How Do You Diagnose Vulvodynia?

“The nerve endings in the skin of the vulva appear to become over-sensitive & send abnormal signals which are felt as a sensation of pain. Stress can make it worse. It is thought to affect about 15 in 100 women. It is not contagious or related to hygiene or hygiene products. Vulvodynia is one type of ‘complex regional pain syndrome’, others including migraine & fibromyalgia” [1]

Vulvodynia is a long-term pain condition of the vulva, which involves feeling pain for three months or more. This pain does not have a clear cause, and it affects women’s lives in very negative ways,as they have to cope with the consequences, such as sexual dysfunction [2].

“Before diagnosing Vulvodynia, your Pain Specialist will ask you detailed questions about where your pain hurts, when it hurts, & what the level of your pain is. They will also discuss your medical, sexual & surgical history, including pain characteristics and any accompanying bowel, bladder, or sexual problems, in order to understand the location, nature and extent of your symptoms” [2,3]

What happens during a diagnosis?

Vulvodynia is diagnosed by ruling out other conditions which could be generating the pain. Your Pain Specialist, who should be chosen for having expertise in field of Vulvodynia, will employ various diagnostic exams and tools. This includes giving you a pelvic exam if you are experiencing pelvic pain or any other gynaecological symptoms, such as urinary problems, abnormal vaginal discharge, skin changes, or unusual vaginal bleeding. Generally speaking, a pelvic exam only takes less than 30 minutes – yet it allows your Pain Specialist to check for any abnormalities in your pelvis, cervix, ovaries, vulva, vagina, uterus and rectum; and, for the purpose of ruling out an active skin disorder or infection, lets them carefully examine secretions from the vulva and vagina [2].

Assessing Your Pelvic Floor Muscles

Your pelvic exam will also incorporate evaluating your pelvic floor muscles, thus helping to pinpoint any other areas of pain.

Routine Cultures & Hormonal Testing

Routine cultures for bacterial and yeast infections are also taken. Moreover, your Pain Specialist may take a blood test to determine your levels of oestrogen, progesterone and testosterone. Further, “your Pain Specialist will likely perform a cotton-swab test. During the test, gentle pressure is applied to various vulvar sites, and you are asked to rate the severity of the pain. If any areas of skin appear suspicious, your Pain Specialist may examine them with a magnifying instrument or take a biopsy of the area” [4].


[1]. British Association of Dermatologists Patient Information Leaflet updated September 2012, reviewed September 2018 .
[2]. The Mayo (2020). “Vulvodynia, Diagnosis”
[3]. NIH (2017). “How do health care providers diagnose vulvodynia?”
[3]. Vulvodynia Association (2021). “Diagnosis.”