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It is underdiagnosed and often misdiagnosed as vaginitis. The etiology of vulvodynia remains unknown, making it difficult to identify or develop effective treatment methods. The purpose of this article is to (1) review the presentation and evaluation of vulvodynia, (2) review the research on vulvodynia treatments, and (3) aid the clinician in the selection of vulvodynia treatment methods. The level of evidence to support vulvodynia treatment varies from case series to randomized controlled trials (RCTs). Oral desipramine with 5% lidocaine cream, intravaginal diazepam tablets with intravaginal transcutaneous electric nerve stimulation (TENS), botulinum toxin type A 50 units, enoxaparin sodium subcutaneous injections, intravaginal TENS (as a single therapy), multimodal physical therapy, overnight 5% lidocaine ointment, and acupuncture had the highest level of evidence with at least one RCT or comparative effectiveness trial. Pre to posttest reduction in vulvar pain and\/or dyspareunia in non\u2010RCT studies included studies of gabapentin cream, amitriptyline cream, amitriptyline with baclofen cream, up to 6 weeks\u2019 oral itraconazole therapy, multimodal physical therapy, vaginal dilators, electromyography biofeedback, hypnotherapy, cognitive behavioral therapy, cold knife vestibulectomy, and laser therapy. There is a lack of rigorous RCTs with large sample sizes for the treatment of vulvodynia, rendering it difficult to determine efficacy of most treatment methods. Clinicians will be guided in the selection of best treatments for vulvodynia that have the highest level of evidence and are least invasive.<\/jats:p>","DOI":"10.1111\/jmwh.13456","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T06:09:36Z","timestamp":1671430176000},"page":"9-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Evaluation and Treatment of Vulvodynia: State of the Science"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3754-6176","authenticated-orcid":false,"given":"Judith M.","family":"Schlaeger","sequence":"first","affiliation":[{"name":"Department of Human Development Nursing Science University of Illinois Chicago College of Nursing  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-0526","authenticated-orcid":false,"given":"Jennifer E.","family":"Glayzer","sequence":"additional","affiliation":[{"name":"Department of Human Development Nursing Science University of Illinois Chicago College of Nursing  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Villegas\u2010Downs","sequence":"additional","affiliation":[{"name":"Department of Human Development Nursing Science University of Illinois Chicago College of Nursing  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Human Development Nursing Science University of Illinois Chicago College of Nursing  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Glayzer","sequence":"additional","affiliation":[{"name":"Department of Sociology, Anthropology, and Social Work University of Dayton College of Arts and Sciences  Dayton Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences Oklahoma State University  Stillwater Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Tokyo Ariake University of Medical and Health Sciences  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Yajima","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Tokyo Ariake University of Medical and Health Sciences  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuari","family":"Takakura","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Tokyo Ariake University of Medical and Health Sciences  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Kobak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Illinois Chicago College of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara L.","family":"McFarlin","sequence":"additional","affiliation":[{"name":"Department of Human Development Nursing Science University of Illinois Chicago College of Nursing  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001359"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12718"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2012.02803.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2019.05.004"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2002.02032.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","unstructured":"YoungAL MillerAD.\u201cThis girl is on fire\u201d: sensemaking in an online health community for vulvodynia. 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