Pain from other STIs typically stems from general inflammation. “They tend to create more swelling in the vaginal tissues, which tend to be sensitive to pain and discomfort, as well as burning and itching,” says Dr. anil. In any case, if you have pain and inflammation of any kind in the vaginal area, you need a doctor to examine you to get things under control.
How to treat it: Fortunately, according to Dr. Segura among the easiest to deal with on this list. “There is a clear route to treatment with antibiotics, and there is a clear way to prevent it – abstinence or using condoms,” she explains. Chlamydia, gonorrhea, and other sexually transmitted diseases can typically be eliminated with medication; and herpes, while not curable, can be managed to reduce future outbreaks and pain.
4. Vaginal dryness
Vaginal dryness is all about the hormone estrogen—specifically, a lack of it. (FYI: The problem isn’t unique to postmenopausal women, either.)
“Ultimately, estrogen itself is a growth hormone that improves vaginal blood flow, vaginal wall thickness, and vaginal elasticity and lubrication,” says Dr. anil. And when not enough estrogen is flowing through your body — whether it’s from your birth control pills, breastfeeding, or, yes, menopause — it can get pretty painful.
How to treat it: If you feel like your vagina isn’t lubricating like it used to, it might be time to see your doctor, says Dr. anil. They can treat you with something local or even change your birth control method to make you a little more comfortable.
5. Your partner’s penis
While you might be inclined to blame your own anatomy, you might want to take a look at your partner as well. “Do you really have pain in your vagina or is it pain during penetration – something you feel in your stomach?” says Mary Jane Minkin, MD, gynecologist and founder of MadameOvary.com. “That can be very difficult to distinguish.”
Basically, that “stomach ache” could actually be coming from a penis penetrating you uncomfortably (possibly because it’s large for your anatomy). If sex makes you uncomfortable — and you suspect your partner’s size is to blame — try switching positions, especially ones that don’t allow for super-deep penetration, like the reverse cowgirl. And be sure to use lube…lots of lube.
And if it’s not the size, then maybe what’s on your partner’s penis. do they have piercings Do you have piercings? Both can cause discomfort during sex. It’s also important to consider the condoms used, adds Dr. added Simon. You could be allergic to latex, which can cause itching and vaginal pain.
How to treat it: Your family doctor or gynecologist can find out by examining you and having an honest conversation with you. They may suggest changing your condoms or trying a lube.
According to the American College of Obstetricians and Gynecologists (ACOG), vulvodynia is chronic vaginal pain with no apparent cause (i.e., not due to an infection or other medical condition). “Approximately 9 percent of women will experience this type of pain in their lifetime,” says Dr. Minkin and describes the discomfort that occurs when penetrating or even inserting a tampon.
However, in some women, attacks of pain occur spontaneously and are unrelated to sex or touching the affected area. “It’s mysterious that it can come and go,” says Dr. Minkin.
Vulvodynia isn’t well understood, but doctors believe the pain comes from the extra nerve fibers in that outer part of the vagina and vulva. “This is the most unnerved part of the vagina,” says Dr. anil.
How to treat it: Doctors who diagnose vulvodynia often treat it with topical medications like lidocaine, which are also used for fibromyalgia, another chronic pain disorder with no known cause.
Endometriosis is a pretty confusing condition — and quite difficult for doctors to diagnose, too. Endometriosis is when uterine tissue grows in places outside of the uterus (like your pelvic region, your abdomen, or even other places like your lungs).
The condition is also incredibly painful. “It creates chronic inflammation and scarring around tissues that can cause pain,” says Dr. anil.
How to treat it: Endometriosis is typically treated with hormone therapy or surgery to remove any tissue that is causing pain.
8. Pelvic Inflammation (PID)
Pelvic inflammatory disease — an infection in your uterus, fallopian tubes, or ovaries — is another inflammatory condition that can cause pain in your vagina. “It can lead to or cause scarring in the pelvic organs [the pelvic organs] stick together and cause chronic aches and pains,” says Dr. anil.
How to treat it: After a pelvic exam and an ultrasound to determine if you have the condition (which can develop if you leave an STI untreated, FYI), your doctor will likely put you on a course of antibiotics to fight the infection .
9. Vulvovaginal atrophy
Vulvovaginal atrophy is thinning, drying, and inflammation of the vaginal walls that can occur when your body produces less estrogen, which is most common after menopause, according to the Mayo Clinic. This condition can make sex and urination uncomfortable.
How to treat it: Once diagnosed by your gynecologist, the condition is usually treated with lubricants and hormone therapy.
10. Cervical cancer
Pelvic pain (along with back pain, abnormal bleeding, brown discharge, fatigue, nausea, and weight loss) is a symptom of cervical cancer. If you have these symptoms and have not had a Pap smear in the past year, talk to your doctor.
If you’ve gone to your doctor and found nothing is wrong, you should also consider events in your life that may have led to your pain.
“Have you disclosed your history of child abuse, sexual assault, or trauma during a vaginal birth?” asks Dr. Simon. All of these non-obvious factors could lead to vaginal pain, she explains.
If you’ve had sexual assault or surgery that resulted in a traumatic healing experience, telling your doctor can help recommend the right treatment – be it therapy, medication, etc. It’s important for both doctors and patients to educate themselves Remembering that mental health is as important a part of a wellness check as anything else.
Ultimately, you shouldn’t have to deal with vaginal pain or area discomfort – so raise any concerns with a doctor.
Hey, talking about vaginal pain can be super awkward (even though it shouldn’t be!). But talking to a healthcare provider is key to finding relief and ruling out any underlying condition that requires special treatment.
If you’ve already reported your symptoms and feel like they’ve been dismissed or misdiagnosed by a particular provider, know it’s not uncommon — especially for women and people of color, says Dr. Simon. An important question to ask when discussing healthcare disparities is, “Does the patient feel entitled to ask questions of their healthcare provider?” Simon points this out.
Do you feel like you could ask your doctor, “What else could it be, doctor?” and they’d respond with something other than a discharge? If the answer to that question is no, and you don’t feel heard, know that these professionals encourage you to get a second opinion.
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