Acupuncture for Vulvodynia

A Holistic Approach to Chronic Pelvic Pain

Acupuncture for Vulvodynia

Vulvodynia is a chronic condition that affects millions of women, characterized by persistent vulvar pain that often has no identifiable cause. This pain can manifest as burning, stinging, irritation, or rawness, and it can significantly impact daily activities, intimate relationships, and overall quality of life. The journey to finding effective treatment for vulvodynia is often long and frustrating. 

Throughout my years of clinical experience, I have helped many patients with vulvodynia reduce pain and dependance on medications.  When acupuncture is used to stop the pain and reduce inflammation this provides an opportunity for the body to heal itself offering relief from pain, improvements in sexual function, and a reduction in urinary issues. 

In this article, we’ll explore how acupuncture can help manage vulvodynia, looking at its potential mechanisms, what to expect during treatment, and how it fits into a broader strategy for pelvic health. Whether you are new to acupuncture or seeking to add another tool to your vulvodynia management plan, this guide will provide valuable insights into how this therapy may offer a path to lasting relief.

Understanding Vulvodynia

Vulvodynia is characterized by chronic pain or discomfort in the vulva. The pain can be constant or intermittent and may present as burning, stinging, throbbing, or rawness. For many women, this condition becomes a persistent issue, significantly affecting their ability to engage in daily activities, exercise, or sexual intimacy.

Despite being relatively common, vulvodynia often goes undiagnosed or misdiagnosed. Studies estimate that nearly 16% of women will experience vulvar pain at some point in their lives, yet many suffer in silence due to the intimate nature of the symptoms and a lack of awareness. Women may see multiple healthcare providers before receiving a proper diagnosis, leading to feelings of frustration and isolation. This delay in diagnosis often contributes to the emotional and psychological burden associated with vulvodynia.

What to Expect During Acupuncture for Vulvodynia

Acupuncture offers a personalized and holistic approach to managing vulvodynia.

For those new to this therapy, understanding what to expect during treatment can help ease any concerns and set realistic expectations for the journey ahead.

acupuncture on belly

Initial Visit

During your first visit we will discuss your medical history, current symptoms, stress levels, and other factors that could be contributing to the pain. I will also take your pulse and look at your tongue examination, as well as push on many acupuncture points and muscles, to identify any imbalances in the body’s energy (Qi), blood flow, and tension in the muscles.

In TCM, pelvic pain is often associated with stagnation in the flow of Qi, lack of circulation of Qi, as well as an accumulation of dampness. After your examination, I will develop a customized treatment plan tailored to your specific needs, targeting the root causes of your vulvodynia.

The Treatment Plan

Acupuncture treatment typically involves a series of sessions, as its effects are cumulative. Most patients begin with sessions once or twice a week, gradually tapering to bi-weekly or monthly appointments as symptoms improve. Each session usually lasts between 45 to 60 minutes. 

The number of sessions required can vary depending on the individual and the severity of their symptoms. Some patients may notice improvements within a few sessions, while others may need ongoing treatment for several months. 

acupuncture models historic

Combining Acupuncture with Other Therapies

Acupuncture can be easily integrated into a broader treatment strategy which may include pelvic floor physical therapy, dietary changes, and herbal medicine.

Additionally, incorporating stress-reduction techniques like mindfulness, meditation, or yoga can support the benefits of acupuncture and improve overall health.

Research and Evidence on Acupuncture for Vulvodynia

While acupuncture has been practiced for centuries and is widely used to manage various types of chronic pain, scientific research on its specific effectiveness for vulvodynia is still evolving.

Studies on acupuncture’s broader application for chronic pain, neuropathic pain, and muscle tension provide valuable insights into its potential benefits for vulvodynia.

How Acupuncture Works

Acupuncture has been extensively studied for its role in pain management, including conditions like chronic pelvic pain, headaches, back pain and neuropathy (1). Acupuncture helps by modulating pain pathways, reducing inflammation, and improving blood circulation. These mechanisms are highly relevant to vulvodynia, which often involves nerve hypersensitivity, inflammation, and pelvic floor muscle dysfunction.

Pain Modulation and Nerve Function: Research suggests that acupuncture and electroacupuncture can affect the nervous system by stimulating the release of endorphins and neurotransmitters, such as serotonin and dopamine, which play key roles in pain modulation and mood regulation.(2) 

Reducing Pelvic Floor Muscle Tension: Several studies have found acupuncture effective in reducing muscle tension, particularly in the pelvic floor muscles (3). By targeting specific acupuncture points around the pelvic region, such as BL32 (Ciliao) and GB30 (Huantiao), acupuncture can help release tight muscles, decrease muscle spasms, improve overall pelvic blood flow, and calm the nerves that go to the pelvic floor. This is particularly relevant for women with vulvodynia, where muscle tightness often contributes to their pain.

Enhancing Blood Flow and Reducing Inflammation: Acupuncture has been shown to increase microcirculation in targeted areas, promoting better blood flow and reducing inflammation. For vulvodynia patients, improving circulation to the pelvic region can support healing of the tissues, calm irritated nerves, and enhance nutrient delivery to the affected areas, which may alleviate discomfort and improve tissue health over time.

Clinical Research 

A pilot study examining acupuncture for vulvodynia demonstrated promising results, indicating that acupuncture could significantly reduce vulvar pain and dyspareunia (painful intercourse) in women with vulvodynia. (4)

This study used a standardized treatment which included the following acupuncture points focused on regulating the flow of Qi, improving blood circulation, and calming the mind.

GV20 (Baihui) – Governing Vessel 20

Function: This point is often used to calm the mind, alleviate stress, and promote relaxation. It’s commonly used in treatments for neurological issues and to lift Qi, helping with emotional distress or anxiety associated with chronic pain.

CV4 (Guanyuan) – Conception Vessel 4

Function: Known for its strong influence on the reproductive system and overall vitality, CV4 is often used to nourish the body’s Qi and blood, strengthen the kidneys, and improve energy flow to the pelvic area. It’s commonly used for gynecological issues and pelvic pain.

CV2 (Qugu) – Conception Vessel 2

Function: CV2 is used to promote the circulation of Qi and blood in the lower abdomen and pelvic region. It helps in alleviating pain, regulating the reproductive organs, and addressing issues related to urinary or reproductive health.

Spleen 6 acupuncture point

LI4 (Hegu) – Large Intestine 4 (bilateral)

Function: LI4 is a powerful point for pain relief and is used to promote the movement of Qi throughout the body. It is often paired with LV3 (Liver 3) to regulate Qi flow, reduce pain, and release tension. This combination is known as the “Four Gates,” which opens energy pathways and provides pain relief.

KD11 (Henggu) – Kidney 11 (bilateral)

Function: KD11 is used to treat pelvic pain, urinary issues, and reproductive health. It strengthens kidney energy, which, according to Traditional Chinese Medicine (TCM), is closely linked to reproductive function and pelvic vitality.

ST30 (Qichong) – Stomach 30 (bilateral)

Function: ST30 is important for regulating the lower abdomen and pelvic area. It is often used for menstrual issues, reproductive health, and pelvic pain, as it promotes the flow of blood and Qi to the pelvic region.

SP6 (Sanyinjiao) – Spleen 6 (bilateral)

Function: This point is widely used in gynecological treatments and is known to affect the reproductive organs, regulate blood flow, and relieve pain in the pelvic area. It is considered a key point for issues involving the lower abdomen and is often combined with other points to treat menstrual pain, infertility, and vulvodynia.

LV3 (Taichong) – Liver 3 (bilateral)

Function: LV3 helps regulate the flow of Liver Qi, which is crucial in treating conditions associated with pain and emotional stress. This point is often used to relieve tension, promote emotional balance, and alleviate pain, especially when paired with LI4 (the “Four Gates” combination).

Results: 

Women in the acupuncture group reported less vulvar pain and reduced pain during intercourse after receiving ten acupuncture treatments over five weeks. Additionally, there was a notable improvement in overall sexual function among these participants. 

Hope for the Future

These findings support what we see in the clinic, that acupuncture offers a non-invasive and effective treatment option for managing vulvodynia symptoms.

It is my hope that research continues and improves to better understand the power of acupuncture as a treatment for vulvodynia, further research with larger samples and more rigorous designs is recommended. I would also like to see research examine different acupuncture methods and approaches that can help explore how the acupuncture community can best treat this condition. 

Mind-Body Connection: Stress Reduction and Mental Health

Stress and emotional health play a significant role in the experience of vulvodynia. Chronic pain often leads to anxiety, depression, and heightened stress levels, which can exacerbate symptoms and create a cycle of pain and tension. 

In addition to acupuncture Incorporating mindfulness practices, such as meditation or deep breathing exercises, can help manage stress and reduce the intensity of vulvodynia symptoms. Combining mindfulness with acupuncture can deepen its calming effects, supporting both mental and physical healing.

woman enjoying sunshine

Feel better, Get acupuncture

Vulvodynia is a challenging condition that affects many aspects of life, from physical comfort to emotional well-being. Acupuncture offers a holistic treatment option that addresses the underlying imbalances contributing to vulvodynia’s chronic pain.

By targeting key areas such as nerve sensitivity, muscle tension, and blood circulation, acupuncture can provide relief and promote healing. Acupuncture’s benefits extend beyond pain management helping to promote more relaxation and help with stress management. 

Acupuncture can be integrated into a broader treatment plan—incorporating pelvic floor physical therapy, mindfulness, and self-care- bringing about long-lasting relief and a better quality of life.

References: 

  1. Vickers AJ, Vertosick EA, Lewith G, et al; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005.
  2. Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014;120(2):482-503. doi:10.1097/ALN.0000000000000101.
  3. Yao L, Li F, Wang D, Sheng S. Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound. Medicine (Baltimore). 2021;100(42). doi:10.1097/MD.0000000000027236.
  4. Schlaeger JM, Xu N, Mejta CL, Park CG, Wilkie DJ. Acupuncture for the treatment of vulvodynia: a randomized wait-list controlled pilot study. J Sex Med. 2015;12(4):1019-1027. doi:10.1111/jsm.12830.