Vulvodynia

Vulvodynia is vulvar pain present for at least three consecutive months without an identifiable cause. The pain may be localized to the vestibule or more generalized, and it may be provoked by touch, penetration, tampon insertion, or pressure—or occur without an obvious trigger. The pain is real even when the vulva looks normal. Peripheral nerve sensitization can lower the threshold for pain in vulvar tissues, while central sensitization can amplify and prolong the signal within the nervous system. This nociplastic component helps explain why light touch may feel burning, cutting, raw, or disproportionate to the visible examination. Repeated pain can also produce pelvic-floor guarding, which adds muscular tenderness and makes sitting, intercourse, or examination more difficult. An experienced nurse notices the mismatch between symptom severity and visible findings without dismissing either one. “Nothing abnormal seen” is not the same as “nothing is wrong.” The assessment must measure both the pain and what the pain prevents the patient from doing. Psychological support is part of treatment because chronic genital pain can create fear, anticipatory muscle tension, sleep disruption, relationship strain, and...