Vulvodynia, a condition shrouded in mystery, affects 7% of American women and many times is misdiagnosed as vaginitis.1 The chronic vulvar pain disorder — often described as itching, burning or stabbing sensations — presents symptoms ranging from persistent discomfort to pain during intimacy.2 To better assist patients, we will explore the signs and symptoms of vulvodynia, illuminate the connection with pelvic floor dysfunction and discuss various ways to help patients: topical medications, pelvic floor physical therapy and the intriguing world of acupuncture.