Vulvodynia was defined by the International Society for the Study of Vulvovaginal Disease (ISSVD) in 2003 as vulval discomfort, described as burning, stinging or irritation within the vulvovaginal region. This definition was to be in the absence of visible findings or identified clinical signs of neurological conditions. The condition can either be localised or general, with the discomfort experienced, being spontaneous or provoked by physical contact.

Other causative potential diagnosis include infections and dermatological issues. Importantly psychosexual concerns are to be ruled out as a causative nature. More often than not, the woman ends up on a long and arduous journey from General Practitioner, to Gynaecologist, onto a Physiotherapist and to a Psychologist. Too infrequently, she may be referred to a Sexologist.

Although a multidisciplinary approach is ideal to address the various often layered problems that gives rise to such a diagnosis of vulvodynia, from a retrospective clinical observation, it would be more beneficial to introduce the concept of a sexologist directly. Moreover, many women appear to be labelled with this diagnosis when in fact, it is often a complex psychosexual issue peppered with relationship difficulties.

The label of vulvodynia has the negative ability to cause increased emotional trauma, fear, anxiety and guilt. Subsequently, causing sexual problems rather than answers.

So who begins this discussion with the woman? Who opens the line of communication up to explore the layers? More importantly, why should we?

Disclosure of interest statement Nothing to Declare.