Vaginal pain is a common discomfort, but it typically does not indicate a serious health condition. Most of the time, it is just a consequence of using very tight clothes or it can occur due to an allergy to a condom or soap. It can also be an common finding of pregnancy, especially in the later stages in which the weight of the fetus starts to apply pressure on the vagina.
When vaginal pain is frequent, does not improve with time or presents with other symptoms, it can also be a sign of more serious health problems, such as an STI or cysts.
If you are experiencing vaginal burning or pain with urination, skin redness in the area, swelling, wounds, lumps, or bleeding, it’s important to see your doctor for assessment and treatment as indicated.
The main causes of vaginal pain are:
1. Tight clothes
Wearing tight clothes is usually the main cause of vaginal pain. Clothes that are too tight and made of synthetic materials can decrease airflow to the genital area, which increases the temperature and moisture. Hot and wet skin is the perfect breeding ground for fungi and bacteria.
What to do: It is advised that you wear looser clothes that are made of breathable fabrics, and wear cotton underwear. Sleeping without underwear is also beneficial as it allows for more airflow in the genital area for longer periods of time. If your symptoms do not improve with changes to clothing, you should see your doctor for assessment.
Vaginal pain during pregnancy is common and does not present a risk to the mother or the baby. It is most common in the third trimester which is when the baby’s weight within the uterus starts putting pressure on the mother’s organs and starts to get closer to the vaginal canal.
Read more about vaginal pain during pregnancy and what can cause it.
What to do: This is a normal, expected finding, and therefore treatment is not required. However, if the pain persists and occurs with other symptoms, it’s important to visit your obstetrician so that she can examine you.
3. Allergic reactions
Some women have increased sensitivity to some products, such as soap, fabric softener, menstrual pads, toilet paper, or some types of condom. The usual symptoms of allergic reactions are swelling, redness, itchiness, pain, or burning in the vagina.
What to do: It’s important to identify the cause of the allergy and avoid using any product that may trigger a reaction. Depending on your symptom intensity, the doctor may prescribe medication like topical anti-inflammatories to use on the affected region.
4. Urinary tract infections
Women are likely to have more than one urinary tract infection, or UTI, in their lifetime. This is because the female urethra is short and the vagina and the anus are close together, which favors the migration and proliferation of fungi and bacteria. UTIs generally happen with inadequate hygiene or due to tight clothes, which don’t allow for much air-flow.
When you have a urinary infection, you usually feel like you need to urinate but not much urine comes out. You may also feel pain, burning, or itchiness in the vagina. Learn more about the most common UTI symptoms and a UTI in men can present differently.
What to do: As soon as you notice the first symptoms of a urinary tract infection, you should see your doctor who will order a urine test to identify the agent that is causing the infection. Once identified, treatment can be initiated. It is generally done with antibiotics, such as amoxicillin or ciprofloxacin. Learn about other UTI medications that are typically prescribed as well as some natural remedies for UTIs you can use to complement your treatment plan.
5. Sexually transmitted infections
Sexually transmitted infections or STIs are diseases caused by microorganisms that are spread through unprotected sexual intercourse. Your risk for catching an STI is higher if you have more than one partner during the same time period. Common symptoms of an STI include redness, small wounds, lumps or warts in the genital region, burning sensation when urinating, vaginal discharge, and pain.
Read more about the most common STIs and how they present.
What to do: If you have symptoms of an STI and recently engaged in risky behavior, you should see your doctor for assessment. While performing an assessment, he or she will likely collect a specimen for lab analysis to confirm an infection. Usually, treatment is done through antibiotics, antifungal medication, or antivirals and depends on the underlying infection.
Even though some STDs are curable with treatment, it’s important to use a condom during sexual intercourse and to avoid intercourse with more than one partner.
Some cysts can change the anatomy of the vagina and lead to pain. This happens with ovarian cysts, which are pockets full of liquid that form inside or around the ovary. Learn more about the symptoms associated with ovarian cysts and how they are treated.
Some vaginal cysts can also cause pain, such as Bartholin’s cyst and Skene duct cyst, which are cysts formed in glands that are located in the vagina. Read more about vaginal cysts and what can cause them.
What to do: If you notice bleeding that occurs outside the menstrual period, pain during sexual intercourse, difficulty getting pregnant, late periods or vaginal pain, you should see your doctor, as these symptoms may be a sign of a cysts.
The treatment prescribed by the doctor will differ depending on the size of the cyst. Treatment can vary with simple approaches, like antibiotics, to more complex approaches like surgical interventions to remove the cyst, or even the uterus.
7. Vaginal dryness
Vaginal dryness happens due to decreased estrogen production, which is a female hormone that commonly becomes lower during menopause. When the production of mucous decreases, you may feel vaginal pain, generally during sexual intercourse.
What to do: To decrease the discomfort caused by a dry vagina, you can use lubricants to ease sexual intercourse, use vaginal moisturizers, or even undergo hormone therapy under doctor supervision.
Vaginal pain and extreme difficulty penetrating can be caused by vaginismus, which is a rare disease. Although it is not very well known it is thought to be caused by physical factors, genital diseases or psychological trauma (from sexual abuse, traumatic labor, or previous surgical procedures, for example).
What to do: In order to find out if you have vaginismus, you should see a gynecologist for assessment and guidance. There is treatment available, which can be done with medication and psychological therapy which can help improve sexual intercourse.
9. Vulvar cancer
Vulvar cancer is most frequently diagnosed in women between the ages of 75 and 75. It is associated with risk factors like smoking, immunosuppressant treatment, uterine cancer, or HPV infection, and can cause symptoms like constant itching, inflammation, or ulcers in the vulva that bleed, cause pain or are sensitive.
What to do: Older adult women who experience symptoms should consult a gynecologist for assessment. The doctor may order a biopsy to confirm a diagnosis and recommend treatment, which generally involves surgery.