What Causes It and How Is It Treated?

There are many possible reasons why you may be experiencing a sore vagina, also called vulvar pain. Some causes, like irritation or menopause, may be evident. Other causes, like a sexually transmitted infection (STI) or a cyst, are not as apparent.

What people call “vagina pain” may 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. When the vagina and vulva are inflamed, it’s referred to as vaginitis.

Causes of Vaginal Soreness

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 vaginitis, or inflammation, leading to soreness and itching around the vulva and vaginal opening. Other symptoms include:

• Pain during sex
• Pain when peeing
• Thick, white discharge that’s sometimes smelly

Some people are more prone to yeast infections, including people who:

• Use hormonal birth control
• Have recently taken antibiotics 
• Are pregnant
• Have diabetes
• Have problems with their immune system

Hygiene habits can sometimes raise your risk (for example, not quickly changing out of sweaty workout clothes).

Bacterial Vaginosis (BV)

Bacterial vaginosis (BV) is an infection that happens when too much bacteria grows in your vagina.

Not everyone has symptoms, but if you do, you might notice:

• A strong fish-like odor
• A thin white or gray vaginal discharge
• Pain, itching, or burning in the vagina
• Pain or burning when peeing 
• Itching around the outside of the vagina

Your risk of getting BV is higher if you:

• Douche often
• Have multiple or new sex partners
• Don’t have enough lactobacilli (a type of bacteria that’s good)

Sexually Transmitted Infections

Sexually transmitted infections (STIs) can also cause vaginal/vulvar pain and many other symptoms depending on the specific STI. Vaginal symptoms may include:

• Unusual discharge
• Sores or warts in the vaginal area
• Itching and burning
• Painful or frequent peeing
• Itching and redness
• Abnormal vaginal odor

Some examples of STIs include:

If you think you could have an STI, talk to your healthcare provider. You and your partner should be tested to reduce the risk of passing it on or having complications.

Urinary Tract Infection

Urinary tract infections (UTIs) are prevalent, especially in women. It is estimated that 50% to 60% of women will have one or more UTIs during their lifetime.

UTIs happen when bacteria enter the urinary tract. Symptoms include:

• Pressure or pain in the pelvic area
• Frequent and/or urgent need to urinate (even when the bladder is empty)
• Cloudy urine that could have a strong odor
• Red, pink, or brown urine
• Pain or burning while urinating

A UTI can make it painful to have sex.

Irritation or Allergy

Vaginal irritation and allergies can cause soreness. The irritation or allergy may be 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 with no identifiable cause and has been present for at least three months. Pain may be felt over the entire vulva or only in one area and may cause different types of symptoms, such as:

• Burning or stinging
• Irritation
• Rawness
• Aching or throbbing
• Soreness
• Swelling

Symptoms of vulvodynia may be constant, or they may come and go. Symptoms can start and stop without warning, or they may occur only when the area is touched.

Genetics, hormones, pelvic floor conditions, nerve irritation or damage, or trauma may raise your risk. Vulvodynia can also happen after medical procedures such as chemotherapy or surgery involving the nerve supply in the area.

Vulvar Vestibulitis

Vulvar vestibulitis, also known as vestibulodynia, is pain in the vulvar vestibule. This is the area of the vulva between the labia minora and encompasses the clitoris, urethral opening, and vaginal opening. Like vulvodynia, a diagnosis comes with pain that lasts longer than three months. It can cause symptoms like:

• Burning sensation
• Pain with intercourse
• Pain with tampon use
• Sensation of cutting

Researchers need to learn more about the causes of vestibulodynia. However, some causes include the human papillomavirus (HPV), frequent yeast infections, and recurrent bacterial vaginosis. Some neurological conditions that cause the brain to confuse normal sensations like touch, stretching, or pleasure as pain may also be involved in vestibulodynia.

Bartholin’s Cyst

Bartholin glands are responsible for lubricating the vagina. 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 walking or sitting harder. This may require treatment.

Endometriosis

Endometriosis occurs when the lining or tissue of the uterus (womb) builds up outside the uterus. Not everyone has the same symptoms, but some common symptoms of endometriosis include:

• Pelvic pain
• Painful menstrual cramps that may go into the abdomen (stomach) or lower back
• Heavy or irregular periods
• Pain during sex 
• Pain with urination or during a bowel movement 
• Bloating
• Pain 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.

You may leak urine or have trouble controlling bowel movements if you have pelvic floor dysfunction. These issues can be caused by:

• Aging
• Pregnancy and childbirth
• Straining to go to the bathroom 
• Injuries
• Surgery (previous hysterectomy or prior surgery to correct prolapse) 

Menopause

Vaginal pain can occur because of hormonal changes during menopause. The vagina may become drier. Vaginal tissue can become thin and tear more easily. These changes can make sex painful.

Other symptoms may include:

• Irritation or burning
• Bleeding
• Ulcers or sores
• Greater sensitivity to personal care products

There is also an increased risk of infection, which can lead to vaginal pain.

Lichen Sclerosus

Another condition called lichen sclerosus can occur at any age but is most common in postmenopausal women. It is a rare skin condition that causes itchy and painful patches of thin, white, wrinkled-looking skin on the vulva and/or anus.

Lichen sclerosus is a chronic condition, and currently, the cause is unknown.

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

See a healthcare provider if your symptoms bother you and don’t go away. If you have 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, seeing an obstetrician or gynecologist may be best.

Seek immediate medical attention if you have been sexually assaulted. Do not clean yourself or change your clothes ahead of your visit.

These are other signs that you need to see a doctor:

• The pain is severe.
• You have bleeding unrelated to your period.
• You have a fever.

If you have severe pain, bleeding, and/or a fever, you may need to visit the emergency room (ER).

Are There Tests to Diagnose the Cause of Vaginal Soreness?

It can take time to find out precisely 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 history
• Ask when your pain started, how it feels, and what makes it worse
• Ask about any other symptoms
• Examine your vulva and vagina for signs of infection or injury
• Use 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 infections
• Sexually transmitted infections
• Bacterial vaginosis
• Urinary tract infections

Some give immediate results, while others may need to be sent to a lab for analysis.

Self-tests that check for allergies and sensitivities 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 a UTI
• Blood 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 appear on a magnetic resonance imaging (MRI) test, a computerized tomography (CT) scan, or a laparoscopy—a surgery 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.

How to Treat Vaginal Soreness

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 with medications. They won’t go away on their own and can cause serious health consequences if left untreated.

In some cases, medication can resolve or cure the pain. Antibiotics or antifungals 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
• Topical or oral retinoids, topical steroids, and phototherapy for Lichen sclerosis

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 is 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 severe. Medication, physical therapy, and even surgery may be needed to restore your health.