Why Does My Vagina Hurt?

Most of us know the discomfort of menstrual cramps, but experiencing vaginal soreness or vaginal pain outside of your regular cycle can be both concerning and downright frustrating.

Vaginal pain can take on many forms, and it’s a fairly common occurrence for many females. This guide aims to address all your concerns about the reasons behind vaginal discomfort. We'll cover common symptoms and causes along with proactive measures to help you stay healthy, so you can find relief and peace of mind.

What are the Symptoms of Vaginal Pain?

Vaginal pain can be a distressing and uncomfortable experience, and it may manifest through a variety of symptoms.

While some females experience vaginal pain during sex, others may feel it worsen during periods, urination, or even when they’re wearing tight clothing⁽¹⁾. Overall, the symptoms of vaginal pain can range in nature and intensity, so it’s vital to pay close attention to what your body is telling you. 

As you experience vaginal pain, make sure to take note of everything you're feeling. Determine if the discomfort is localized to the vagina and vulva or if it's also affecting the surrounding areas.

The underlying cause of vaginal pain plays a significant role in determining the types of symptoms you may experience and how severe they can be. To help your healthcare provider identify the root cause, it's a good practice to keep track of your symptoms, noting their pain level, frequency, and any potential triggers.

Common symptoms of vaginal pain include: 

• Itching: Vaginal itching is most commonly caused by infections and skin conditions. It is a common side effect of bacterial vaginosis and yeast infections but not UTIs⁽⁴⁾. 
• Burning: A burning sensation in the vaginal area can be indicative of various conditions, including irritation, UTIs, STIs, and allergies⁽⁵⁾.
• Tension: Tension or tightness in the vaginal muscles can lead to discomfort and pain. Certain conditions, such as vaginismus, can lead to involuntary muscle contractions and tension⁽⁶⁾.
• Muscle spasms: Involuntary muscle contractions or spasms in the vaginal or pelvic area can lead to significant pain. Vaginismus or interstitial cystitis can be possible causes^(6,7). 
• Tenderness or sensitivity: Infections, trauma, or inflammation may result in the vaginal area becoming sensitive or tender to touch. This makes even simple activities like sitting, walking, or wearing tight clothing uncomfortable⁽⁸⁾. 
• Swelling: Vaginal swelling is uncomfortable and painful. It may result from infections, physical irritation, or allergies⁽⁹⁾.
• Pain during intercourse: Pain during sexual intercourse, also referred to as dyspareunia, is a common symptom of vaginal pain. It can have various causes, including infections, trauma, decreased lubrication, and various skin conditions⁽¹⁰⁾.

Common Causes of Vaginal Pain

Each underlying cause of vaginal pain requires a different approach to diagnosis and treatment. If you’re dealing with soreness or stinging in your vaginal area, understanding the potential causes can help you effectively address and alleviate your discomfort. Here are some of the most common causes of vaginal pain:

Bacterial Vaginosis (BV)

Bacterial vaginosis (BV) occurs when the vaginal pH balance is off due to an imbalance of good bacteria versus bad bacteria in the vagina⁽¹¹⁾. It can result in off-white, gray or green colored vaginal discharge, a foul odor, and pain or discomfort.

Yeast Infections

Yeast infections often lead to symptoms such as vaginal itching and a burning sensation. Additionally, they may cause redness and swelling in the vulva, accompanied by a thick, white, odorless vaginal discharge. These infections are typically triggered by an overgrowth of the fungus Candida albicans, which can occur due to factors like antibiotic use, hormonal changes, or a weakened immune system⁽¹²⁾. 

Sexually Transmitted Infections (STIs)

STIs like chlamydia, gonorrhea, and herpes can cause significant vaginal pain⁽¹³⁾. Detecting these infections early and seeking prompt treatment is crucial for preventing complications and effectively managing any discomfort.

Urinary Tract Infections (UTIs)

While they can both cause vaginal pain, the key distinction between UTIs vs. yeast infections lies in the fact that UTIs result in painful urination and lower abdominal discomfort⁽¹⁴⁾. If you don't completely clear the infection from your body or follow best practices for possible UTI prevention, you're also more likely to experience recurring UTIs.

Sexual Intercourse

• Dyspareunia: Pain during intercourse is known as dyspareunia. It can be caused by infections, vaginal dryness, or trauma⁽¹⁰⁾. 
• Vaginismus: Vaginismus is a medical condition characterized by involuntary muscle spasms in the vaginal area, making penetration painful or sometimes even impossible⁽⁶⁾.

Endometriosis

Endometriosis can also cause vaginal pain. This condition involves the growth of tissue similar to the uterine lining outside the uterus⁽¹⁵⁾. As this tissue responds to hormonal changes during the menstrual cycle, it can become inflamed, leading to pain and discomfort in the vaginal area⁽¹⁶⁾.

Vulvodynia

Vulvodynia is a chronic condition characterized by persistent and unexplained vulvar pain, discomfort, or burning sensations, often without any identifiable cause such as infection or injury. It can significantly impact a person's quality of life and can make sexual intercourse and daily activities painful⁽²⁾.

Physical Trauma

Potential injuries or trauma, especially from childbirth, may lead to pain in the vaginal area due to tissue damage and tears⁽¹⁷⁾. 

Allergies and Irritation

Allergic reactions or irritation caused by products like detergents, fragrances, latex condoms, or tight clothing can result in itching, burning, or other forms of discomfort⁽⁵⁾. 

Hormonal Changes

Fluctuations in hormones throughout the menstrual cycle can lead to occasional discomfort and pain. During your period, the uterus contracts to remove its lining. Prostaglandins, which are compounds that cause pain and inflammation, initiate these contractions. When prostaglandin levels are higher, menstrual cramps tend to be more severe, resulting in greater pain⁽¹⁸⁾. 

Pelvic Floor Weakness

The pelvic floor supports the bladder, uterus, and colon. Since the vagina, urethra, and colon all pass through your pelvic floor muscles–a weakness in the pelvic floor muscles can lead to vaginal pain. Pain typically occurs during urination, bowel movements, or sexual intercourse. Pelvic floor therapy may help alleviate painful symptoms⁽¹⁾.

When to See a Doctor

If you’re experiencing vaginal pain, it’s important to seek medical attention. Your doctor can help you identify the underlying cause of your pain based on your symptoms and sexual and urinary health to develop a treatment plan. Here are a few situations or symptoms that indicate you should make an appointment with your doctor: 

• Persistent or severe pain
• Unusual discharge
• Pain during or after intercourse
• Blood in urine or bleeding in general
• If you’re pregnant
• Suspected STI
• Changes in vaginal appearance

There are also more serious conditions that cause vaginal pain, so seeking medical attention if you are experiencing the above symptoms can help you identify problems early. A more serious condition such as endometriosis, cervical cancer, or pelvic inflammatory disease are best managed when diagnosed early. Routine gynecological exams and open communication with your doctor can aid in early detection so you get the intervention you need. 

To determine the underlying cause of your vaginal pain, your doctor will likely perform a physical exam and conduct diagnostic tests, including vaginal swabs and pH testing⁽³⁾. Early diagnosis is key to getting the help you need as soon as possible and improving your overall health. 

Treating Vaginal Pain

There are various vaginal pain treatments available depending on the underlying cause. Common treatments include: 

• Medications: When the pain is caused by a bacterial infection, antibiotics may be prescribed. For other cases, pain relievers can help manage discomfort. 
• Lifestyle changes: In the case of allergies or irritants, it’s important to identify and avoid triggers such as perfumed products, detergents, or latex condoms. When experiencing vaginal dryness, using water-based lubricants can help ease vaginal pain during sex⁽¹⁹⁾. 
• Physical therapy: Pelvic floor therapy is often recommended for those experiencing vaginismus or pelvic floor weakness^(6,20). 
• Psychological therapy: Vulvodynia is sometimes treated with therapy, such as cognitive-behavioral therapy, to address the psychological aspects of pain and develop coping strategies⁽²⁾.
• Surgery: In rare cases, surgery is considered when other treatments have failed, antibiotic resistance, or when the underlying issue is anatomical⁽²¹⁾. 

Vaginal Pain Risk Factors

Vaginal pain can be influenced by various risk factors, including age, medical history, and more^(10,24). In terms of age, women taking oral contraceptives may experience increased vaginal dryness that could cause pain and those who do have vaginal births may experience stretching and potential trauma to the vaginal area that leads to significant pain⁽¹⁰⁾. Women going through menopause may experience hormonal changes that heighten discomfort or pain due to vaginal dryness and thinning of the vaginal walls⁽²²⁾. 

Your medical history can also contribute to vaginal pain risk factors. Prior vaginal infections can make you more susceptible to recurrent infections⁽²³⁾. A history of pelvic inflammatory disease, often caused by STIs, can lead to scarring or damage to reproductive organs⁽²⁴⁾.

Reducing Your Risk of Vaginal Pain

Preventative measures play a vital role in maintaining vaginal health and minimizing your chances of encountering vaginal pain. Here are some practical tips and strategies for preventing vaginal pain: 

1. Maintain good hygiene
2. Practice safe sex, and be mindful of lubricant and condom choices
3. Get regular gynecological check-ups

Because UTIs often lead to discomfort and pain, understanding the anatomy of the urinary tract and how to promote urinary health can help reduce the risk of vaginal pain. 

Proactive self-care is one of the best ways to help prevent potential vaginal pain. Staying hydrated, incorporating pelvic floor exercises into your routine, wearing breathable fabrics, and choosing lube with intention can all help promote vaginal health.

Final Notes

Your sexual, reproductive, and urinary health are interconnected and play a fundamental role in your overall well-being. 

The more you understand your body and symptoms, the better you can treat and prevent vaginal pain. Prioritize your sexual health by educating yourself on everything from the link between new sexual partners and UTIs to common causes from factors like infections and hormonal changes. 

Take your health into your own hands by implementing a proactive approach and seeking professional medical advice when needed.

Note: references to "female", “women”, “male”, and “men” in this article refer to sex assigned at birth, not gender.

This article does not replace medical advice. We recommend you seek treatment if you think you are experiencing a UTI.