Itching, burning, or all-around ouchy private parts aren’t easy to talk about, but you should be vocal about vaginal pain to your healthcare provider, because persistent discomfort down there can indicate an underlying medical problem. (And also because who wants their sexytime parts to hurt?). Here are five reasons why your vagina may be in pain and how to solve them.
Every vagina is naturally filled with bacteria, and that’s a good thing, as long as the right kind of bacteria are in control. To envision what happens when you get bacterial vaginosis, think of the vagina as a nightclub. (Stay with me here.) Lactobacillus bacteria is the big, strong security guard preventing the riffraff (bad bacteria) from wrecking havoc by making sure your vagina is just the right amount of acidic. But if levels of lactobacillus drop too low it’s like a bodyguard going on a break, which means lots of bad bacteria can sneak into your vagina, leading to bacterial vaginosis. Although BV isn’t technically an STI, because it’s very possible to experience it without having sex, having sex with a new person can leave your vagina more susceptible. Not only can bacterial vaginosis be painful, it could make susceptible to STIs.
Symptoms: A bad (usually fishy) smell, itching, discharge (white, grey or green), burning when you pee, and maybe even a fever. You may also be asymptomatic.
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Treatment: BV doesn’t always need to be treated (sometimes your vagina regains its bacterial balance on its own), but when it does a provider can prescribe you an antibiotic like metronidazole, clindamycin or tinidazole.
Similar to what happens with BV, a yeast infection occurs when the balance of microbes in your vagina gets out of whack, in this case due to an overgrowth of a fungus called Candida. Yeast infections affect 75% of women in their lifetime, but some women are afflicted more frequently than others.
Symptoms: Itching and white, thick discharge are common signs. You may notice an odor, but in contrast to the fishy smell of BV, a yeast infection will smell sweet or bread-like (we can call these bad carbs). Other possible symptoms include pain with sex and urination, vaginal redness and a burning feeling.
Treatment: There are over-the-counter treatments available, and yeast infections can clear up on their own, but if your symptoms persist you should see a healthcare provider to make sure they’re caused by yeast and not something more serious. Your doctor can prescribe an antifungal medication called fluconazole, an oral drug, if drugstore remedies aren’t working, or if you get yeast infections more than four times a year.
Perimenopause is the period before menopause, when your hormones begin to fluctuate and your ovaries begin to produce less estrogen, though estrogen production can spike and drop as menopause approaches. It can begin as early as your 30s and usually lasts from four to eight years.
Symptoms: Lower estrogen levels can lead to the drying and thinning of vaginal tissues, which can lead to pain during sex. Other signs of perimenopause include moodiness or depression, irregular or heavy periods, and hot flashes. Low estrogen can also make you more susceptible to vaginal and urinary infections, so there may be more than one cause of your discomfort down below.
Treatment: If you think you are in perimenopause, see a healthcare provider to rule out other issues, such as a thyroid disorder. Treatment for perimenopausal vaginal pain often includes estrogen replacement, possibly through birth control pills (depending on your health profile) or topical estrogen, which you put inside your vagina to prevent dryness and thinning tissues. If you mostly only experience vaginal discomfort during sex then using liberal amounts of a water-based lube could be the only treatment you need.
Sexually Transmitted Infections
Many STIs cause vaginal pain — trichomoniasis, gonorrhea and genital herpes to name a few common causes. If you’ve had a new sexual partner or are uncertain of a partner’s STI status and you experience vaginal pain then definitely get tested for STIs (and you should get tested even if you don’t have pain, since STIs often have no symptoms!).
Symptoms: Trichomoniasis and gonorrhea can make sex painful, and symptoms of genital herpes are burning and a blister or blisters on the crotch or in that general area. With gonorrhea, look for discharge and pain with peeing. Trichomoniasis often causes a bad-smelling discharge, soreness, vaginal itching and urinary pain as well. But don’t guess which STI you might have — get tested using home tests like the Healthy Woman Kit, which checks for gonorrhea and trichomoniasis, as well as chlamydia, syphilis, and HIV. If you notice a blister or blister on your genitals, see a doctor to learn if it’s herpes.
Treatment: Trichomoniasis and gonorrhea can be treated with prescription antibiotics, usually a combo of an injection and oral azithromycin are used to treat gonorrhea, according to the CDC, and oral metronidazole or tinidazole are used for trichomoniasis. Herpes cannot be cured, but can be well managed (and often made asymptomatic) with antiviral medicine.
Pelvic Floor Dysfunction
Though you may not realize it, there’s a reasonable chance you have a pelvic floor disorder – one in four women do. Pelvic floor dysfunction keeps you from using your pelvic floor muscles the right way. (Yes, there is a right way!) There may not be a clear reason for your pelvic floor dysfunction, but giving birth and injury are two known causes.
Symptoms: Painful sex, urinary pain, and pain with bowel movements are signs. You may also not be able to control the release of urine or stool. (Yikes!) Your doctor can make the diagnosis by talking to you and conducting one or more exams.
Treatment: You have options, both medical and natural. A muscle relaxant, biofeedback, warm baths, and pelvic floor physical therapy may be parts of your treatment plan.
The Bottom Line
If your personal parts are in pain or discomfort, don’t suffer in silence. See a healthcare provider for a diagnosis and solution.
About the Author
Gena Hymowech is a writer from Brooklyn, NY who covers health and entertainment.
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.