Vulvodynia is defined as vulvar pain of at least three months duration without a clearly identifiable cause. Currently, there are few established treatments. We report two cases of vulvodynia treated successfully with relief of insomnia, using Japanese herbal medicine including saiko. Case 1: A 29-year-old female had been in a poor physical condition for two years. Initially, she had vulvar itching, which gradually became vulvar pain. At the first consultation, she complained of not only vulvar pain but also insomnia and feeling cold. Additional symptoms included severe fatigue, constipation, frustration, stiff shoulder, and heart palpitations. There were no abnormal findings in the genital region. We began treating the insomnia and coldness using saikokeishikankyoto. By the time of the second consultation two weeks later, her insomnia and coldness completely resolved, vulvar pain disappeared, and other symptoms improved. Case 2: A 46-year-old female experienced vulvar pain two months before the first visit to the hospital. The pain increased gradually and she awakened every 30 minutes in the night with severe vulvar pain. However, there were no abnormal findings in the genital region. We used saikokaryukotsuboreito, an antidepressant and a sleeping pill. Her insomnia improved gradually, and vulvodynia resolved two weeks after the improvement of the insomnia. These results suggest that saiko is effective on vulvodynia with insomnia.