There are several treatments for this condition. The important thing is to combine them in the best way for each individual, taking into account the general health and lifestyle, the relationship if the woman has one, and her emotional needs. There are online and off lone support groups which can be accessed through the Vulval Pain Society

• Treating the problem as a nerve pain syndrome with tricyclic anti-depressants, especially amitriptyline (usually started at 10 to 25 mg each night increasing to 50 to 75 each night if required), or gabapentin (starting at 300 mg day 1, then 300 mg twice on Day 2, 300mg three times on day 3, then increasing further according to response up to a maximum of 1.8 g per day) seems helpful. This may reduce the nerve pain as well as help the emotional distress that goes with it. The choice of medication and the dosage may only be arrived at after some experimentation, so your doctor will help with getting this right.
• Topical steroid creams may be beneficial especially for vestibulodynia in women who have sensitive skins or a history of eczema
• Identifying anything that could irritate the sensitive vulval area such as soap, shower gel, bubble bath, feminine wipes etc is very important. These possible irritants should then be excluded. Aqueous cream can be used as an alternative to soap for women who find it difficult to accept using water alone.
• Vulval massage using an appropriate lubricant can have a desensitising effect, and increase the areas of touch and the range of touch that can be tolerated.
• Lidocaine gel or ointment may be helpful to numb any trigger point before penetration
• Sex Therapy is frequently indicated especially where there is a relationship, to address the concerns of the partner and enable the gradual introduction of sexual activity once the symptoms are under control.
• Introduction of vaginal trainers. See vaginismus for more on these.
• Pelvic floor exercises. See Kegel's exercises.
• Acupundture has been found to be helpful in some women.
• Osteopathy has been found to be helpful in some women.
• Yoga can also help, as it focuses the mind on specific areas and how breathing can affect sensations.
• Probiotics have been reported to have a beneficial effect, and need to be used in three ways. Each day you need to swallow your daily dose, insert 1 or 2 capsules into the vagina at night, and place the contents of 1 capsule onto the vulva. Try Nature's ScienCeuticals Advanced ProBiotic for example.

Sex Problems for Women Vulvodynia and Vestibulodynia