Vulval pain: vulvodynia

Vulvodynia is defined as pain or discomfort of the vulva usually present for at least 3 months, without an identifiable medical cause. It can have a significant impact on the physical and psychological well-being of affected women. It should be considered within the differential diagnosis in a number of gynaecological presentations, including superficial dyspareunia, apparent persistent/recurrent candidiasis and chronic vulval symptoms such as discomfort and itch. Although vulvodynia is widely considered to be an idiopathic pain syndrome and a diagnosis of exclusion, research continues into its pathogenesis. There is no ‘one-size-fits-all’ approach to treatment; successful management often relies upon a multimodal and multidisciplinary approach. Despite its high prevalence, vulvodynia remains a poorly recognized condition, and women often experience barriers in accessing diagnosis and treatment. Promoting increased awareness of vulvodynia among clinicians and the wider public is therefore an important endeavour.