Vulvodynia in Fibromyalgia & Chronic Fatigue Syndrome

Chronic Pain in Women's External Genitalia
Vulvodynia is common in people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS).1 It's a chronic pain condition that affects the vulva, which is the external portion of the female genitalia.
Vulvodynia can have a major impact on your life. While a lot of us with FMS and ME/CFS deal with, it is not a symptom - it's a separate condition that needs to be diagnosed and treated on its own. Any source of pain has the potential to make your FMS and ME/CFS symptoms more severe, which makes proper treatment especially important.
The pain or discomfort of vulvodynia doesn't come from any obvious source. The tissues appear healthy, there's no infection, and there's no injury to blame it on. However, that doesn't mean it's not "real." How do you know it's real? Because you can feel it. Many women don't describe their discomfort as pain but as itching, burning, stinging, irritation, stabbing, and/or rawness.
Vulvodynia Symptoms
Symptoms of vulvodynia can range from mild discomfort to severe and debilitating pain. It may be only in one area or it may move around. It may be sharp or diffuse, and it may come and go.
Symptoms include:
Burning or stinging
Overall soreness
Vulvodynia can cause pain during sexual intercourse, exercise, sitting, and other aspects of daily function. Medical science has identified several types of vulvodynia, and each one has a unique set of symptoms.
Vulvodynia Causes
We don't yet know what causes this condition, but healthcare providers believe certain factors may contribute to its development, including a history of vaginal infections, past injury, hormonal changes, skin allergies or hypersensitivity. However, these factors aren't necessary for developing this condition.
Vulvodynia is not believed to be a sign of something more serious, such as cancer, and it is not a sexually transmitted disease.
Vulvodynia Diagnosis
The first step toward getting a diagnosis of vulvodynia is telling your healthcare provider what you're experiencing. That may be uncomfortable for you, but it's important to have that conversation so you can start down the path toward feeling better.
Before diagnosing vulvodynia, your healthcare provider will likely rule out other potential causes of your symptoms, such as skin conditions, bacterial or yeast infection, and other medical conditions.
Treatment and Management
A range of treatments is available to help you combat the symptoms of vulvodynia. They include:
Medications: Tricyclic antidepressants and anticonvulsants may help alleviate your pain. (They don't mean that you are depressed or that it's "all in your head.") Antihistamines (allergy drugs) may help with itching.
Topical creams: Cortisone or estrogen creams are sometimes effective.
Myofascial release: This technique can alleviate pain in the pelvic muscles, which may contribute to vulvodynia.
Antidepressants and anticonvulsants are common treatments for FMS and ME/CFS as well. Your healthcare provider can help you find the drug(s) that best fit your conditions. If you're seeing multiple practitoners, make sure each one knows what medications you are taking.
You may be able to manage symptoms by making a few changes in your daily routine, such as:
Keeping soaps and other hygiene projects away from the vulva
Wearing loose-fitting underwear (Pain from clothing is a common problem for people with FMS.)
Vulvodynia in FMS & ME/CFS
Researchers don't know exactly why vulvodynia is common in FMS and ME/CFS. However, a prominent theory is that they all share a common underlying mechanism - central sensitization.
In central sensitization, the central nervous system (brain and spinal cord) become hypersensitive to unpleasant stimuli. That can include pressure, noise, smells, and chemicals. Sometimes, it involves the skin as well.
A Word From Verywell
Women with vulvodynia can struggle with more than pain. This condition may make you feel isolated, especially if problems with sex have an impact on your relationships. Embarrassment may keep you from talking about what you're going through, which could further isolate you from other people.
You may find that some people don't believe in your vulvodynia pain, which can make you feel invalidated. That can be especially painful if it comes from your sexual partner, who may feel rejected when you avoid sex. Open communication may help you resolve hurt feelings in both of you. You may want to consider couple's counseling as well.
A 2012 study of vulvodynia and comorbid conditions showed that feelings of invalidation were worst in women who also had ME/CFS. That's not surprising since ME/CFS is poorly understood and often not taken seriously.
Like any chronic illness, vulvodynia can lead to depression. If you believe you could be depressed, talk to your healthcare provider about the treatment options that are available to you.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Arnold LD, et al. Obstetrics and gynecology. 2006 Mar;107(3):617-24. Vulvodynia: characteristics and associations with comorbidities and quality of life. doi:10.1097/01.AOG.0000199951.26822.27
Sadownik LA. Etiology, diagnosis, and clinical management of vulvodynia. Int J Womens Health. 2014;6:437-49. doi:10.2147/IJWH.S37660
National Vulvodynia Association. What causes vulvodynia?
Cleveland Clinic. Vulvodynia: management and treatment.
Fleming KC, Volcheck MM. Central sensitization syndrome and the initial evaluation of a patient with fibromyalgia: a review. Rambam Maimonides Med J. 2015;6(2):e0020. doi:10.5041/RMMJ.10204
Nguyen RH, Ecklund AM, Maclehose RF, Veasley C, Harlow BL. Co-morbid pain conditions and feelings of invalidation and isolation among women with vulvodynia. Psychol Health Med. 2012;17(5):589-98. doi:10.1080/13548506.2011.647703
Additional Reading
Arnold LD, et al. American journal of obstetrics and gynecology. 2007 Feb;196(2):128.e1-6. Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study. doi:10.1016/j.ajog.2006.07.047
Carter JE. Surgical treatment for chronic pelvic pain. JSLS. 1998;2(2):129-39
Hartmann D, Strauhal MJ, Nelson CA. Treatment of women in the United States with localized, provoked vulvodynia: practice survey of women's health physical therapists. J Reprod Med. 2007;52(1):48-52.
Smith HS, Harris R, Clauw D. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome. Pain Physician. 2011;14(2):E217-45.