Current approaches to the conceptualization of vulvodynia focus either on issues of sexuality or underlying pathophysiology but tend to neglect the central symptom of pain. An adequate understanding of this condition will not be achieved, however, without examining all three factors and how they interact. A multiaxial pain approach has provided data regarding the intensity, location, temporal pattern, underlying system, and sensory quality of vulvodynic pain. In addition, standardized vulvar pain measurement techniques, including a new device called a vulvalgesiometer, have been developed, making possible the collection of reliable pain ratings. To date, this approach has been promising for the differential diagnosis, classification, and understanding of vulvar pain conditions.