The female sexual organ is composed of many nerve endings, which makes it extremely sensitive and delicate1. When pain or sensitivity occurs, it is a sign that something might not be right and investigation is needed when vaginal pain occurs. Vaginal pain can happen for many reasons and under a variety of circumstances, especially during sexual intercourse, menstruation, and urination.

Sex

Although vaginal pain can occur without sexual activity, it often happens during intercourse, and the reasons are often related to sex. Vaginal pain can lead to low libido (sexual desire), vaginal dryness, or an inability to achieve orgasm due to discomfort during intercourse. Vaginal pain can be chronic and last for years in some women. The degree of severity varies between women. It often occurs in the absence of physical signs or visible abnormalities. It can be severe and interfere with sexual activity, causing painful intercourse (dyspareunia). However, there are several other causes of vaginal pain during or after sex2.

What Causes Vaginal Pain?

It is unclear why some women develop this condition, since the pain can be linked to various factors. It may or may not also be associated with sexually transmitted diseases (STDs).

Main Causes

Some theories suggest that vaginal pain may be related to:

  • Inflammation due to sexually transmitted diseases
  • Acute infection such as vaginitis
  • Vaginal dryness
  • Infections or other issues with the digestive system, especially the intestines or bladder
  • Fibromyalgia, chronic generalized pain syndrome
  • Ovarian cysts
  • Ectopic pregnancy

In addition to other issues such as fibroids, endometriosis, nerve damage or irritation, allergic reactions to soaps or even condoms, muscle spasms, a history of sexual abuse, and frequent use of antibiotics. Family or genetic factors have also been suggested to play a role in vaginal pain. Unfortunately, the exact cause has not been determined and most women have no known contributing factors. In cases of vaginal dryness, the problem may be related to the use of water-based lubricating gel. If you are trying to conceive, choose fertility-friendly lubricating gels, such as FamiGel. In addition to solving the lubrication issue, it mimics fertile mucus, creating a favorable environment for sperm to survive longer and reach the egg more easily.

Vaginal Pain During Pregnancy

Vaginal pain can occur during the third trimester of pregnancy due to increased pressure on the cervix. Women who have experienced vaginal pain before pregnancy may continue to have this symptom during pregnancy3.

Characteristic Symptoms of Vaginal Pain

Pain in the vagina and female external genital organs (the vulva, which includes the labia, clitoris, and vaginal opening) is most common as a result of infection.

Pain During Sexual Intercourse

Pain in the vagina during sexual intercourse is called dyspareunia, and symptoms can include:

  • Burning or throbbing pain in the vulva or vaginal opening
  • Sharp and burning pain in the inner area of the vagina
  • Itching
  • The pain may be constant or intermittent
  • Pain during intercourse

Some women report pain localized to one side or a specific area of the vagina, while others experience more generalized pain. Typically, there are no physical signs or changes that accompany vaginal pain, but sometimes there is evidence of inflamed skin.

Are There Risk Factors for Vaginal Pain?

Since the cause is not well understood, it is difficult to predict who is at risk of vaginal pain. It can affect women of all ages and races. It can start as soon as adolescence begins and may occur before or after menopause. It can happen during the menstrual period or independently of it.

Diagnosis of Vaginal Pain

The diagnosis is made based on characteristic symptoms. The physician may perform a pelvic exam to discover if abnormalities, infections, or other issues with the pelvis or vagina are causing the pain. A cotton swab may be used to gently touch the genitals to identify painful areas. The doctor may also ask questions about how and when the vaginal pain occurs.

Diagnostic Tests

If endometriosis is suspected, which is characterized by pelvic pain, some diagnostic tests may be performed, including:

  • Colonoscopy or sigmoidoscopy to examine sections of the colon;
  • Barium enema, which involves inserting a solution into the rectum and taking X-rays to look for problems;
  • CT scan;
  • Magnetic resonance imaging (MRI);
  • Ultrasound of the pelvic organs;
  • Cystoscopy, which uses a small camera to examine the urethra and bladder.

Treatment For Vaginal Pain

Vaginal pain can be managed with medical treatments and self-care (home remedies). Not all treatments will be effective for all women, and a woman may need to try different treatments to find the most effective option for her. If it is just discomfort during intercourse, lubricating gels may also provide a solution, at least temporarily.

Medications

Some helpful medications include:

  • Topical creams
  • Topical or local anesthetics
  • Anticonvulsants (anti-seizure medications are sometimes helpful in treating chronic pain)
  • Antibiotics (in the case of infections)

Alternative Therapies

Other medical therapies for women with severe vaginal pain include:

  • Nerve block injections, in which medications are injected to reduce nerve sensitivity in affected areas
  • Pelvic floor exercises have helped some women.
  • Surgical removal of affected tissue can be beneficial for women with vaginal pain due to vulvar vestibulitis syndrome (a specific type of vaginal pain located in the area of the hymenal ring).

Home Remedies For Vaginal Pain

Home remedies and self-care measures for vaginal pain can bring relief to many women. Some measures to relieve vaginal pain include:

  • Rinsing the area with cold water, especially after urination and sexual activity
  • Warm sitz baths
  • Using topical ice packs wrapped in a towel
  • Conversely, using a hot water bottle may help some women
  • Using unscented intimate soap
  • Using plain, unscented toilet paper
  • Wearing cotton underwear
  • Avoiding tight clothing in the area

Additional care includes: avoiding swimming pools or hot tubs with chlorinated water, using water-based lubricant during intercourse, avoiding activities like cycling that put pressure on the vulvar area, and keeping the vulvar area dry and clean. Over-the-counter antihistamines may help reduce itching, especially at night.

Complications of Vaginal Pain

Vaginal pain can be debilitating and interfere with daily activities and sexual relationships. This may cause women to feel a loss of control over their bodies, leading to significant emotional and physical discomfort. If no physical cause of vaginal pain is diagnosed, a sex therapist or couples counselor may help identify an emotional cause behind the pain. This is the case in vaginismus, which causes significant pain when the vulva and vagina are manipulated. Counseling sessions can help diagnose and treat the problem through communication, relaxation, and open dialogue about sex. The most important thing is to not try to diagnose vaginal pain on your own. It is necessary to consult a doctor to rule out physical causes and seek a therapist if you need to address emotional issues. Also see: Discomforts During Sexual Intercourse – How to Overcome Them