Vulvodynia: Understanding Vulval Pain and How Traditional Chinese Medicine May Help
Vulvodynia is a chronic pain condition affecting the vulva, the external area surrounding the vaginal opening.
Although it can significantly affect comfort, relationships, intimacy and everyday life, vulvodynia is still a condition that many people know very little about.
Importantly, the pain is real even when there are no visible changes to the skin and medical tests do not identify an obvious underlying cause.
What Is Vulvodynia?
Vulvodynia is generally defined as vulval pain that has lasted for at least three months without a specific identifiable cause.
The discomfort may affect the entire vulva or be concentrated in a particular area, such as around the vaginal entrance.
Pain may be constant, come and go, or be triggered by touch or pressure.
It can feel like:
Burning or stinging
Soreness or rawness
Throbbing
Sharp or stabbing pain
Increased sensitivity
Pain during sexual intercourse
Pain when inserting a tampon
Discomfort when sitting
Pain or irritation when wearing tight clothing
Living with persistent vulval pain can also affect sleep, concentration, exercise, intimate relationships and emotional wellbeing.
What Causes Vulvodynia?
The exact cause of vulvodynia is not completely understood.
Research suggests that several factors may be involved, including:
Increased sensitivity or irritation of the nerves
Previous vaginal infections
Hormonal changes
Pelvic-floor muscle dysfunction
Changes in the way the nervous system processes pain
Stress and muscle tension that may increase the experience of existing pain
There is not always one single cause, which is why treatment often needs to be individualised.
Why Medical Assessment Is Important
Persistent or recurring vulval pain should always be assessed by an appropriate healthcare professional.
Before vulvodynia is diagnosed, other possible causes of vulval discomfort may need to be investigated, including:
Thrush or other vaginal infections
Sexually transmitted infections
Vaginal dryness
Hormonal changes
Vulval skin conditions
Lichen sclerosus
Dermatitis
Pelvic-floor problems
Other gynaecological conditions
If you experience persistent, recurring or unexplained vulval pain, speak with your GP, gynaecologist or specialist vulval clinic.
How May Traditional Chinese Medicine Support Someone With Vulvodynia? Understanding Vulval Pain
Traditional Chinese Medicine takes an individual, whole-person approach to health.
From a TCM perspective, symptoms are considered alongside the person's overall health, lifestyle, emotional wellbeing and individual pattern of imbalance.
A consultation may therefore consider more than the location of the pain.
Depending on the individual, a practitioner may also ask about:
Menstrual health
Digestion
Sleep
Energy levels
Stress
Emotional wellbeing
Temperature sensations
Other areas of pain or tension
A personalised treatment plan can then be developed according to the individual's presentation.
TCM should be considered a complementary approach and should not replace appropriate medical assessment or treatment.
Acupuncture and Vulvodynia
Vulvodynia: Understanding Vulval Pain and How Traditional Chinese Medicine May Help
Acupuncture involves inserting very fine needles into carefully selected points on the body.
Within Traditional Chinese Medicine, acupuncture is traditionally used to support the smooth movement of Qi and Blood and to address the individual's underlying TCM pattern.
From a modern pain-management perspective, researchers are also investigating how acupuncture may influence the nervous system and the body's natural pain-modulating mechanisms.
Early research suggests that acupuncture may help some people manage vulvodynia-related pain, including pain during sexual intercourse.
However, research is still developing and acupuncture should not be presented as a cure for vulvodynia.
Instead, it may be explored as one part of a wider, multidisciplinary approach to managing persistent pain.
Traditional Chinese Herbal Medicine
Traditional Chinese Herbal Medicine may also be considered as part of an individualised TCM treatment plan.
Herbal formulas are traditionally selected according to the person's individual TCM pattern, rather than simply being prescribed because someone has a diagnosis of vulvodynia.
For example, a TCM assessment may identify patterns described in traditional terminology as Heat, Dampness, Qi and Blood stagnation, or deficiency. The herbal approach chosen will depend on the person's overall presentation.
Chinese herbal formulas may be prescribed internally or, in some circumstances, herbs may be prepared for external use.
It is important that herbal remedies are professionally selected because herbs may interact with prescription medicines, supplements or existing medical conditions.
Always tell your practitioner if you:
Take prescription or over-the-counter medicines
Use other herbal remedies or supplements
Have allergies
Are pregnant or breastfeeding
Have liver, kidney or other significant medical conditions
Herbal medicine should complement appropriate medical care rather than replace it.
Herbal Sitz Bath and External Steam Therapy
Within Traditional Chinese Medicine, an herbal sitz bath may sometimes be recommended as an external therapy.
A sitz bath involves preparing selected herbs in warm water and allowing the external vulval and pelvic area to come into gentle contact with the herbal preparation.
From a traditional TCM perspective, different herbal combinations may be selected according to the individual's pattern, with the intention of soothing the area and addressing patterns traditionally described as Heat, Dampness or stagnation.
Some TCM practices also use a carefully controlled herbal steam treatment before or alongside a sitz bath.
However, the vulval area is extremely sensitive. Steam must never be excessively hot or applied in a way that could burn the skin. Direct vaginal steaming over boiling water is not recommended.
Herbs or other preparations should also never be inserted inside the vagina unless specifically prescribed as an appropriate licensed medical treatment by a qualified healthcare professional.
For someone experiencing vulvodynia, even normally gentle products can sometimes aggravate sensitive tissue. For this reason, herbal sitz baths or external steam treatments should only be considered following an individual assessment.
If an herbal preparation causes increased burning, itching, redness, swelling or discomfort, stop using it and seek appropriate advice.
Scientific evidence specifically supporting herbal sitz baths or steam therapy for vulvodynia is currently limited, so these approaches should be considered complementary TCM therapies rather than proven treatments for the condition.
Stress, Muscle Tension and the Pain Cycle
It is important to be clear that vulvodynia is not simply caused by stress and it is not “all in the mind.”
It is a genuine pain condition.
However, living with persistent pain can understandably cause stress, anxiety, disrupted sleep and fear of activities that may trigger discomfort.
In turn, this can sometimes contribute to increased muscle tension and nervous-system sensitivity.
For some people, approaches that encourage relaxation may therefore form part of their overall management plan.
These may include:
Acupuncture
Pelvic-floor physiotherapy
Gentle movement
Mindful breathing
Relaxation techniques
Counselling or psychological support
Appropriate pain-management strategies
Pelvic-Floor Tension
The pelvic-floor muscles may contribute to symptoms in some people with vulvodynia.
When these muscles remain tense or become difficult to relax, activities such as sexual intercourse, tampon insertion or prolonged sitting may become uncomfortable.
A specialist pelvic-health physiotherapist can assess the pelvic-floor muscles and provide appropriate treatment and exercises.
Acupuncture may sometimes be explored alongside pelvic-floor therapy as part of a wider treatment plan.
What About Cupping?
Cupping is another therapy used within Traditional Chinese Medicine, usually on areas such as the back, shoulders and other muscular areas.
It may be used to promote relaxation and work with muscular tension elsewhere in the body.
However, cupping should not be presented as a proven treatment for vulvodynia, and cups would not normally be applied directly to sensitive vulval tissue.
Where appropriate, a practitioner may discuss whether complementary treatment for general muscular tension or relaxation could form part of an individual's wider wellbeing plan.
Gentle Self-Care
Simple lifestyle measures may help reduce irritation and make day-to-day symptoms more manageable.
These may include:
Wearing loose-fitting cotton underwear
Avoiding scented soaps, deodorants and intimate washes
Avoiding vaginal douching
Using cool or lukewarm water rather than very hot baths
Avoiding sitting in one position for long periods
Considering pads instead of tampons if tampons cause discomfort
Using an appropriate lubricant during sexual activity
Discussing suitable emollients with a GP or pharmacist
Everyone is different, so what feels soothing for one person may not be suitable for another.
A Combined and Individual Approach
Vulvodynia is a complex condition and improvement may take time.
There is no single treatment that works for everybody.
Conventional treatment may involve several healthcare professionals, including a:
GP
Gynaecologist
Pelvic-health physiotherapist
Pain specialist
Psychologist or psychosexual therapist
Traditional Chinese Medicine may also be explored alongside appropriate medical care.
Depending on your individual assessment, a complementary TCM treatment plan at Prodigious Hands may include:
Acupuncture
Traditional Chinese Herbal Medicine
Herbal sitz bath or carefully controlled external herbal steam therapy
Cupping where appropriate
Lifestyle and self-care advice
At Prodigious Hands, we believe treatment should be personalised to the individual rather than simply treating a diagnosis.
If you have already received appropriate medical assessment and would like to explore whether Traditional Chinese Medicine may complement your current care, we can arrange a consultation to discuss your symptoms and individual needs.
Prodigious Hands
170 Swinton Park RoadSalford, M6 7PA
Telephone: 07767018021
Email: prodigioushands@hotmail.com
References
NHS – Vulvodynia (vulval pain)
Schlaeger JM et al. – Acupuncture for the treatment of vulvodynia: a randomised wait-list controlled pilot study
Spinillo A et al. – Beyond the placebo effect: a systematic review and network meta-analysis of treatment strategies for vulvodynia
Research exploring Traditional Chinese Medicine pattern differentiation in women with vulvodynia
Medical Disclaimer
This article is provided for general information and educational purposes only. It does not provide a diagnosis or replace medical advice, examination or treatment from a GP, gynaecologist or other appropriately qualified healthcare professional.
Traditional Chinese Herbal Medicine, herbal sitz baths and other complementary therapies are not suitable for everyone. Individual assessment is required before treatment.
If you experience persistent, recurring or unexplained vulval pain, please seek appropriate medical advice.
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