Vaginas are pretty awesome, but they can also be confusing. They’re self-cleaning, self-regulating and able to communicate with us in ways we don’t always understand.
For example, a throbbing feeling when you’re turned on is normal and depends on how fast or slow your blood flows down there. This changes as you go through your menstrual cycle or become pregnant.
Pain
The pain you feel inside your vulva and vagina can be caused by infection, irritation or something in the genital area. If you have persistent vulva pain (also called vulvodynia), it’s important to see an OB-GYN for diagnosis and treatment. Vulvodynia can affect your quality of life and your sexual relationship with your partner. It can also cause psychological problems like low self-esteem, anxiety and depression.
A symptom of bacterial vaginosis is thin, milky discharge with a fishy odor. You may also have pain in your vulva and vagina, itching and burning when you pee. You may have a hard time penetrating your clitoris, and sex can be painful for both partners.
Yeast infections are another cause of pain in the vulva and vagina. They’re caused by an overgrowth of a yeast called Candida albicans, which can be found in other moist areas of your body, such as your mouth and skin folds. Trichomoniasis is a sexually transmitted infection caused by microscopic one-celled parasites that can be spread during sex. Yeast infections can be triggered by hormonal changes, such as those that occur during pregnancy and menopause.
Bleeding
Bleeding between periods is quite common and most of the time it’s nothing to worry about. But it’s important to see your doctor if you’re bleeding frequently or for several months in a row. This could mean you’re pregnant, having an infection or have a gynaecological problem like uterine fibroids.
Spotting between your period is usually blood that mixes with your normal vaginal discharge and is bright red. You might notice it on toilet tissue or when wiping.
Light spotting that doesn’t mix with the rest of your discharge may be implantation spotting, which is an early sign of pregnancy. This happens around 10 to 14 days after you conceive and can last for a few days. It’s not unusual to have sex before implantation spotting and it doesn’t usually cause pain or blood clots.
It’s important to go to a GP if you have blood-coloured vaginal discharge, especially if it’s out with your menstrual period or after sex. Your GP will check that you aren’t pregnant and might do an ultrasound of your uterus to find out what is causing the bleeding. They may also suggest a D&C or hysteroscopy to remove tissue from your cervix or uterus to examine it for signs of a problem.
Irritation
Most women have a little bit of clear or slightly cloudy, non-irritating and fairly odorless discharge in the vulva area. Sometimes (usually toward the end of the menstrual cycle) it can be a little thicker and more intense. But this is normal and nothing to worry about.
A lot of things can make a vagina feel irritated or itchy. A yeast infection can cause itching, as well as pain and a burning feeling. Sex can also upset the natural balance of bacteria in the vulva and may cause a yeast infection to overgrow. Irritation can also be caused by wearing tight underwear, using perfumed soap in the genital area and by swimming in chlorinated water. It’s a good idea to wash the outside of your vulva with unscented soap after urinating and after sexual intercourse, and to avoid talcum powder.
If you’re itching, contact a healthcare professional right away. They’ll ask you about your symptoms and may do a pelvic exam. They’ll also likely give you advice on how to prevent itching, and maybe even a prescription to help with the itch.
Swelling
From ballooning feet to inexplicable pickle cravings, it’s no secret that pregnancy can wreak havoc on the body. Swelling of the vulva and vagina is very common during pregnancy, thanks to things like excess blood flow and hormones, added pressure from a growing fetus, and enlarged pelvic structures, Twogood explains.
The vulva and vagina can also be swollen for noninfectious reasons, such as irritation or an allergic reaction. Typically, this occurs from products that come in contact with the truly delicate skin there, such as soaps, shower gels, laundry detergents, or perfumes. Often, removing the suspected irritant will lead to relief.
Another common cause of vulvar and vaginal swelling is infection, such as cellulitis or an abscess. Usually, these kinds of infections are treated with antibiotics, and they’ll usually go away on their own if you get on top of them quickly enough. Other times, however, you’ll need to see a doctor or nurse who can use a smooth, tube-shaped tool (speculum) and a small cotton swab to get a closer look at your vulva.
Discharge
Vaginal discharge is normal and varies throughout the menstrual cycle. But if it changes significantly in color, amount or consistency, it can be an indication that something is wrong. A clumpy, white or cottage cheese-type discharge may be a sign of thrush, which is a yeast infection. It often has a strong yeasty smell and is itchy, burning or painful around the vulva and genitals.
Yellow or green discharge, a rash and a bad odor can indicate a sexually transmitted infection known as gonorrhea or chlamydia. Yellow or frothy discharge is also a sign of another STI called trichomoniasis.
To determine what is causing your symptoms, doctors ask questions about when the symptoms began and do a pelvic exam with a speculum and their hands. They might do a wet mount to look at the acid level of the discharge and do a Pap test (a sample from the cervix) to check for signs of abnormal cells. The doctor may also take a sample of the discharge to do an STI test to see if you have gonorrhea, chlamydia or trichomoniasis.
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