Pain in the vagina: a stabbing or burning vaginal pain

Pain in the vagina or vaginal pain is a common complaint in women. Vaginal pain can consist of cramps or a nagging pain. Pain in the vagina can also be felt as a burning or stabbing pain (‘stitching from below’). There are many different reasons why the vagina can hurt. Usually it is not a serious problem. It is very uncomfortable to have pain in an intimate place. In addition, pain in and from the vagina has a negative impact on your quality of life. One of the most common causes of vaginal pain accompanied by burning is a fungal infection (Candida) that can grow in the vagina.

  • Symptoms of vaginal pain
  • Causes of pain in the vagina
  • Infection
  • Dyspareunia
  • Other possible causes
  • Who is at risk for vaginal pain?
  • Hormonal changes
  • Medicines
  • Age
  • Vaginal dryness
  • Complaints due to dry vagina
  • Causes of vaginal dryness
  • Vaginal yeast infection
  • Focal vulvitis
  • Pain in vagina due to STDs
  • Cancers or other growths in or near the vagina
  • Bladder pain syndrome (interstitial cystitis)
  • Vaginismus
  • What is it?
  • Causes
  • Other causes of vaginal pain
  • Diagnosis and research
  • Physical examination and pelvic examination
  • Additional research
  • Treatment of pain in the vagina
  • Medicines
  • Surgery
  • Self-care
  • Nutrition and supplements
  • Prognosis of vaginal cramps and pain

 

Pain in the vagina / Source: Ruigsantos/Shutterstock.com

Symptoms of vaginal pain

The specific symptoms of vaginal pain vary depending on the underlying cause. For example, vulvar vestibulitis is a condition that causes pain only with external stimulation (sexual intercourse). The entrance to the vagina is irritated, burning or chapped, and it hurts when you have sexual intercourse. In contrast, vulvodynia is a condition that causes constant chronic pain. Depending on the specific condition, you may experience one or more of the following symptoms associated with vaginal pain:

  • burning pain in the vagina
  • vaginal itching
  • vaginal dryness
  • vaginal odors
  • general pain
  • prickly feeling
  • throbbing vaginal pain
  • stabbing pain in the vagina
  • nagging pain
  • cramping pain or vaginal cramps
  • raw or chapped feeling
  • vaginal redness
  • painful vagina due to pressure (sitting, cycling, exercising, tight clothing, touching)
  • a vaginal swelling
  • emotional/psychological problems
  • lesions, lesions, ulcers or blisters
  • pain during or after sexual intercourse or using a tampon
  • stimulating feelings
  • vaginal itching
  • frequent urination / constant urge to urinate
  • pain during sexual intercourse
  • abnormal vaginal bleeding
  • general signs (of an infection) such as fever, chills, loss of appetite, weight loss, fatigue
  • an abnormal vaginal discharge (brown, white, yellow, green, sticky, smelly)

If vaginal pain is caused by an infection, you may develop abnormal vaginal discharge. For example, it may look or smell different than normal. This may indicate a fungal or bacterial infection.

Causes of pain in the vagina

Pain in the vagina may be limited to the vaginal area. Or it can radiate to your pelvis (pelvic pain) or cervix.

Infection

The most common cause of vaginal pain is an infection, such as:

  • fungal infection
  • gonorrhea
  • chlamydia

 

Dyspareunia

Vaginal pain can also result from a condition called dyspareunia. This is a medical term for painful sexual intercourse or pain shortly before, during or shortly after sex. It can be caused by insufficient lubrication during sex due to hormonal changes or lack of sexual arousal. Vaginal pain can also result from psychological conditions, such as childhood sexual abuse. In some cases, the doctor may not be able to determine the cause of the pain.

Other possible causes

Other possible causes of vaginal pain include:

  • trauma caused by sex, childbirth, surgery, or other medical procedures
  • vulvovaginal atrophy due to a drop in estrogen after menopause
  • vulvar vestibulitis
  • cervical cancer

 

Who is at risk for vaginal pain?

Women of all ages can experience vaginal pain. In some cases, your medical history can increase your risk.

Hormonal changes

For example, hormonal changes caused by pregnancy, menopause, or hysterectomy (an operation to remove the uterus) can increase your risk of vaginal pain. If you have had breast cancer in the past, you are also at higher risk.

Certain medications can lead to a dry vagina, which can cause pain / Source: Stevepb, Pixabay

Medicines

Certain medications can also increase your risk of vaginal pain. Statins are medications that help lower cholesterol. These medications are known to cause vaginal dryness. This can lead to vaginal pain.

Age

Getting older is also a risk factor. Menopause causes changes in your hormone levels and leads to thinning of your vaginal tissue. This can lead to a dry vagina and complaints such as itching of the vagina, irritated vagina, and a burning sensation or pain in the vagina.

Vaginal dryness

Complaints due to dry vagina

Vaginal dryness can cause irritation of the vagina, with complaints such as:

  • itch
  • a burning and/or stabbing sensation in the beginning of the vagina
  • pain during sex
  • pain when urinating
  • (sometimes) an unpleasant odor due to the changed acidity in the vagina

If you have sex with reduced (or complete absence of) sexual arousal, burning pain (at the entrance to the vagina) may occur. This is because the mucous membrane becomes damaged.

Causes of vaginal dryness

During a period of tension, your body produces less moisture, which can cause dry eyes, mouth and vagina. The use of certain medications (e.g. antidepressants, antihistamines and diuretics) can also cause vaginal dryness. In addition, certain medical treatments (such as chemotherapy) can cause complaints of vaginal dryness. Certain diseases and conditions can also cause vaginal dryness, for example diabetes, endometriosis and some kidney diseases. After giving birth and during breastfeeding, a woman may temporarily suffer from a drier vagina. Furthermore, it is a known fact that a woman can suffer from vaginal dryness during and after menopause. This is because the production of the hormone estrogen decreases.

Vaginal yeast infection

A vaginal yeast infection is often caused by the fungus Candida albicans . The vaginal flora can be disturbed by, for example, washing the vagina with soap, use of antibiotics or an increased estrogen level, which changes the amount of bacteria or fungi. This gives some fungi the opportunity to grow too much, resulting in a fungal infection. The following symptoms and complaints may occur:

  • red, swollen labia and itching (on the labia)
  • burning sensation in the vagina / pain in the vagina
  • pain during sex
  • pain when urinating/urining
  • more and different discharge than normal

 

Focal vulvitis

This concerns a clinical picture involving a range of complaints:

  • chronic complaint of burning, stabbing pain in the vagina
  • irritation or roughness near the vulva
  • a recurring or persistent pain in the vagina associated with sexual intercourse
  • After sexual intercourse there is a scratchy and burning sensation
  • tightened muscles around the vagina (pelvic floor area)

Focal vulvitis mainly occurs among young women. Treatment consists of calming the local inflammatory response.

Pain in vagina due to STDs

Many sexually transmitted infections (STDs) have few or no symptoms at all, especially in their early stages. However, some STDs can cause pain and discomfort in the vaginal area.

Cancers or other growths in or near the vagina

It is possible for cysts, polyps or tumors to grow in (near) the vagina, and these can cause pain and discomfort in the woman. Persistent vaginal pain is always a reason to visit the doctor. For example, a Bartholin’s cyst can develop if the drainage ducts of the Bartholini’s glands (a mucous gland, of which every woman has two, located on either side of the entrance to the vagina at 5 and 7 o’clock) become blocked. This causes mucus to accumulate, the affected gland swells and a cyst forms near the entrance to the vagina.

Bladder pain syndrome (interstitial cystitis)

Bladder pain syndrome or interstitial cystitis (IC) is a rare and painful form of chronic bladder inflammation (cystitis) that mainly affects women (90% of cases). Most people with bladder pain syndrome suffer from pain, which can manifest itself in many ways. For example, there may be pain in the bladder, which worsens as the bladder contents increase. But pain in the lower abdomen that sometimes radiates to surrounding body parts such as the back, pelvis, groin and/or flanks is also common. Female patients often have painful stitches in the vagina; men in the penis, testicles, scrotum and perineum. Both men and women can feel pain in the urethra.

Vaginismus

What is it?

Vaginismus means that you are unable to insert a penis, finger or tampon into your vagina. When you try this, the muscles of your pelvic floor involuntarily tighten. The muscles can be tense to such an extent that the vagina feels completely closed. As if nothing can fit in it. Sometimes you can insert something into your vagina, or you can insert it a little bit, but because your pelvic floor muscles are tense, this is a painful experience. Sometimes the mere thought of penetration triggers a vaginistic reaction. Other times a woman tenses especially when the vagina is touched.

Causes

A woman can sometimes have sexual intercourse, but it can be quite painful. In that case there is no vaginismus, but dyspareunia (= pain during intercourse). The causes of dyspareunia are often different from those of vaginismus, although there is some overlap.

Other causes of vaginal pain

There are also other causes that can cause vaginal pain. An example is endometriosis, a condition that occurs in fertile women and causes abnormal growth of the uterine lining in places other than the uterus. For example, foci of endometriosis may occur on or near the cervix, vagina, rectum or urethra.

Speculum or duckbill / Source: Saltanat, Wikimedia Commons (Public domain)

A feeling of pressure in the vagina or pelvis can be caused by a vaginal prolapse. Prolapse is often the result of a weakening of the pelvic muscles due to lower levels of the hormone estrogen after menopause.

Diagnosis and research

Physical examination and pelvic examination

A doctor can perform a pelvic examination to determine whether abnormalities (growths and shape changes), infections or other problems are present that could explain the complaints. A pelvic examination is a physical examination in which the doctor (gynecologist) examines the vagina, cervix, uterus, fallopian tubes, ovaries and rectum. The doctor also uses a speculum, colloquially called a ‘duckbill’, to open the vagina to view the cervix and take samples for a smear test. Also can use a cotton swab to gently touch the genitals and other areas to identify the precise location of the pain. The doctor will also ask a lot of questions about how and when you experience vaginal pain.

CT scan / Source: IStock.com/Pavel Losevsky

Additional research

Some diagnostic tests may be performed, such as:
Colonoscopy or sigmoidoscopy to examine parts of the colon;

  • Barium enema, a special form of radiography of the colon and rectum using a special fluid (barium sulfate), which is necessary to clearly visualize specific parts of the colon;
  • CT-scan;
  • MRI scan;
  • Ultrasound of the pelvic organs;
  • Cystoscopy, with which the doctor looks at the urethra and bladder with a small camera.

 

Treatment of pain in the vagina

To relieve or eliminate your vaginal pain, the doctor will try to treat the underlying cause. The doctor may prescribe a multi-step approach. For example, he or she may recommend a local anesthetic (a substance that ensures that painful stimuli are no longer felt) or oral medication. In rare cases, surgery will be recommended.

Medicines

If there is a bacterial infection or a fungal infection, the doctor will probably prescribe antibiotics or antifungals respectively to treat it. You should take all prescribed doses even if your symptoms disappear before you complete treatment. This reduces the chance of the infection returning.
The doctor may also recommend an ointment or cream, such as lidocaine gel. Lidocaine applied to the skin makes the skin numb and is prescribed for pain, itching and nerve pain.
Topical steroid creams can also help reduce irritation, swelling, and burning sensations.
Tricyclic antidepressants (medicines for depression) or anticonvulsants (medicines for epilepsy) can also help reduce chronic pain.

Surgery

In rare cases, the doctor may recommend anesthesia injections or nerve blocks to counteract vaginal pain. The doctor may also recommend surgery to treat vulvodynia, vulvar vestibulitis, or cervical cancer.

Self-care

Some home remedies and over-the-counter treatments can help relieve vaginal pain. For example, applying witch hazel to the vaginal area can soothe irritation. To relieve or prevent pain during intercourse, it may help to use a lubricant. To reduce vaginal itching, over-the-counter antihistamines may help.

Pecans / Source: Tseiu, Pixabay

Nutrition and supplements

If vaginal pain stems from chronic urinary tract infections, taking calcium citrate supplements can help reduce symptoms that contribute to vaginal pain. Calcium citrate is a commonly suggested natural remedy for urinary tract infections. Avoiding foods high in oxalates can also help prevent urinary tract infections. These foods include leeks, okra, rhubarb, almonds, peanuts, pecans and pistachios. But before taking supplements or changing your diet, check with your doctor first.

Prognosis of vaginal cramps and pain

Your outlook depends on the underlying cause of the vaginal pain, as well as the treatment you receive. In many cases, following the doctor’s recommended treatment plan can provide lasting relief.

read more

  • Vaginal discharge: odor and color (yellow, brown or green)
  • Vaginal itching or itchy vagina: causes and symptoms
  • Swelling or lump in vagina: causes of vaginal swelling
  • Vaginal cramps: stitches, pain and cramps in the vagina
  • Sore vagina: causes and symptoms of pain in vagina
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