Vaginal pain

Pain in the vagina or female external genitalia (the vulva, which includes the labia, clitoris, and vaginal opening) is most often the result of an infection. But there may be other causes of vaginal pain that indicate problems in the body and malfunctions. What is typical for vaginal pain is that in fact, a completely different organ may be hurting and the pain may radiate to the vagina. What are the causes of this pain and what to do about it?

Causes of vaginal pain

They can be very difficult to identify. Therefore, when the vagina hurts, it can be dangerous for the female body.

1. It could be an infection, which is accompanied by itching and vaginal discharge.
2. Pain may occur during bleeding.
3. Vaginal pain can occur during menopause.
4. The vagina may hurt during or after sex, as well as during arousal before intercourse.
5. The source of pain may be in the rectum, but radiate to the vagina.
6. The causes of pain may be psychological.
7. Vaginal pain can be caused by increased vaginal dryness.

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Pain in the vulva and vagina - diseases-provocateurs

Pain in the vulva and vagina is called one word - vulvovaginal pain. This is a symptom that unites several diseases: vulvodynia (pain in the vagina and vagina of unknown origin), as well as severe pain in the area preceding the vagina (when there is no sexual intercourse, but pain occurs due to tumors, injuries, skin diseases ).

Diseases that cause vaginal pain may also include vaginismus (when the muscles of the vagina and the area in front of it hurt when contracting, as soon as someone tries to insert a finger or penis, suppository or tampon into the opening). With vaginismus, the genitals are not damaged or deformed, rather the pain is associated with nerve reflexes.

Pain in the vulva and vagina can also be caused by dyspareunia. This is irritation and pain in the vagina during sexual intercourse, as well as before and after it. Such pain can be a signal of very dangerous diseases of the genitals, so if pain occurs, it is important to immediately contact a gynecologist and not delay the visit.

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Pain associated with vaginal dryness and atrophy

Other vaginal symptoms that are commonly associated with vaginal atrophy include vaginal dryness, itching, irritation, and/or pain during intercourse (known as dyspareunia). Vaginal changes may also lead to an increased risk of vaginal infections.

In addition to vaginal pain, women may experience other symptoms during menopause. Hot flashes, night sweats, mood changes, fatigue, urinary tract infections, urinary incontinence, acne, memory problems, and unwanted hair growth are symptoms that have been reported for women going through menopause.

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Inflammatory diseases of the pelvic organs

Very often after sexual intercourse a woman experiences pain in the vagina if the genitals are inflamed. The same thing happens after sexual intercourse. In this case, the woman does not experience orgasm, which completely reduces the quality of her intimate life.

The culprits of these pains may be stagnation of blood flow in the organs located in the pelvis, as well as chronic inflammation in these organs.

Pelvic inflammatory disease (PID) is an infection of organs including the uterus, fallopian tubes, ovaries, and cervix. It causes vaginal pain.

Inflammatory diseases of the pelvic organs develop as a result of the spread of sexually transmitted diseases.

In most cases, pelvic inflammatory disease is caused by gonorrhea and/or chlamydia.

Young, sexually active women who have multiple partners are at greatest risk for pelvic inflammatory disease.

Pelvic inflammatory disease sometimes causes no symptoms. In other cases, it can cause fever, abdominal and pelvic pain, vaginal discharge, painful urination, or painful intercourse.

Women who have given birth may develop a condition called endometritis. This is a condition in which the uterine cavity becomes inflamed and painful. This condition is accompanied by pain in the vagina and its vestibule.

With salpingo-oophoritis, the uterine appendages become inflamed and painful. This occurs because after childbirth, a woman's immune system is significantly weakened, and the genitals cannot be protected from infections and inflammations as before. The causes of this disease can also be strong nervous stress, as well as increased physical activity.

They can provoke deformations of the pelvic organs, sores can form on the surface inside the uterus, which hurt. They should be treated only in a hospital under the supervision of an experienced gynecologist.

Inflammatory diseases of the pelvic organs are treated with antibiotics.

Complications of pelvic inflammatory disease may include pelvic scarring and infertility.

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Surgeries and injuries as causes of vaginal pain

The vagina can be injured after or during surgery, as well as during childbirth. Injuries can also occur in the perineum area, causing pain. The reason is the increased load on the woman's genitals during childbirth. The vagina and uterus are stretched during childbirth, which causes severe pain, the tissues may not withstand and tear or become injured. The birth canal through which the baby passes is also subject to high loads and, as a result, injuries and stretches.

Because of this, the perineum is often subject to tears during childbirth, so it is cut and stitched up.

If the perineum is torn again after this, it becomes more difficult to stitch it a second time - the woman experiences pain, and the tissues do not heal as quickly. There may be inflammation in the area where the stitches were placed, and the tissues may not heal properly. In addition, the doctor is not always able to restore the damaged organ to its previous state.

Because of this, the blood supply may be disrupted in the places where the tissue was excised, the nerves that pass through the genitals become inflamed, their activity is disrupted, and the woman complains of pain in the vagina. Especially during sexual intercourse.

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The cause of vaginal pain is ligament rupture

If a woman has pain in the lower abdomen, the cause may be a ligament rupture. This is rare, but if it does happen, you need to know that the ligaments bear increased load during childbirth. They support the uterus, which is greatly strained and stretched during childbirth. The sacrouterine ligaments may not withstand the load and burst. Then the woman is bothered by very severe pain, which is not easy to cope with even in a hospital setting.

The cervix after the ligaments are torn is completely immobilized, so during sexual intercourse the woman experiences very severe pain in the vagina. To relieve it, anti-inflammatory drugs, medicinal herbs with a calming effect, and physiotherapy are needed.

These include laser therapy, electrophoresis, and magnetic therapy. These procedures are carried out so that scar tissue and, most importantly, adhesions, dissolve and the inflammatory process passes.

What are adhesions? This is connective tissue that is located around the tissues and organs of the pelvis. If adhesions do not dissolve, they can give a woman a feeling of pain in the vagina for many years after surgery.

When adhesions in the pelvic organs dissolve, the cervix becomes more mobile, its body too, and then the pains disappear on their own. The woman can lead a full sexual life.

Causes of vaginal pain may also be a small amount of lubrication, changes in the body during menopause and hormonal imbalance. An experienced gynecologist will help to cope with all these phenomena. More about hormonal changes as causes of vaginal pain.

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Mental stress as a cause of vaginal pain

Not all women can relax during sex. Then the lubrication in the vagina is practically not released, and the penis causes severe pain when rubbing against the walls of the vagina.

A woman who has already experienced this process more than once is afraid before the onset of sexual intercourse. She cannot become aroused, lubrication is not released. This provokes even greater vaginal dryness and contraction of its muscles, which results in even greater pain during penetration of the penis.

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Causes of vaginal pain - sexually transmitted infections

Sexually transmitted diseases can be the culprits of pain in the vagina and near its entrance. Infections that cause sexually transmitted diseases are ureaplasma, mycoplasma, candida, chlamydia, gardnerella, genital herpes, and so on.

They have the bad property of causing inflammation of the vulva – its mucous membrane, and also provoke inflammatory processes in the cervix, vagina, and uterine appendages.

When the genitals are infected and inflamed, their walls become very vulnerable and such organs are easily injured. It is enough to simply touch the outer tissues of the vagina, as it becomes irritated, pain occurs in it.

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Vaginal Dryness and Pain During Menopause

Vaginal atrophy is a medical term that refers to the thinning of the vaginal wall that occurs during menopause (the time when a woman's menstrual periods stop).

Before menopause, the labia are swollen, bright red, and moist. When estrogen levels drop, the lining of the vagina becomes thinner, drier, light pink to bluish in color, and less elastic. These are normal changes that doctors notice in perimenopause and postmenopausal women. But the vagina may be painful.

Estrogen levels begin to drop as menopause approaches. Estrogens are hormones produced by the ovaries. Estrogens control the development of the female body, giving it desirable characteristics such as breasts, body contours, hips, and buttocks. Estrogens also play an important role in regulating the menstrual cycle and pregnancy.

Most women reach menopause between the ages of 45 and 55, but it can happen earlier or later. The average age for menopause is 51. Every woman is different, and there is no definitive way to predict when a woman will enter menopause. Additionally, menopausal women experience symptoms of varying severity during the transition. Not all perimenopausal and postmenopausal women will have equally severe pain symptoms.

Vaginal Bleeding and Pain – The Facts

Normal vaginal bleeding is when there is occasional blood discharge from a woman's uterus.

Normal vaginal bleeding is also called menorrhea. The process by which menorrhea occurs is called the menstrual cycle.

In order to determine whether uterine bleeding is an abnormal process with pain and other changes and to find out their cause, the doctor must answer 3 questions: is the woman pregnant? What is the nature of the bleeding? Is the woman in the period of ovulation?

Abnormal vaginal bleeding in women who are ovulating is most often excessive and frequent, uneven, or a decrease in the amount of blood discharge.

There are many causes of abnormal vaginal bleeding associated with abnormal ovulation and vaginal pain.

A woman who has irregular menstrual periods with vaginal pain requires a physical examination, with particular emphasis on checking thyroid function, breasts, and pelvic area.

Treatment for irregular vaginal bleeding and vaginal pain depends on the cause. Once the cause is determined, the doctor decides whether treatment is really necessary.

Postpartum vaginal pain

Cases of postpartum vaginal pain are very common. It occurs in 60% of cases in women who have given birth. These pains are quite long-lasting – from three to six months. The causes are difficult to determine, so postpartum pains are treated with painkillers and anti-inflammatory drugs, as well as antispasmodics.

Risk groups include women after their first birth, nursing mothers, and women who have had late births (after 35).

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Hormonal imbalance and vaginal pain

After childbirth and during menopause, as well as in the period before menopause, pain may occur in the vagina. At this time, sex hormones are produced much less than during normal functioning of the reproductive system. Low production of estrogens is especially dangerous for the female body during lactation (breastfeeding).

Thus, the body does not produce enough lubricant. Vaginal dryness causes vaginal pain during sex, as well as during and after childbirth.

The vaginal mucosa is dry, it is irritated in response to the penetration of the penis, but the vagina does not stretch without lubrication and therefore hurts. To cope with this medical problem, you need to buy gels for vaginal moisturizing, then sexual intercourse will be complete.

Often a woman has a dry vagina and pain in it after childbirth. When a woman stops breastfeeding, the hormonal balance is restored, and vaginal dryness may go away on its own. If this does not happen, it is advisable to consult a doctor for hormone replacement therapy.

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Vulvodynia and vaginal pain

Women with vulvodynia have chronic pain in the vulva. Until recently, doctors did not recognize vulvodynia as a disease with real pain in the vagina.

Even today, many women with vaginal pain do not have a definite diagnosis. They may remain in isolation, provided that doctors continue to investigate.

Researchers are working hard to uncover the causes of vulvodynia and find better ways to treat it.

Types of Vulvodynia

Vulvodynia affects the vulva and external female genital organs. These include the labia, clitoris, and vagina, which can cause severe pain.

There are two main subtypes of vulvodynia.

General pain in various areas of the vagina. Vaginal pain may be constant or come and go. Touching or pressing on the vagina, including during sex, may make the pain worse. But this can make the pain worse.

Vaginal pain can also occur when it is not the vulva that is causing the pain, but the entrance to the vagina. A woman may feel that with this type of pain, it only occurs after touching or pressure, such as during intercourse.

Possible Causes of Vulvodynia

Doctors don't always know the causes of vulvodynia. And there's no evidence that sexually transmitted disease infections can cause vulvodynia.

Researchers are trying to find the causes of vulvodynia. These may include

1. Nerve damage or irritation of vaginal tissues
2. Abnormal reactions in germ cells following infection or injury
3. Genetic factors that make the vulva vulnerable to chronic inflammation
4. Increased sensitivity of the vagina to yeast infections
5. Vaginal muscle spasms
6. Allergies or vaginal irritation from chemicals or other substances
7. Hormonal changes in the body
8. Sexual violence
9. Frequent use of antibiotics

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Risk groups for vulvodynia

Women of any age, from adolescence onwards, can be prone to vaginal pain. There are between 200,000 and 6 million women with vulvodynia worldwide. White women, African-American women and Hispanic women are the most affected, and it is now known that they suffer from vulvodynia equally.

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Physical and Emotional Impact of Vulvodynia

Vulvodynia, with its vaginal pain, can have a huge impact on a woman's life. It can impair her ability to have sex, exercise, socialize, and work. A National Institutes of Health (NIH) study found that most women with vulvodynia and vaginal pain feel "out of control" because of it - unable to have sex and unable to enjoy life. They need special support - medical and psychological.

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Signs and Symptoms of Vulvodynia

Although the condition lurks for months to years, symptoms of vulvodynia usually begin suddenly.

1. Burning, tingling in the vagina
2. Pain in the vagina, throbbing or dull
3. Itching
4. Burning pain is the most common symptom of vulvodynia.
5. Some women describe the pain as a knife-like pain, or as if acid had been poured onto the skin.
6. Although the vulva usually appears normal, the labia may appear slightly inflamed or swollen.

How Vulvodynia Symptoms Change

Symptoms can vary among many women with vulvodynia. And the severity of symptoms also varies from woman to woman. Riding a bike, inserting tampons, and other fairly innocent movements can cause vaginal pain in women with vulvodynia.

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You may experience symptoms of vulvodynia:

• All the time, or just once
• During activities such as exercise, sitting or walking - or even at rest
• Pain may occur in one specific area of the vagina or throughout the entire vaginal area.

The impact of vulvodynia on the body

Symptoms of vulvodynia, including vaginal pain, are not signs of a life-threatening condition. But vaginal pain can significantly affect a woman's ability to function. For example, if symptoms are severe or sex is difficult, it can affect intimate relationships.

And this, in turn, can affect the overall health of the woman and make her feel depressed. Do not hesitate to seek help in such cases. Many women find ways to manage vaginal pain.

Treatment of vulvodynia

Although there is no traditional treatment, self-care can provide relief from vaginal pain. Women with vulvodynia need to test what works best for their pain because it varies from person to person. Women may need to try several pain management options before finding a combination that works for them.

Self-care for vulvodynia

Here are a few things women can do to help relieve or control vaginal pain symptoms.

Avoid potential irritants

It may help to avoid anything that could irritate the vulva. These may include using certain types of soap, taking anti-inflammatory medications, douching, or taking contrast showers. Here are some tips:

• Use dermatologically tested detergents and do not use chemical fabric softeners.
• Toilet paper should be soft and white.
• Choose 100% white cotton underwear sets, natural sanitary pads and tampons.
• Avoid getting shampoo on the vulva area.
• Avoid scented creams and soaps, scented pads or tampons, and spermicidal contraceptives.
• Avoid hot tubs or pools with high chlorine levels.
• Rinse your vagina with cool water after each urination and intercourse.
• Avoid foods that irritate the vagina. Undesirable menu items may include such foods as greens, legumes, berries, chocolate or nuts.
• Wear loose clothing - avoid tight pants and skirts.
• Keep your vulva clean and dry.

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How to relieve pressure on the vaginal area

Certain activities put pressure on the vagina and cause pain.

Use water-soluble lubricants during sex.

Avoid activities that put direct pressure on the vulva. This includes cycling and horseback riding, even just sitting on a hard stool.

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Pain relief

These steps can help relieve vaginal pain

• Take warm or cool foot baths.
• After intercourse, to relieve vaginal pain, apply ice or frozen gel wrapped in a towel to the lower abdomen.
• Try relaxation techniques.

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Treatment of vulvodynia: drugs, therapy, surgery

There is no single treatment for vulvodynia that works for all women. Women will need to try a combination of treatments for the best results. Your doctor may suggest these types of vulvodynia treatments. Also remember that chronic pain can affect you emotionally. Consider group emotional support methods, they are very effective.

• Medicines
• Local anesthetics such as lidocaine
• Estrogen creams
• Tricyclic antidepressants
• Anticonvulsants
• Drugs for blocking nerve endings
• Interferon injections
• Therapy
• Physical therapy, which includes exercises to strengthen pelvic muscles and reduce muscle spasms
• A biofeedback technique that helps you learn to relax your vaginal muscles to reduce pain
• Surgery

If you have vulvodynia syndrome, your doctor may suggest surgery to remove the diseased tissue, especially if other options have not provided relief.

Symptoms of vaginal pain

Symptoms characteristic of vaginal pain can be completely different: pain can be sharp, aching, dull, cutting, pulling. These sensations can be constant, can bother from time to time or occur during or after sex. If a woman takes painkillers, this does not mean that the pain will not return again - the problem is not solved.

Additional symptoms of various diseases withvaginal pain may be the following.

• Vaginal itching and whitish discharge may be a sign of a genitourinary infection.
• Pain in the vagina can occur after or during sexual intercourse – then the cause may be inflammation of the genitals, their injuries or deformations
• Vaginal pain can bother a woman due to bleeding, the cause of which can be difficult to determine at first
• The vagina can also hurt when a woman is going through menopause.
• A woman may suffer from pain in the vaginal area for unknown reasons, in particular, they may have a neurotic origin.
• Pain in the vaginal area can be wandering, it can arise in completely different organs (for example, in the rectum) and radiate to the vagina.

If you tolerate this pain and do not treat it, the disease that manifests itself with this pain may worsen. In order not to bring yourself to pathological processes in the internal organs, you need to see a gynecologist for an examination, and if the pain is unbearable, call an ambulance. It is not recommended to take painkillers before its arrival, because it will be difficult to diagnose the symptoms later.

What parts of the body can vaginal pain radiate to?

This may be the area of the rectum, perineum or sacrum. The nature of the pain that radiates to these organs may be cutting, paroxysmal, pressing, deep, dull, aching. It seems to the woman that in the place where the pain occurs there is some quite noticeable obstacle like an un-removed tampon, finger or hard foreign object.

True, these pains can be felt near the very surface of the vagina and be shallow – this type of pain occurs in 60-70% of cases in women.

The nature of vaginal pain during sex

It can be sharp, cutting, paroxysmal. If the vagina starts to hurt during sex or lovemaking, it means that the woman has serious problems either with gynecology or with the mental perception of sexual intercourse. Because of these pains, intimate life can be at risk, so at the first symptoms of vaginal pain during sexual intercourse, you need to immediately solve these problems in the gynecologist's office.

Pain when aroused

Pain before and after sexual intercourse can be of different nature – cutting, burning, cramping. Pain in the vagina and vulva in women is distinguished by types: pain after childbirth, superficial pain, deep pain. This pain in women can be so unbearable that the vagina is irritated in the most seemingly innocent circumstances. This can be when sitting on a hard stool, when riding a motorcycle or bicycle, during an examination by a gynecologist. It can intensify even when the gynecologist simply touches the surface of the vagina with a tampon.

How to determine if there is inflammation of the genitals?

You need to monitor the symptoms that a person is experiencing. If these symptoms are present, then you most likely have inflammation.

1. Burning sensation in the vaginal area
2. Itching in the genital area
3. Vaginal discharge is mucous or purulent and may have an unpleasant, pungent odor.

If these symptoms are not enough, you need to undergo additional laboratory tests. What should you take for tests in the gynecologist's office?

1. Vaginal smear for flora.
2. Vaginal bacterial cultures.
3. Bacterial cultures from the cervical canal.
4. Diagnostics of PRC.

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Diagnosis of vaginal pain

It is very difficult to determine the causes of pain in the vaginal area, especially if a woman does not consult a gynecologist for a long time and the disease becomes chronic.

If the cause of the pain is nevertheless found as a result of laboratory tests, ultrasound of the genitals and palpation, then the doctor directs all efforts to eliminate the cause of the pain in the vagina. A woman needs to see not one doctor, but several: a proctologist, urologist, neurologist, endocrinologist, to get a complete picture of the disease and prescribe the optimal treatment.

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10 Important Questions to Ask Your Doctor About Vaginal Pain

Some of the questions below may be very relevant to the treatment of vaginal pain.

1. What is my diagnosis?
2. What can I do at home to control my pain symptoms?
3. Will pain medications help me feel better?
4. What treatment would you recommend for me?
5. Are there any activities I should avoid?
6. How can vulvodynia affect my sex life?
7. What should I tell my partner about my condition?
8. Can vaginal pain affect my ability to have children?
9. What can I do to support my condition?

Doctors to see for pain relief

• Gynecologist.
• Psychiatrist.
• Sexologist.

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Treatment for vaginal pain

Once the tests are done, the doctor gets a clear picture of the pathogens that are causing the pain. Then he can prescribe local and general treatment. It looks like antibacterial and anti-inflammatory drugs. Among the methods of treatment with them are douching with anti-inflammatory drugs, vaginal suppositories that have an anti-inflammatory effect.

If the girl is not breastfeeding and is not pregnant, she may be prescribed hormonal suppositories, antibacterial medications in oral form. A course of treatment from 5 days to a week may be enough for the woman to recover.

If a nursing mother still has to take antibiotics, she cannot breastfeed her baby during this time – she can express milk and feed the baby artificial milk supplements.

But the mother can also do with local non-oral means (suppositories, douching), then a break in feeding is not necessary. But this can be done at the initial stages of the disease of the genitals, when the inflammation process has not yet become chronic.

Antibacterial therapy for vaginal pain relief is used when a person is infected with microorganisms of viral origin. If these are microorganisms that can only be destroyed with complex antibacterial agents, the mother will have to stop breastfeeding the baby for the duration of the treatment. If this is not done, the infection can penetrate the baby's body and spread throughout the mother's body, which can lead to complications.

Microorganisms of viral nature that are difficult to get rid of are trichomonads, gonococci, chlamydia, and so on.

Pain Prevention: How to Strengthen Your Muscles

To strengthen the pelvic floor muscles and restore or activate blood circulation in them, physical exercises are needed.

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Exercise to strengthen muscles

The woman is in a lying or sitting position. You need to tense the vaginal muscles and count to two, then relax them. Do this 20-30 times. If a woman does this exercise 3 times a day, her muscles will strengthen in just a month. And they will strengthen well in 3-4 months.

At this time, you should be prepared for the fact that in the area where the stitches were placed, there may be a feeling of discomfort and slight pain.

If you do not skip exercises and diligently do them for at least three months, the wounds will heal well and the muscles will become stronger. Then there will be no rough scar tissue at the site of the stitches.

If a scar has formed at the site of the sutures and the tissue has become inflamed, then surgery will be necessary after the mother has stopped breastfeeding. The surgery involves excision of the scar tissue and the subsequent rehabilitation process. But this should be done no later than six months after the first surgery, otherwise the tissue will become rough and will heal poorly. After all these procedures have been carried out and the vaginal muscles have been strengthened, the pain in it should subside and no longer bother you.