Skip to main content

Women's health

Vulval pain

Vulval pain, burning, stinging, rawness or soreness of the external genital area, has many causes: infection, skin disease, oestrogen deficiency and nerve-related pain (vulvodynia). Persistent pain deserves systematic assessment, not another blind course of thrush cream.

Key points

The essentials at a glance.

What to look out for, who treats it, and what usually happens next.

  • Short-lived soreness with discharge is usually infection; persistent pain with a normal-looking vulva suggests vulvodynia

  • Itching with white skin changes points to lichen sclerosus or lichen planus, which need steroid treatment and follow-up

  • After menopause, oestrogen deficiency commonly causes burning and rawness that vaginal oestrogen resolves

  • Repeated negative swabs and failed thrush treatments are a signal to reassess the diagnosis, not repeat it

  • Effective treatments span skin therapy, hormonal treatment, nerve-modulating medication and pelvic floor physiotherapy

  • Ask for referral to a vulval clinic when pain persists beyond a few weeks

Understanding it

About Vulval pain.

The vulva can hurt for structurally different reasons: microbes (thrush, herpes, bacterial infection), inflammatory skin disease (lichen sclerosus, lichen planus, dermatitis from soaps and pads), hormone-deficient tissue after menopause, and sensitised nerves firing without visible damage. Each has a distinct treatment, which is why cycling through over-the-counter antifungals while the real cause advances is the most common story vulval clinics hear.

A methodical work-up, history, careful examination, swabs, and biopsy where skin change is present, sorts the causes apart, usually in one or two visits. Treatment then matches mechanism: antimicrobials for confirmed infection, potent steroids for inflammatory dermatoses, local oestrogen for atrophic tissue, and a combined nerve-pain programme for vulvodynia. In the UK you can start with your GP: on the NHS, a routine referral to a specialist clinic often means waiting 20–45 weeks or more to be seen, while a private consultant will typically see you within around two weeks, with any tests arranged soon after.

Frequently asked

Common questions about Vulval pain.

Quick, plain-English answers to what people ask us most.

  • What causes vulval pain?

    Causes include infections (such as thrush or herpes), skin conditions like lichen sclerosus, vulvodynia (chronic pain without an identifiable cause), and, less commonly, nerve-related pain or other gynaecological conditions.

  • What are the symptoms of vulval pain?

    Symptoms vary by cause but can include burning, stinging, rawness, itching, or pain during intercourse, which may be constant or triggered by touch or specific activities.

  • Is vulval pain dangerous?

    It isn't usually dangerous, but persistent or unexplained pain should be assessed to identify and treat the underlying cause, as many causes have effective treatments once correctly diagnosed.

  • Can vulval pain be treated?

    Yes, treatment depends on the cause: infections are treated with specific antimicrobial treatment, skin conditions with targeted topical treatment, and vulvodynia with a combination approach including topical treatments, pelvic floor physiotherapy, and sometimes specific pain medication.

  • How is vulval pain investigated?

    Assessment typically includes a detailed history, clinical examination, and sometimes swabs or a skin biopsy if a specific skin condition is suspected.

  • How long does treatment take to work?

    This varies considerably by cause; infections often improve within days of appropriate treatment, while chronic conditions like vulvodynia may take weeks to months of a combined treatment approach to see significant improvement.

  • Vulval pain vs vulvodynia - what's the difference?

    Vulval pain is a general term for pain in the vulval area from any cause, while vulvodynia specifically refers to chronic vulval pain lasting three months or more without an identifiable cause on examination or testing, diagnosed once other specific causes have been excluded.

  • When should I see a specialist about vulval pain, and how quickly can I be seen privately?

    See a gynaecologist or vulval specialist if pain persists or the cause isn't clear. NHS waits can be lengthy; private specialists can often see you within about two weeks.