- Vaginal pain can be caused by a yeast infection if it is accompanied by itching and white discharge.
- If you are also experiencing pain during sex, it could be a sign of dryness or an STI.
Experiencing discomfort down there? Vaginal pain can range from mild irritation to an intense throbbing sensation around your vagina or pelvis.
Regardless of how it feels, vaginal pain is, well, a pain. It can ruin your quality of life, causing you daily distress, and sometimes worsening when you go to the bathroom or have sex.
Vaginal pain is common since there are so many causes for it that frequently affect women.
The root cause of vaginal pain can range from something as simple and fleeting as a yeast infection to something more serious and chronic, such as endometriosis.
Here are six common causes of vaginal pain and how to treat them, according to OB-GYNs.
1. Yeast infection
Yeast infections are extremely common, affecting an estimated 75% of women at least one time in their life. They are one of the most frequent causes of vaginal pain, burning, discomfort, and itchiness, says Dr. Courtney Martin, OB-GYN at Loma Linda University Health.
A yeast infection is caused by an overgrowth of yeast, a type of fungus, in the vagina. Martin says yeast infection symptoms include:
- Thick, white, cottage cheese-like discharge
- Vaginal soreness
- Overall irritation of the vagina and vulva
- Swelling and redness
- Burning while urinating or during sex
- Itching
How to treat it: Yeast infections may be treated with over-the-counter topical antifungals or prescription antifungal pills. If you're using OTC treatments and your symptoms don't improve in a week, or if this is your first potential yeast infection, Martin recommends seeing your OB-GYN.
2. Sexually transmitted illnesses (STIs)
If you're sexually active, STIs are a possible cause of your vaginal discomfort, Martin says. Some examples of common STIs that could potentially cause vaginal pain are:
- Chlamydia
- Gonorrea
- Trichomoniasis
- Genital herpes (herpes simplex virus, or HSV)
- Human papillomavirus (HPV)
Oftentimes, STIs are asymptomatic. But for some people, symptoms such as vaginal pain and discomfort may show up. Martin says aside from vaginal pain, some other STI symptoms to look out for are:
- Pain during sex
- Unusual vaginal bleeding
- Abnormal or foul smelling vaginal discharge
- Burning while urinating
- Bumps or sores on your vulva
- Swollen lymph nodes in the groin area
- Fever
How to treat it: First, see your doctor for STI screening to determine which infection is causing your symptoms, which will also determine your treatment options. Martin says treatment may involve antibiotics if the STI is caused by bacteria or antiviral drugs if it's caused by a virus.
If you're sexually active, Martin recommends using protection to lessen your chances of contracting an STI and getting tested regularly so you can catch infections early.
3. Vaginal dryness
Your vagina is meant to be a moist environment. However, various factors can lead to vaginal dryness, which can result in vaginal pain, says Dr. Maria Sophocles, OB-GYN and Medical Director of Women's Healthcare of Princeton.
Sophocles says vaginal dryness may cause pain throughout the day whether you are sitting, exercising, or having sex. One of the most common causes of this is vaginal atrophy associated with menopause when your estrogen levels drop.
Aside from menopause, other factors that may trigger vaginal dryness are:
- Breastfeeding
- Cancer treatment
- Diabetes
- Giving birth
- Hormonal birth control pills
- Medication side effects
- Ovary removal
Vaginal dryness can lead to further complications resulting in more pain. For example, Sophocles says if your vagina is too dry when you have sexual intercourse, this can result in tiny micro-cuts in the vagina which leads to more pain during and after sex.
How to treat it: Vaginal moisturizers, available over-the-counter, are helpful for short-term relief from vaginal dryness and the associated pain. You can alsol use plenty of lubricant during sex to smooth things along, Sophocles says.
It's important to see your doctor to determine the cause of the dryness. If low estrogen is the culprit, Martin says topical estrogen therapy (through a tablet, ring, or cream) can provide some long-term relief.
4. Pelvic floor dysfunction
The pelvic floor refers to the muscles that support your pelvic organs. One type of pelvic floor dysfunction that may cause vaginal pain (and pain in the surrounding area) is hypertonic pelvic floor.
In this case, Martin says the pelvic floor muscles spasm and are not able to relax. Essentially, your pelvic floor muscles are constantly contracting, which can lead to general pain, pain during sex, and difficulty going to the bathroom.
"If you have this dysfunction, instead of relaxing your muscles properly, your body will just keep tightening them and creating tension," Martin says.
Every individual experiences pelvic floor dysfunction differently. Aside from vaginal pain, other possible symptoms are:
- General pelvic pain or pressure
- Difficulty urinating
- Painful urination
- Constipation
- Pain or difficulty during bowel movements
- Painful sex
- Difficulty having an orgasm
How to treat it: Pelvic floor physical therapy is the most common treatment for pelvic floor dysfunction. With a pelvic floor therapist, you will work on special exercises that can help you learn to appropriately contract and relax the muscles. They might also utilize massage.
In some cases, Martin says prescription medications or injections can be helpful for treatment, too.
5. Vulvodynia
Vulvodynia refers to chronic vaginal pain without a specific cause. "This diagnosis often can be missed, hard to make, or mistaken for recurrent yeast infections or vaginitis, even when cultures and swabs show nothing is wrong," Martin says.
The vaginal pain may involve burning, soreness, throbbing, and itching in and around your vagina. Usually, the pain and discomfort are the only symptoms of vulvodynia, and in most cases, the vulva appears to look normal and healthy.
Doctors do not fully understand the cause of vulvodynia, but nerve irritation may play a role. "The pudendal nerve supplies the vaginal area and can be inflamed causing symptoms of burning, pain, and abnormal signaling to the brain," Martin says.
Other potential causes include a history of vaginal infections, muscle spasms, or hormonal changes.
How to treat it: Depending on the severity of your symptoms, some treatment options are:
- Pelvic floor physical therapy
- Nerve block injections
- Topical numbing agents
- Prescription medications for pain
6. Endometriosis
Endometriosis is when cells similar to that of your uterine lining grow outside of your uterus, causing pain that may be perceived in the vagina, says Sophocles. These cells can cause lesions on your ovaries, fallopian tubes, or other nearby organs.
The pain associated with endometriosis is typically the worst when you have your period. Aside from vaginal pain, other symptoms of endometriosis include:
- General chronic pelvic pain
- Heavy periods
- Irregular bleeding between periods, aka spotting
- Painful ovulation
- Painful urination
- Painful bowel movements
- Pain during sex
- Infertility
How to treat it: A doctor can make a formal diagnosis of endometriosis through a biopsy of endometrial growths. There is no cure for endometriosis, but Sophocles says treatment may involve pain medications, hormone therapy, or surgery, depending on the severity of your condition.
Insider's takeaway
The causes of vaginal pain vary. If you're experiencing vaginal pain, especially if it's persistent, it's important to see your doctor for a proper diagnosis.
An OB-GYN can conduct a pelvic exam and do any necessary lab work to determine what the cause of your pain may be, and get you on track to feeling better.