When Sex Hurts, It Could Be Vulvodynia

Vulvodynia is fairly common, but not well-known to doctors (or Carrie Bradshaw of HBO's Sex and the City). She said "Vulvo-what-ia?" 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 on 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.

Vulvodynia is a Common Cause of 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 known as generalized and localized vulvodynia. Some women experience pain only with touch or penetration (such as with the insertion of a tampon, penis, or speculum). Others experience pain all the time—even wearing pants is painful.

To further confuse diagnosis, some women might have always experienced pain with vaginal penetration, from the very first tampon use or sexual attempt. For other women, the pain might not have started until later in life.

Read more about sexual pain:

• Pain During Sex: Can Your Vagina Be Too Tight?
• 6 Sex Positions to Try if Sex Is Painful

Causes of Vulvodynia

It is difficult to determine the reasons for the disease to vary between women. Explanations are hard to come by. The pain might be neurological for women who have an overgrowth of nerves in the genital area. There could be a hormonal cause for some cases as well. Other women may develop the issue after experiencing an allergic reaction or having a general weakening of the pelvic floor. Also, "an infection can be a trigger for some women," says Veasley.

Experts do agree on two things. First, it's not primarily a psychological problem. And, secondarily, although it's rarely cured, it is often treatable.