If you have a pain in the vulva, it’s important to know what’s going on so that it can be treated quickly and effectively. Here are some of the most common reasons why your vulva may be sore:
Treatment depends on the cause of your pain. For example, STIs are usually treated with antibiotics.
Endometriosis
Endometriosis occurs when tissue similar to the lining of your womb grows in other parts of your body. It causes pain, inflammation and scarring. This condition can also interfere with fertility. The cause of this condition is not known, but experts believe that hormones or immune factors may play a role.
Each month, your uterus undergoes hormonal changes. These hormones make the lining of your womb thicken in preparation for a fertilized egg. But when this lining is not used, it breaks down and bleeds. Normally, this blood would leave the body through your vagina. However, with endometriosis, this blood enters your pelvic cavity and triggers pain and inflammation. This blood can also cause scar tissue to form.
If you have endometriosis, your doctor can diagnose it by performing a pelvic exam and examining you for cysts or scars. They can also use a laparoscopy, which involves inserting a camera through your vagina. If your pain is severe, they might need to perform a larger operation called a laparotomy.
The most common type of endometriosis is deep infiltrating endometriosis (DIE). This is the most severe form of the disease and affects your ovaries, fallopian tubes and bowels. It can also lead to dark, fluid-filled cysts, called chocolate cysts. This form of the condition can also obstruct your fallopian tubes and prevent pregnancy. The good news is that surgery can reduce or eliminate symptoms and improve fertility.
Vulvodynia
Vulvodynia is a painful condition that affects the area around the vagina. It usually starts in a woman’s early twenties and can be difficult to diagnose. Women who have vulvodynia can experience pain, tenderness, itching and burning sensations in the vulva. They can also have trouble with their menstrual cycle and feminine hygiene. It is important for women to talk about their symptoms with a doctor.
To make a diagnosis, your health care provider will do a pelvic exam and carefully inspect the vulva. He or she will ask questions about your symptoms and past treatments. Your doctor may also order blood tests to check for yeast infections or other conditions.
Treatment for vulvodynia varies from one person to the next. It depends on the underlying cause and how severe your symptoms are. Some treatments include using an anesthetic gel that contains lidocaine to numb the pain. This can be applied up to 20 minutes before sex and helps reduce pain during sexual activity. Medications like antidepressants and neuropathic pain agents can be taken orally or as creams to help relieve nerve pain. Nerve block injections are also available for more severe pain.
Psychological counseling is also helpful for women with vulvodynia. It can help them develop coping strategies and deal with the effects of chronic vulvar pain on their relationships. It can also help them deal with depression and feelings of low self-worth associated with vulvar pain.
Genital herpes
The herpes virus that causes genital herpes can cause pain in the top of your vagina. You can get herpes from skin-to-skin contact with someone who has it or through oral sex. You can also get it by having a baby with a mother who has herpes.
Herpes sores on the vulva look like clusters of painful or itchy blisters that may ooze whitish fluid. The blisters eventually turn into sores that scab over and heal. During an outbreak, you might have warning signs, such as pain, tingling or itching, before the herpes sores appear.
If you have herpes, your first outbreak can be especially severe. But once the sores go away, you’ll have fewer and fewer outbreaks over time. During an outbreak, you can use a topical ointment or pill to help relieve the pain.
The virus that causes herpes never leaves your body, but it goes into hibernation in nerve cells near the areas where you have herpes sores. The virus can awaken and cause more herpes sores at any time.
You can reduce your chances of getting herpes by telling your sex partners that you have herpes and using condoms during sexual intercourse. You should also put a little lubricant in your vulva after sex to keep the area moist and soft. Just avoid putting on a lubricant with alcohol in it, as this can cause irritation.
Vaginal dryness
Vaginal dryness can be uncomfortable and lead to itching around the vulva. It can also make sex less enjoyable and cause pain during sexual penetration. It’s a common symptom of menopause and occurs when the body’s levels of the hormone estrogen drop. It can also be caused by medications like oral contraceptives and certain antidepressants. Women who have a condition called Sjogren’s syndrome, which can cause dryness in many parts of the body, may also experience vaginal dryness.
Women with vaginal dryness should avoid tight-fitting underwear and pantyhose and use only water-based lubricants for intercourse (since non-water-based lubricants can damage condoms). A diet rich in fruits and vegetables and taking a prenatal vitamin can help too. Vaginal lubrication products can be found in most stores and don’t require a prescription.
Talking to a doctor is important, especially for women with painful sex or vaginal discharge that could be a sign of infection. The OB-GYN can run tests to check the cervix and vagina for thinning or signs of irritation. She can also recommend over-the-counter lubricants and prescribe creams or tablets to increase the body’s natural estrogen levels. The OB-GYN can advise about hygiene practices and other treatment options that can help with the symptoms of vaginal dryness, such as a pelvic floor physiotherapist to help release overactive pelvic muscles.
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