Can Vulvodynia go Away?
Vulvodynia is a chronic vulvar pain condition lasting at least three months, with no clear identifiable cause. It can feel like burning, stinging, rawness, or sharp pain around the vulva, especially the vestibule (the entrance to the vagina).
For many, the pain is provoked/triggered by touch, sex, tampon use, or tight clothing. For others, the pain is unprovoked and constant.
It affects up to 10–28% of women at some point in their lives. Despite how common it is, it’s often misdiagnosed or misunderstood. Vulvodynia can significantly affect quality of life, sexual relationships, and emotional health.
Researchers believe vulvodynia results from a combination of factors: increased nerve endings in the vulvar tissue, pelvic floor muscle dysfunction, hormonal changes, chronic inflammation, and central sensitization (an overactive pain-processing system in the brain and spinal cord).
In this blog we will explore treatment options and answer the question many of my patients ask… “Can vulvodynia go away?”
Can Vulvodynia Be Treated?
Yes! And in many cases, it can significantly improve or even fully resolve with the right approach. Because vulvodynia often involves both muscular and neurological components, multimodal treatments are recommended.
This means combining physical, psychological, and sometimes pharmacological strategies. One of the most effective and evidence-based treatments is pelvic floor physical therapy.
Pelvic Floor Physical Therapy
Pelvic floor physical therapy focuses on releasing tension, improving coordination, and restoring normal muscle function in the pelvic floor muscles which support the bladder, uterus, and rectum.
For many women with vulvodynia, these muscles are overly tight or reactive, which can worsen pain.
A 2021 randomized controlled trial by Morin et al. found that women with provoked vestibulodynia who received pelvic floor physical therapy had a significant reduction in pain from 7.3/10 to 2.7/10 on average compared to a more modest improvement from topical lidocaine use. These improvements lasted at least 6 months post-treatment.
Pelvic floor physical therapy may include:
Manual therapy to release muscle tension and trigger points
Biofeedback to retrain muscle control
Vaginal dilator training
Breathing techniques and posture correction
Education on movement and body awareness
Electrical stimulation (like TENS) to interrupt pain signaling
A 2024 systematic review confirmed these findings, showing that pelvic floor physical therapy and other rehab strategies reduced pain significantly, with a large effect size, compared to no treatment.
The Mind-Body Connection: Cognitive Behavioral Therapy and Mindfulness
Chronic pain doesn’t only affect the body, it also impacts thoughts, emotions, and behavior.
Cognitive behavioral therapy (CBT) has been shown to reduce pain intensity, sexual distress, and anxiety in women with vulvodynia. In fact, CBT has been found as effective as surgery (vestibulectomy) in long-term outcomes with fewer side effects.
Mindfulness-based CBT can help reduce fear, catastrophizing, and the emotional distress that often accompanies chronic vulvar pain. These interventions also improve outcomes when combined with physical therapy.
Medical and Alternative Treatments
Some women benefit from additional interventions, especially if pelvic floor physical therapy alone isn’t enough. These include:
Topical anesthetics like lidocaine, used nightly or before intercourse
Oral medications (e.g., tricyclic antidepressants, gabapentin) for nerve pain
Botulinum toxin (Botox) injections to reduce pelvic muscle spasm
Surgery (vestibulectomy), in very rare cases where other treatments fail
Nutritional support, though more research is needed
Every treatment should be tailored to the individual’s specific symptoms, pain pattern, and underlying factors.
Can Vulvodynia Go Away?
Yes! Many women report full remission of symptoms, particularly when starting treatment early and following a consistent care plan. Pelvic floor physical therapy is often the cornerstone of this recovery, especially when paired with home exercises and psychological support.
In a 2022 review, up to 80% of women with vulvodynia improved significantly with pelvic floor physical therapy. While results can take several months, the majority of women who stick with therapy, especially those who add CBT or medical management, see long-lasting relief.
Final Thoughts
Vulvodynia is real, distressing, and deeply personal, but it’s also very treatable. A multidisciplinary approach that includes pelvic floor physical therapy, emotional support, and personalized medical care offers the best chance of recovery.
If you’re struggling with persistent vulvar pain, don’t give up. Seek out a pelvic health specialist, ask for a referral to a trained physical therapist, and consider working with a counselor familiar with chronic pain.
Relief is possible and for many, with the right support, vulvodynia can go away.
Looking for pelvic floor physical therapy in Jacksonville Beach, FL?
If you’re looking for personalized, one-on-one sessions to address your postpartum pelvic health concerns or you are looking to get back into workouts after having a baby and don’t know where to start, we provide pelvic health physical therapy services to women in the Jacksonville Beach area.
If you’re looking for providers who will listen to you and help you get to the root cause of your pelvic concerns, we’ve got you. We’re here to help you if you’re experiencing pelvic pain, pelvic heaviness, leaking, or are pregnant/postpartum and want to continue safely working out/running/lifting during your pregnancy and get back to your sport after birth.
Get started today by booking a discovery call.
References:
Calafiore, D., N. Marotta, C. Curci, et al. 2024. “Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta‑Analysis.” Physical Therapy & Rehabilitation Journal 104 (7): pzae054.
Morin, M., C. Dumoulin, S. Bergeron, et al. 2021. “Multimodal Physical Therapy versus Topical Lidocaine for Provoked Vestibulodynia: A Multicenter, Randomized Trial.” American Journal of Obstetrics & Gynecology 224 (2): 189.e1–189.e12.
van Reijn-Baggen, D. A., I. J. M. Han-Geurts, et al. 2022. “Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy.” Sexual Medicine Reviews 10 (2): 209–230.
Bardin, M. G., P. C. Giraldo, and N. Martinho. 2020. “Pelvic Floor Biometric Changes Assessed by 4D Translabial Ultrasound in Women With Vulvodynia Submitted to Physical Therapy: A Pilot Study.” Journal of Sexual Medicine 17: 2236–2246.
Smith-Perez, M., et al. 2025. “Effectiveness of Nonpharmacological Conservative Therapies for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis.” American Journal of Obstetrics & Gynecology 232 (1): 42–71.