Female Genital Sores: Main Causes and What To Do

November 2020

Injuries in the vagina or vulva can happen for different reasons, and the main ones are friction during sexual intercourse, allergy to clothes or sanitary pads, or lesions due to pubic hair removal. However, these injuries can also signal sexually transmitted diseases, such as genital herpes and syphilis, when other symptoms appear, as well as the wounds.

Therefore, when injuries to the vagina or vulva do not disappear quickly or if they come with other symptoms such as itchiness, pain, discharge, or bleeding, it is important to go to a gynecologist to do specific tests that diagnose the cause of the wound, and from there adequate treatment will be started.

Female Genital Sores: Main Causes and What To Do

The main causes of vaginal wounds include:

1. Lesions and allergies

Wounds in the vagina or vulva can happen due to panties that are too tight and that cause friction, friction during sexual intercourse, or lesions due to pubic hair removal. In addition, an allergy to the fabric of the panties or sanitary pad can also lead to wounds, as one of the symptoms related to the allergy is itchiness in the genital area, which can cause wounds.

What to do: in these cases, the wound usually heals on its own after a few days. However, to encourage healing it’s important to use comfortable clothes and cotton panties, as well as avoid hair removal and sexual intercourse while the wound is there. If no improvement is noticed after a few days, we recommend you visit a gynecologist to see if you should apply a lotion that will help the wound to heal.  

2. Sexually transmitted diseases 

Sexually transmitted diseases are some of the main reasons for wounds in the vagina, and the most common ones include:

  • Genital Herpes: is an infection caused by the virus Herpes simplex, and it is contracted through contact with blisters or ulcers in the genitals due to sexual contact. It causes redness and small blisters which cause pain, burning, or itchiness. 
  • Syphilis: is caused by the bacteria Treponema pallidum,which most of the time is transmitted through sexual contact with no protection. Generally, the initial stage happens after three weeks of contamination, with one, painless ulcer. If it’s not treated, syphilis can evolve to other stages and become serious;
  • Chancroid: it’s an infection caused by the bacteria Haemophilus ducreyi, which causes multiple painful blisters that secrete pus and blood; 
  • Lymphogranuloma venereum: is a rare infection, caused by the bacteria Chlamydia trachomatis, and it usually causes small lumps that become painful, deep wounds that come with buboes;
  • Granuloma inguinale is caused by the bacteria Klebsiella granulomatis, and causes lesions that are subcutaneous nodules or small lumps that evolve to nonpainful ulcers, which grow slowly and can cause great damage to the genital area.

If the injuries in the vagina or vulva are caused by sexually transmitted diseases, it is common for those wounds not to disappear with time, and they usually come with other symptoms such as discharge, bleeding, and pain during intercourse. 

It’s important to remember that genital infections represent a risk of infection by HIV, as well as opening the way to an infection by the virus and other microorganisms, so they should be avoided by using condoms and treated with a gynecologist or an infectious disease specialist.

What to do: In these cases, it’s important to visit a gynecologist and do tests that will help to identify the infection that caused the appearance of the wound. This will help in starting the most suitable treatment, which can be done with antibiotics or antivirals. It’s important that the partner also be treated, even if he does not show symptoms of the disease.

Female Genital Sores: Main Causes and What To Do

3. Auto-immune diseases

Some auto-immune diseases can also cause wounds in the genital area, such as  Behçet’s disease, Reiter’s syndrome, lichen planus, erythema multiforme, genital ulcers, pemphigus, pemphigoids, dermatitis herpetiformis, or Linear IgA bullous disease. These diseases are usually rare, and they usually happen in teenagers, adults,  or elderly women and they may also present ulcers in the mouth, anus, and other regions.

The wounds caused by auto-immune diseases can also come with systemic symptoms, such as fever, weakness, weight loss, or danger to other organs, such as kidneys, danger to blood flow. These symptoms can be worrying and should be investigated and treated by a rheumatologist or dermatologist.

What to do: if you have an auto-immune disease, or there is an auto-immune disease in your family history, you will need to tell a gynecologist as soon as the wound is identified, so that medication can be taken to regulate immunity, in the form of corticosteroids or immunosuppressors and also lotions to help heal the wound. In addition, auto-immune diseases can lead to hypersensitivity and so we recommend you avoid using allergic products, such as cosmetics and avoid very spicy foods that have a strong color and smell. 

4. Cancer

Cancer is a rare cause of vaginal wounds that generally causes itchiness, foul smell, and secretions and it is more common in elderly women. The chance of a vaginal wound becoming cancer is greater when caused by the HPV virus. 

What to do: if you know you have HPV, visit a gynecologist as soon as you see the wound with discharge, so that a biopsy can be done. If it is confirmed, treatment for vaginal cancer can be started, which usually involves the removal of the affected area through surgery, as well as completing the treatment with radiotherapy, chemotherapy, and checking the nearby lymph nodes.

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  • FEDERAÇÃO BRASILEIRA DAS ASSOCIAÇÕES DE GINECOLOGIA E OBSTETRÍCIA . Manual de Orientação Ginecologia Oncológica. 2010. Available on: <https://www.febrasgo.org.br/images/arquivos/manuais/Manuais_Novos/Manual_Ginecologia_Oncologica.pdf>. Access in 08 Oct 2020
  • INTERNATIONAL JOURNAL OF GYNECOLOGICAL CÂNCER,. Oncology Guidelines for the Management of Patients With Vulvar Câncer.. 2017. Available on: <http://www.esgo.org/media/2019/01/ESGO_Vulvar-Cancer_A4PT.pdf>. Access in 08 Oct 2020
  • MINISTÉRIO DA SAÚDE. Protocolo Clínico e Diretrizes Terapêuticas (PCDT). 2015. Available on: <http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_diretrizes_terapeutica_atencao_integral_pessoas_infeccoes_sexualmente_transmissiveis.pdf>. Access in 08 Oct 2020
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