies, thereby empowering them to successfully make their way through this disorder’s intricate psychological and physical elements via group-based multidisciplinary, support.
Vulva Pain Symptoms
There are two major categories of vulvodynia:
- Localised Vulvodynia: this relates to the individual experiencing pain in solely one region of the vulva, although in the majority of cases, this is at the vestibule (the opening of the vagina). The pain frequently comes about as the result of pressure on a particular area from various activities. These include: sitting for an extended period of time, inserting a tampon, and having sexual intercourse
- Generalized Vulvodynia.: describes experiencing pain in various regions of the vulva. The pain is generally continuous, with intermittent periods of relief. Symptoms can be exacerbated by various factors such as wearing tight trousers or shorts, and sitting for extended periods of time – both of which generate pressure on the vulva [3]
References
[1]. Faye RB, Mikes BA. Vulvodynia. [Updated 2025 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. As cited by the NIH.
[2]. Judith M. Schlaeger et al. (2022). Journal of Midwifery & Women’s Health
Volume 68, Issue 1 pp. 9-34. Cited by Wiley.
[3]. Mount Sinai Org (2025). “Vulvodynia.”https://www.mountsinai.org/health-library/diseases-conditions/vulvodynia