Understanding Pain In The Vulva Area

Vaginal pain is a common issue for people with vaginas, and it can be temporary or chronic. The pain can be internal or external, with the internal vagina connecting the uterus to the outside of the body, and the external vulva including the labia, clitoris, and urethral opening. Pain can be experienced in either or both places. There are many causes of vaginal and vulval pain, including yeast infections, bacterial vaginosis, STIs, childbirth, and allergies. One specific type of pain in the vulva is called vulvodynia, which is pain lasting at least 3 months with no specific cause. It is a common gynecological condition, affecting up to 16% of females in the US.

Yeast infections

Vaginal yeast infections are a common problem, with up to 75% of women experiencing at least one in their lifetime. They are caused by an overgrowth of the fungus candida, which is normally present in small amounts in the vagina. When this balance is disrupted, candida can multiply, leading to an infection.

Vaginal yeast infections can cause a range of uncomfortable symptoms, including itching, burning, and irritation in and around the vagina. There may also be a thick, white, clumpy vaginal discharge that resembles cottage cheese, and sex may become uncomfortable or painful. In extreme cases, fissures or sores can develop on the vagina or vulva.

To prevent vaginal yeast infections, it is recommended to avoid douching, using scented feminine products, and wearing tight, synthetic clothing. Maintaining blood sugar control in cases of diabetes can also help lower the risk of infection.

Bacterial vaginosis

The exact cause of BV is unknown, but it is associated with sexual activity, particularly having multiple partners or a new partner. Other risk factors include douching, not using condoms, and using intrauterine devices (IUDs).

BV is usually treated with antibiotics, either in tablet form or as a vaginal cream. It is important to take all the medication prescribed by a healthcare provider, even if symptoms disappear. Treatment may also reduce the risk of getting other sexually transmitted infections (STIs).

While BV can sometimes go away without treatment, it has been linked to adverse pregnancy outcomes such as early pregnancy loss, premature labour, and low infant birth weight. It has also been associated with pelvic inflammatory disease (PID) and an increased risk of STIs. Therefore, it is important to seek treatment, especially if pregnant or planning to become pregnant.

Sexually transmitted infections

STIs are caused by bacteria, viruses, or parasites, and they can have serious health consequences if left untreated. Common STIs include chlamydia, gonorrhea, herpes, HIV, HPV, syphilis, and trichomoniasis. STIs often cause vaginal pain and soreness due to inflammation and infection.

For example, chlamydia and gonorrhea, two common bacterial STIs, can trigger pelvic or lower abdominal pain. If left untreated, they can lead to a more severe infection called pelvic inflammatory disease (PID), which occurs when the bacteria reach the uterus and other parts of the upper reproductive tract. PID is a medical emergency that can lead to infertility if not treated promptly.

Herpes, a viral STI, causes painful sores in the genital area, and these sores can be quite tender to the touch. Genital herpes can also lead to a burning sensation and itching in the vaginal area.

Another STI, trichomoniasis, is caused by a parasite and can result in a frothy, greenish-yellow discharge, as well as pain and a burning sensation during urination or sexual intercourse.

Vaginal pain and soreness are also symptoms of syphilis, an STI that causes sores in the genital area. Syphilis can lead to a sore throat, fever, headaches, and joint pain. If left untreated, syphilis can cause serious health problems, including damage to the brain and spinal cord, heart, and other organs.

It is important to note that STIs can be asymptomatic, and a person may not show any signs or symptoms of infection. However, even without symptoms, STIs can still be harmful and contagious.

If you are experiencing vaginal pain and soreness, it is essential to consult a healthcare professional for diagnosis and treatment.

Childbirth

One common complication of vaginal delivery is tearing of the soft tissue around the vagina and perineum, ranging from minor lacerations to more severe tears affecting skin, muscle, and other tissues. In some cases, an episiotomy, a medical incision, may be required to facilitate the baby's exit. Tears and episiotomies often require stitches, which may take up to 10 days to heal, and the injured area may remain painful for several weeks.

The pelvic floor muscles, which support the bladder and bowel, can also be weakened during childbirth. This can lead to various problems, including urinary incontinence, faecal incontinence, and a feeling of heaviness or dragging in the vagina. Pelvic organ prolapse, where the vagina or cervix descends from its normal position, may also occur due to weakened pelvic tissues.

To promote healing and recovery, it is recommended that women perform pelvic floor exercises, also known as Kegel exercises, to strengthen the pelvic floor muscles. These exercises can help improve bladder control and may also enhance sexual pleasure. Additionally, it is important to attend postpartum check-ups with an OB-GYN to ensure a safe recovery.

While most women recover completely from childbirth without any long-term issues, a small minority may experience ongoing problems such as pain, scarring, or heaviness in the vagina, which can impact sexual function and cause distress. In such cases, seeking advice from a healthcare professional is essential.

Allergies

There are many allergens and irritants that the genital area is exposed to, due to hygienic and sexual practices. These include latex, lube, and semen.

Some people are allergic to latex and using latex condoms can irritate the vagina. Symptoms of a latex allergy include redness, burning, and swelling.

It is also possible to be allergic or sensitive to the ingredients in lube, which can leave similar symptoms to a latex allergy.

Other allergens and irritants include:

• Toilet paper, specifically bleached toilet paper
• Feminine hygiene sprays
• Bubble baths and scented soaps
• Nail polish
• Deodorant sanitary napkins
• Shower gels, soaps, deodorants, hygiene sprays, menstrual and incontinence pads, tampons, garments, and perfumes
• Douches containing acid or alkali that are not properly diluted
• Nickel-plated objects, such as pins, fasteners, zippers, and clasps on sanitary napkins
• Dyes and synthetic resins in underwear
• Tight underwear, such as pantyhose, panty girdles, and tight sanitary napkins
• Disperse orange 3, paraphenylenediamine, and para-aminoazobenzene, which are dyes found in some underwear
• Topical anesthetics, clindamycin, and acyclovir

Frequently asked questions