What people call “vagina pain” may indeed involve the vagina, the inside part that connects to the womb or uterus. But it may also involve the vulva, the outer part of the genitals.
This article explores some of the causes of a vulvar or vaginal pain and soreness. It also explains how these problems are diagnosed and treated.
Causes
Vaginal pain can have many different causes. Some are serious, while others go away on their own or respond to simple treatments.
Yeast Infection
A yeast infection is caused by a fungus. It can cause pain and itching around the vulva and vaginal opening. Other symptoms include:
Pain during sexPain when peeingThick, white discharge that’s sometimes smelly
Some people are more prone to yeast infections. This includes people who:
Use hormonal birth controlHave recently used antibiotics Are pregnantHave diabetesHave problems with their immune system
In some cases, hygiene habits can raise your risk (for example, not quickly changing out of sweaty workout clothes).
Bacterial Vaginosis (BV)
Bacterial vaginosis is an infection that happens when too much of a bacteria grows in your vagina. Not everyone has symptoms.
If you do, you might notice:
A strong odorGrey, white, or foamy dischargeItch Pain when urinating
Your risk of getting BV is higher if you:
Douche oftenHave multiple or new sex partnersDon’t have enough lactobacilli (good) bacteria
Sexually Transmitted Infections
Sexually transmitted infections (STIs) can also cause vaginal/vulvar pain, as well as itching and burning.
Some examples include:
Trichomoniasis Genital herpes (also causes painful sores) Gonorrhea Chlamydia
If you think you could have an STI, talk to your healthcare provider. You and your partner should both be tested to reduce the risk of passing it on or having complications.
Urinary Tract Infection
Urinary tract infections (UTIs) are very common. UTIs happen when bacteria enter the urinary tract.
Symptoms include:
Pelvic painA feeling of pressure in the pelvic areaAn urgent need to urinateCloudy urine that could have a strong odorRed, pink, or brown urine
A UTI can make it painful to have sex.
Irritation or Allergy
Irritation and allergies can cause soreness. You may have a reaction to:
Laundry detergent Soaps Bath products Spermicide Latex condoms Menstrual pads and tampons Douches
Shaving or waxing the area can also cause discomfort, especially when the hair grows back. This pain is usually temporary.
Vulvodynia
Vulvodynia is vulvar pain that lasts more than three months. You may also notice:
Stinging or burningItching
Genetics, hormones, trauma, or nerve damage may raise your risk. Vulvodynia can also happen after medical procedures such as chemotherapy or surgery involving the nerve supply in the area.
Bartholin’s Cyst
A Bartholin’s cyst occurs when the Bartholin glands on the labia, the skin folds around the vaginal opening, become blocked.
A cyst that’s not infected may show up as a painless lump. These often resolve on their own.
If a Bartholin cyst becomes infected, it might swell up, be painful, and make it harder to walk or sit comfortably. This may require treatment.
Endometriosis
Endometriosis is when the lining of the uterus (womb) builds up on the outside of the organ. Not everyone has the same symptoms.
Some common symptoms of endometriosis include:
Pelvic painMenstrual painPain during sex Pain during a bowel movement BloatingPain when peeing
Pelvic Floor Problems
Pelvic floor dysfunction is a health condition where the muscles and tendons in your pelvic area weaken. It can cause vaginal pain, especially during sex.
If you have pelvic floor dysfunction, you may leak urine or have trouble controlling bowel movements.
These problems can be caused by:
AgingPregnancy and childbirthStraining to go to the bathroom InjuriesComplications from surgery
Menopause
Vaginal pain can also occur because of hormonal changes during menopause. The vagina may become drier. Skin can become thin and easy to tear. These changes can make sex painful.
Other symptoms include:
BleedingUlcers or soresGreater sensitivity to personal care products
There is also an increased risk of infection, which can itself lead to vaginal pain.
Vigorous Sex
The tissue in and around the vagina can tear or bruise during rough sex, leading to soreness. Sex can also lead to chafing around the vulva.
These symptoms are more likely if the skin is thin, dry, scarred, or affected by a health condition such as eczema or psoriasis, although all vaginal skin is delicate.
If you think you may have an injury inside your vagina, seek medical care. In rare cases, internal bleeding can be life-threatening.
Vaginismus
Vaginismus is a condition where vaginal muscles spasm. It can make it difficult to have sex. It can also cause pain.
People may develop vaginismus in response to trauma. It can happen because you’re nervous about having sex. But it can also occur during menopause or after childbirth.
Trauma
If you’ve just had a baby, your vagina will be sore for a period of weeks afterward. Sometimes pain from childbirth lasts even longer.
Injuries from straddle accidents, vehicle accidents, sexual assault, and female genital cutting can also cause long-term pain.
When to See a Healthcare Provider
If your symptoms are bothering you and don’t go away, see a healthcare professional. You have several options. If you’re having urinary symptoms, it might be best to see a primary care provider, urgent care provider, or urologist. If your only symptom is vaginal pain, you may want to see a primary care provider, an urgent care provider, or a gynecologist.
It’s especially important to seek medical care if you have vaginal pain or soreness and are pregnant, in menopause, or have a new sex partner. If you’re pregnant, it may be best to see an obstetrician or gynecologist.
Seek immediate medical attention if you have been sexually assaulted. Do not clean yourself of change your clothes ahead of your visit.
Other signs that you need to see a doctor:
Pain is severeYou have bleedingYou have a fever
If you have severe pain, bleeding, and/or a fever, you may need to visit the emergency room (ER).
Diagnosis
It can take time to find out exactly what is behind your pain. You may be able to confirm some causes with an at-home test; others require a medical evaluation.
To identify the cause, a healthcare professional may:
Ask questions about your medical historyAsk when your pain started, how it feels, and what makes it worseAsk about your other symptomsExamine your vulva and vagina for signs of infection or injuryUse a cotton swab to find which spots are sore
At-Home Tests
Tests that detect some causes of vaginal pain are available online and in many drugstores.
There are tests for:
Yeast infectionsSexually transmitted infectionsBacterial vaginosisUrinary tract infections
Some give immediate results, while others may need to be sent to and analyzed in a lab.
Self-tests that check for allergies and sensitivities do exist, but they may not be as reliable as tests performed by a lab or healthcare professional.
Lab Tests
When you visit a healthcare provider, you may need:
Urine tests to confirm UTIBlood tests to check hormone levels Vaginal fluid tests to check for infections Allergy skin tests to check for reactions Biopsies to analyze cell samples
Imaging
In some cases, imaging is the best way to find what’s causing your vaginal pain. For example, a transvaginal ultrasound can show endometriosis.
Endometriosis can also show up on a magnetic resonance imaging (MRI) test, a computerized tomography (CT) scan, or a laparoscopy. That’s a test in which a tiny camera on a long tube takes pictures inside your body.
Imaging tests can also detect pelvic floor problems and internal injuries.
Treatment
Treatment will depend on the exact cause of your soreness or pain. In some cases, changing your routines may be all that is needed. In others, medical intervention may be necessary.
Home Remedies and Lifestyle
Vaginal pain may decrease if you make some simple changes. For example, it may help to:
Temporarily stop having sex Use plenty of lubricant when you do have sex Avoid products that irritate your skin Use cool compresses or gel packs for relief Take a warm sitz bath
Medications
Conditions like STIs need to be treated. They won’t go away on their own and can cause serious consequences if left untreated.
In some cases, medication can resolve or cure the pain. Antibiotics or anti-fungals for infections are a good example. If the pain is from a long-term condition, a healthcare provider can help you manage symptoms with medications, including:
Tricyclic antidepressants and anticonvulsants to relieve vulvodynia Topical anesthetics such as lidocaine or gabapentin to ease pain during sex Estrogen creams or inserts to improve pain from low estrogen in menopause Corticosteroids or nerve block injections to reduce pain Botox injections to relax spasms
Physical Therapy
Your therapist may work with you to build your pelvic floor muscles.
Some people learn to relax vaginal muscles using dilators, which are tapered wand-like tools that come in various sizes.
Psychotherapy
Cognitive behavioral therapy can teach you strategies to relax tense muscles or cope with anxiety, trauma, or pain.
Surgery
If the pain does not go away with other treatments, you may need surgery. For example, if you have an infected Bartholin’s cyst, it may need to be drained.
In some cases, surgery to remove scar tissue helps with endometriosis symptoms. A hysterectomy—removal of the uterus—is another option for endometriosis.
Prevention
To protect your vulva and vagina, you can:
Wear only loose-fitting pants and underwear Choose underwear that are 100% cotton or bamboo Use alcohol-free lubricants Opt for latex-free condoms Avoid douching Limit physical activity that puts pressure on your vulva, such as cycling Stop using soaps, wipes, or products with fragrances and preservatives
Summary
Pain in or around your vagina can have many possible causes. Infection, injury, health conditions, menopause, childbirth, pelvic floor problems, and allergies can all make the vulva or vagina sore.
Most of the time, vaginal pain will go away on its own or with self-care. But some types can be serious. Medication, physical therapy, and even surgery may be needed to restore your health.
A Word From Verywell
Some healthcare providers may minimize women’s concerns about pain. Studies show that women of color, trans and LGBTQ people, and women with low incomes, chronic pain, or disabilities often feel their doctors don’t “get” them and their pain.
When you’re seeking care for vaginal pain—or anything else—you need a healthcare provider who takes your symptoms seriously. If you don’t feel heard and respected, look for another provider.
