When Sex Hurts, It Could Be Vulvodynia

"Vulvo-whatia?"said Carrie Bradshaw on HBO’s Sex and the City, when her friend Charlotte was diagnosed with vulvodynia—defined as otherwise unexplained pain, itching, and burning of a woman’s exterior genitals. A 2006 study quoted by the National Institutes of Health's Office of Research on Women's Health estimated that as many as 18% of women experience symptoms consistent with the condition.

Many doctors haven’t even heard of the diagnosis either. In a 2003 Harvard Medical School study of more than 3,000 women, 60% of women who sought treatment ended up seeing three or more doctors, and 40% of women who sought treatment never received a diagnosis. That’s why the NIH launched a vulvodynia awareness campaign October 24, 2007.

"It’s a life-altering pain condition," says Christin Veasley, a former sufferer who was almost completely cured with surgery and is trying to bring more awareness to the condition as associate executive director of the National Vulvodynia Association.

Most common cause of sexual pain
According to Irwin Goldstein, MD, director of San Diego Sexual Medicine and the editor in chief of The Journal of Sexual Medicine, vulvodynia is the most common cause of sexual pain in premenopausal women.

There are different subtypes of vulvodynia. Some women experience pain only with touch or penetration (such as with a tampon, penis, or speculum). Others experience pain all the time—even wearing pants is painful. Some have always experienced pain with vaginal penetration, from the very first tampon, while the pain didn’t start for others until later in life.

The reasons for it vary from woman to woman—when there is any explanation at all. Some have an overgrowth of nerves in the genital area, for instance, while others may develop the issue after an allergic reaction. Also, "an infection can be a trigger for some women," says Veasley.

Experts agree on two things: It’s not primarily psychological, and although it's rarely cured, it is often treatable.