06/12/2026
Vulvar pain has causes.
Some of the causes we know a lot about and these are considered “specific disorders” according to the Consensus Terminology on Vulvar Pain
(2015). Others, we are learning more about and the research is not super strong on them; we lump these into “vulvodynia” and recognize that there are “potential associated factors.”
Vulvodynia has causes, we just don’t have all the research on them yet to be so definitive, but we will get there! Someday, there will be no term known as
“vulvodynia” because we will know all the causes of v***ar pain.
Here are causes and “potential associated factors” for Vulvar Pain and Vulvodynia:
Hormonal- lack of estrogen and androgens related to menopause (called Genitourinary Syndrome of Menopause), breastfeeding (Genitourinary Syndrome of Lactation), antiandrogen and antiestrogen medications (combined oral contraceptives, spironolactone, tamoxifen).
Musculoskeletal- Hypertonic/overactive pelvic floor muscles, myofascial and biomechanical causes (common with hypermobility)
Inflammatory- lichen sclerosus, lichen pla**s, plasma cell vulvitis, desquamative inflammatory vaginitis (DIV), cytolytic vaginosis (CV), Mast Cell Activation (MCAS)
Infectious- recurrent v***ar candidiasis, tinea cruris, bacterial vaginosis (BV), aerobic vaginitis (AV), ureaplasma
Nerve-related- neuroproliferation (too many nerve endings in the tissue), spinal pathology (Tarlov cyst, annular tear, disc heriation), nerve compression, nerve irritation (pudendal neuralgia, postherpetic neuralgia).
latrogenic/Trauma- postoperative pain, chemotherapy, radiation effects, hormone therapy for breast cancer, perineal tears, episiotomy, female ge***al cutting.
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