What lifestyle modifications or non-pharmacological approaches can I suggest to patients suffering from vulvodynia?

Patients suffering from vulvodynia can benefit from several lifestyle modifications and non-pharmacological approaches aimed at symptom relief and improving quality of life. Firstly, pelvic floor muscle training (PFMT) is recommended as it can improve pelvic floor muscle function, which may reduce pain and discomfort associated with vulvodynia. Supervised PFMT programs lasting at least 16 weeks are advised, with continuation if beneficial ¹.

Physical activity, including gentle supervised exercises such as yoga, may also help alleviate symptoms by promoting muscle relaxation and reducing pelvic floor tension ¹.

Dietary modifications can be beneficial, particularly by encouraging a balanced diet following the Eatwell Guide and maintaining appropriate fluid intake to improve bowel habits and stool consistency, which may indirectly reduce pelvic floor strain and vulvar discomfort ¹. Reducing caffeine intake and modifying fluid intake may also help if urinary symptoms coexist ¹.

Weight management is important for patients with a BMI over 30 kg/m2, as weight loss can improve pelvic floor symptoms and potentially reduce vulvar pain ¹. However, weight loss should not delay other management strategies ¹.

Behavioral approaches such as habit training and prompted toileting may be useful, especially in patients with cognitive impairments, to manage associated pelvic floor dysfunction ¹.

Psychological support and pain management strategies are essential components, as vulvodynia is a chronic pain condition. Exploring patient priorities, goals, and preferred treatment approaches helps tailor care plans. Non-pharmacological pain management, including education, cognitive behavioral therapy, and multidisciplinary approaches, can improve coping and reduce pain impact (Amirthalingam and Nalliah, 2024; Rosen et al., 2019).

Topical treatments and avoidance of irritants such as harsh soaps, tight clothing, and irritant hygiene products are also recommended to minimize vulvar irritation (Amirthalingam and Nalliah, 2024; Rosen et al., 2019).

In summary, a holistic approach combining pelvic floor muscle training, lifestyle and dietary modifications, weight management, behavioral strategies, psychological support, and avoidance of irritants forms the cornerstone of non-pharmacological management for vulvodynia ¹; (Amirthalingam and Nalliah, 2024; Rosen et al., 2019).