What Happens During a Vulvar Pain Evaluation

“Persistent vulvar pain is a complex disorder that can be difficult to treat. Many women experience vulvar pain & discomfort that affect the quality of their lives. Vulvar pain can be caused by a specific disorder, or it can be idiopathic [relating to, or denoting any disease or condition which arises spontaneously, or for which the cause is unknown]. Idiopathic vulvar pain is classified as vulvodynia” [1]. Therefore, getting an accurate diagnosis from a Vulvar Pain Specialist, who can put you on a Holistic Personalised Treatment Plan, is essential

What Happens During a Vulvar Pain Evaluation?

When it comes to evaluating vulvodynia, in the first instance, after the Vulva Doctor has reviewed the patient’s medical history, and asked them various details about their symptoms, duration of pain, sexual history, allergies, previous treatments, and medical and surgical history [1]; if the consultation is on-line, then the Vulva Pain Consultant will then schedule an appointment to administer various tests in order to exclude other treatable causes which could be the root of the pain. If the vulva pain consultation is in-person, then the tests and examination will be conducted at the same time.

These tests may include one or more of the following: fungal culture, vaginal pH, wet mount, Gram stain, plus other point-of-care testing, or polymerase chain reaction testing (which can detect genetic material from a specific organism, such as a virus. This test not only detects the presence of a virus if it is active at the time of the test, it can also detect fragments of the virus even after the infection has dissipated [1].

After this, the Vulva Specialist will conduct cotton swab testing, for the purpose of identifying the areas of pain. These are classed as mild, moderate, or severe; and are differentiated between localised and generalised pain [1].

Treating Vulva Pain

Once your Vulva Pain Specialist has given you a diagnosis, they will then discuss various vulvar care measures with you; and devise a Holistic Personalised Treatment Plan, which you can get started on right away, to ameliorate your condition. This is likely to include multiple treatments, some of which are standard, and some of which are the latest cutting-edge solutions. These comprise: oral (steroids, anticonvulsants or tricyclic antidepressants, that can help reduce long-term pain), topical and injectable medications; nerve blocks; pelvic floor physical therapy; botulinum toxin; the use of stimulators, and more [1].


[1]. ACOG (2016). “Persistent Vulva Pain.”