Vulvar Pain

Some older women develop chronic pain of the vulva without obvious signs of inflammation (vulvodynia). The pain occurs most commonly at the vulvar vestibule (vulvar vestibulitis). The condition is diagnosed when pain is limited to the vulva or vestibule and when usual causes of inflammation are absent on examination and testing.

The cause of vulvar pain is unknown but is thought to be due to irritation of the vulva and vestibule by substances in the urine. Treatment includes avoiding foods that contain oxalates (irritating salts formed from a strong acid called oxalic acid), such as chocolate, nuts, berries, and leafy vegetables like spinach. Calcium citrate tablets may be taken to reduce the excretion of oxalates in the urine. In addition, estrogen cream and anesthetics can be applied to the skin.