There are many possible reasons why you may feel pain or soreness in and around your vagina. Some, like arousal or menopause, may be obvious. Others, such as sexually transmitted infections or cysts, are less likely.
What people call “vaginal pain” may actually involve the vagina, the inner part that connects to the womb or uterus. But it can also involve the vulva, the outer part of the genitals.
This article explores some of the causes of pain and soreness in the vulva or vagina. It also explains how these problems are diagnosed and treated.
Vaginal pain can have many different causes. Some are serious, while others clear up on their own or respond to simple treatments.
Yeast infection is caused by a fungus. It can cause pain and itching around the vulva and vaginal opening. Other symptoms include:
- Pain during sex
- Pain when urinating
- Thick, white, sometimes smelly discharge
Some people are more susceptible to yeast infections. This includes people:
- Use hormonal contraception
- Recently used antibiotics
- Have diabetes
- Have a problem with their immune system
In some cases, hygiene habits can increase the risk of illness (e.g., not quickly changing into sweaty workout clothes).
Vaginal infection (BV)
Bacterial vaginosis is an infection that occurs when too much bacteria grow in your vagina. Not everyone has symptoms.
If you do, you may notice:
- A strong smell
- Gray, white or foamy discharge
- Pain when urinating
Your risk of BV is higher if you:
- Douche often
- Having many sex partners or new sexual partners
- Not having enough lactobacilli (good) bacteria
Sexually transmitted diseases
Sexually transmitted infections (STIs) can also cause vaginal/vulvar pain, as well as itching and burning.
Some examples include:
If you think you may have an STI, talk to your healthcare provider. Both you and your partner should be tested to reduce the risk of transmission or complications.
Urinary tract infections
Urinary tract infections (UTIs) are very common. A UTI occurs when bacteria get into the urinary tract.
- Pelvic pain
- Feeling of pressure in the pelvic area
- An urgent need to urinate
- Cloudy urine with strong odor
- Red, pink, or brown urine
A UTI can cause pain during sex.
Irritation or allergy
Irritation and allergies can cause soreness. You may have a reaction to:
- Washing powder
- Bath products
- Menstrual tampons and tampons
Shaving or waxing the area can also be uncomfortable, especially when hair grows back. This pain is usually temporary.
Vulvodynia Vaginal pain that lasts more than three months. You may also notice:
- Sharp or burning pain
Genetics, hormones, trauma, or nerve damage can increase your risk. Vulvodynia can also occur after medical procedures such as chemotherapy or surgery that involve the nerve supply in the area.
One Bartholin’s cyst occurs when the upper Bartholin glands labia labia, Skin folds around the vaginal opening are closed.
An uninfected cyst may appear as a painless lump. These usually resolve on their own.
If a Bartholin’s gland cyst becomes infected, it can swell, cause pain, and make walking or sitting comfortably more difficult. This may require treatment.
Endometriosis is when the lining of the uterus (womb) builds up outside the organ. Not everyone has the same symptoms.
Some common symptoms of endometriosis include:
- Pelvic pain
- Pain during sex
- Pain during bowel movements
- Pain when urinating
Pelvic floor problems
Pelvic floor dysfunction is a health condition in which the muscles and tendons in your pelvis are weakened. It can cause vaginal pain, especially during sex.
If you have pelvic floor dysfunction, you may experience leaking urine or difficulty controlling bowel movements.
These problems can be caused by:
- Pregnancy and childbirth
- Stressing to go to the bathroom
- Complications from surgery
Vaginal pain can also occur due to hormonal changes during menopause. The vagina may become drier. The skin can become thin and tear easily. These changes can make sex painful.
Other symptoms include:
- Ulcers or sores
- More sensitive to personal care products
There is also an increased risk of infection, which itself can lead to vaginal pain.
Tissues in and around the vagina can tear or bruise during rough sex, resulting in pain. Sex can also lead to chafing around the vulva.
These symptoms are more likely to occur if the skin is thin, dry, scarred, or affected by a health condition such as eczema or PsoriasisAlthough all vaginal skin is delicate.
If you think you may have an injury to the inside of your vagina, seek medical attention. In rare cases, internal bleeding can be life-threatening.
Vaginismus is a condition in which the vaginal muscles are spasmed. It can make it difficult to have sex. It can also cause pain.
People can develop vagus due to trauma. It can happen because you are nervous about having sex. But it can also happen during menopause or after childbirth.
If you just had a baby, your vagina will be sore for a few weeks afterward. Sometimes the pain of childbirth lasts even longer.
Injuries from cycling accidents, car crashes, sexual assaults, and female genital mutilation can also cause long-term pain.
When to see a healthcare provider
If symptoms bother you and don’t go away, see a health care professional. You have several options. If you have urinary symptoms, it is best to see your primary care provider, urgent care provider, or urologist. If your only symptom is vaginal pain, you may want to see your primary care provider, urgent care provider, or gynecologist.
It is especially important to seek medical attention if you have vaginal pain or soreness and are pregnant, menopausal, or have a new sexual partner. If you are pregnant, it is best to see an obstetrician-gynecologist.
Seek immediate medical attention if you are sexually assaulted. Do not shower and change clothes before visiting.
Other signs that you need to see a doctor:
- So hurt
- You are bleeding
- You have a fever
If you have severe pain, bleeding, and/or fever, you may need to go to the emergency room (ER).
It can take time to figure out exactly what’s behind your pain. You can confirm some causes with home testing; Others require medical evaluation.
To determine the cause, the health care professional may:
- Ask questions about your medical history
- Ask when your pain started, what it feels like and what makes it worse
- Ask about your other symptoms
- Check your vulva and vagina for signs of infection or injury
- Use a cotton swab to find pimples
Check at home
Tests to detect some causes of vaginal pain are available online and in many pharmacies.
There are tests for:
- Yeast infection
- Sexually transmitted diseases
- Bacterial vaginosis
- Urinary tract infections
Some give results immediately, while others may need to be sent in and analyzed in a lab.
Self-tests to check for allergies and sensitivities still exist, but they may not be as reliable as those performed by a lab or healthcare professional.
When you visit a health care provider, you may need:
- Urine test to confirm UTI
- Blood test to check hormone levels
- Vaginal discharge test to check for infection
- Skin allergy test to check for reaction
- Biopsy for analysis of cell samples
In some cases, imaging is the best way to find the cause of your vaginal pain. For example, a Transvaginal ultrasound can show endometriosis.
Endometriosis can also show up on magnetic resonance imaging (MRI), computed tomography (CT), or laparoscopy. It’s a test in which a small camera on a long tube takes pictures of the inside of your body.
Imaging tests can also detect pelvic floor problems and internal injuries.
Treatment will depend on the exact cause of your soreness or soreness. In some cases, changing your habits may be all that is needed. In others, medical intervention may be necessary.
Home remedies and lifestyle
Vaginal pain can be reduced if you make some simple changes. For example, it can help:
- Temporarily stop having sex
- Use a lot of lubricant when you have sex
- Avoid products that irritate your skin
- Use cool compresses or gel packs for pain relief
- Take a warm bath
Conditions like STIs need to be treated. They will not go away on their own and can have serious consequences if left untreated.
In some cases, medication can resolve or cure the pain. Antibiotics or antifungals for infections are a good example. If the pain is caused by a persistent condition, your health care provider can help you manage your symptoms with medication, including:
A therapist can work with you to build pelvic floor muscles.
Some people learn to relax the vaginal muscles using dilators, which are tapered wand-like tools of various sizes.
Cognitive behavioral therapy can teach you strategies to relax tense muscles or cope with anxiety, injury, or pain.
If the pain doesn’t go away with other treatments, you may need surgery. For example, if you have an infected Bartholin’s gland cyst, it may need to be drained.
In some cases, surgical removal of scar tissue helps relieve endometriosis symptoms. Hysterectomy — removal of the uterus — is another option for endometriosis.
To protect your vulva and vagina, you can:
- Wear only loose pants and underwear
- Choose 100% cotton or bamboo underwear
- Use alcohol-free lubricants
- Choose latex-free condoms
- Avoid douching
- Limit physical activities that put pressure on the vulva, such as cycling
- Stop using soaps, wipes, or products with fragrances and preservatives
Pain in or around your vagina can have many causes. Infections, trauma, health conditions, menopause, childbirth, pelvic floor problems, and allergies can all cause vulva or vagina pain.
Most of the time, vaginal pain will go away on its own or take care of itself. But some types can be serious. Medication, physical therapy, and even surgery may be needed to restore your health.
A very good word
Some health care providers can minimize women’s anxiety about pain. Studies show that women of color, transgender and LGBTQ people, and women with low income, chronic pain or disability often feel their doctor is not “getting” them and their pain.
When you’re seeking care for vaginal pain — or anything else — you need a health care provider that takes your symptoms seriously. If you don’t feel heard and respected, find another provider.
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