What does it mean if your clit hurts?

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Clitoris Pain

What is clitoris pain?

Clitoris pain can result from damage or injury to any of the structures of the vulva (external genitalia), including the inner and outer labia, the vaginal opening, and the clitoris. The symptoms may be constant or variable and may improve or worsen with movement or sexual activity. Clitoris pain may be described as a raw sensation or a burning, itching or stinging feeling that ranges in intensity from mild to severe. Sometimes, pain perceived in the clitoris is actually referred pain that originates from injury, disease or infection elsewhere in the vulvar region.

Pain and discomfort in the vulva (vulvodynia) is a common cause of clitoris pain, as are skin irritations from rashes or household chemicals. Recurring infections or cancer may also cause clitoris pain. In other cases, clitoris pain may be related to a chronic underlying disease that affects other regions of the body. Other causes of clitoris pain include vaginal yeast infections and sexually transmitted diseases.

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The duration and course of clitoris pain vary widely, depending on the cause. Symptoms caused by injury, such as those following sexual abuse, often have a sudden onset. In other cases, clitoris pain may come from an infection that may develop slowly and persist or worsen over time.

Clitoris pain alone is rarely a serious medical condition; however, it may be associated with symptoms of a serious medical condition. Seek immediate medical care (call 911) if you have high fever (higher than 101 degrees Fahrenheit), severe pain, chills, or rapid heart rate.

If your clitoris pain is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with clitoris pain?

Clitoris pain may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the clitoris may also involve other body systems.

Vulvar symptoms that may occur along with clitoris pain

Clitoris pain may accompany other symptoms affecting the vulvar region including:

  • Bleeding
  • Burning
  • Itching
  • Raw sensation
  • Stinging
  • Throbbing

Other symptoms that may occur along with clitoris pain

Clitoris pain may accompany symptoms related to other body systems including:

  • Bloody or pink-colored urine (hematuria)
  • Difficulty urinating (dysuria) and urinary retention
  • Fever and chills
  • Nerve problems that cause pain, numbness or tingling
  • Pain during sexual intercourse
  • Rash in other areas of the body

Symptoms that might indicate a serious condition

In some cases, clitoris pain may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have clitoris pain along with other serious symptoms including:

  • Abdominal, pelvic, or lower back pain that can be severe
  • High fever (higher than 101 degrees Fahrenheit)
  • Rapid heart rate (tachycardia)

What causes clitoris pain?

Infections and skin disorders may cause clitoris pain. Disease or injury of any of the structures in the vulvar region can also result in clitoris pain. Further, clitoris pain can stem from underlying conditions that involve the body as a whole, such as diabetes. Peripheral neuropathy (disorder that causes dysfunction of nerves that lie outside your brain and spinal cord) associated with diabetes can lead to damage of one or more of the nerves in the vulva region, resulting in clitoris pain, itching, tingling, or a burning sensation.

Common causes of clitoris pain

Common causes of clitoris pain include:

  • History of surgical procedures in the vulvar region
  • Injury from sexual abuse
  • Irritation to the nerves in the vulvar region
  • Rashes in the vulvar region
  • Recurring yeast infections
  • Repeated sexually transmitted infections
  • Skin irritation from chemicals, such as detergent, soap, or feminine hygiene products

Serious or life-threatening causes of clitoris pain

In some cases, clitoris pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a health care provider. These include:

  • Cancers
  • Serious infections

Questions for diagnosing the cause of clitoris pain

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your clitoris pain including:

  • How long have you felt clitoris pain?
  • When do you feel clitoris pain?
  • Do you have any other symptoms?
  • What medications are you taking?

What are the potential complications of clitoris pain?

The potential complications of clitoris pain depend on their cause. Getting prompt treatment of injuries or infections can help you avoid serious complications, such as deformity or widespread infection. Clitoris pain associated with serious medical conditions, such as infection or diabetes, may have long-term and even potentially life-threatening complications.

Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you. Left untreated, conditions that cause clitoris pain may lead to the following complications:

  • Abscess
  • Sepsis (life-threatening bacterial blood infection)
  • Sexual dysfunction
  • Spread of cancer
  • Spread of infection

Heading

The clitoris has just one purpose, and that is pleasure. So experiencing frequent clitoral pain (officially called clitorodynia) can be confusing and disheartening. As with other vulva pain (officially called vulvodynia), a sore clit is incredibly common. However, that doesn’t mean it’s normal and should just be ignored or suffered.

The Clitoris Is Bigger Than It Looks

To troubleshoot pain, it’s a good idea to know more about the part of the body that’s hurting. The clitoris is more than just a little bump a couple inches above the vagina—that part is just the head (glans). The rest of the clit is internal, and it wraps around the vagina. The penis and the clitoris have the same number of nerve endings, but in the clit they’re condensed into a much smaller space, making it even more sensitive.

Clit Sensitivity

Because those nerves are bundled together, some people are hypersensitive to touch and stimulation. That sensitivity could be the culprit for the discomfort. For some, directly touching the clitoris can be painful just because this area is so sensitive. This sensitivity is different from clitordynia – which is chronic pain – and easier to manage!

For some, directly touching the clitoris can be painful just because this area is so sensitive.

This is an opportunity to take your time and explore what you like. When your body gets aroused, your pain threshold changes. Sometimes a clit may hurt when directly touched at the beginning of sexy time – before the person has become aroused – but a little later – as that person has become aroused – the clit touch can feel really good. Go easy, gradually circle around until it feels good to touch, and stroke over the clitoral hood, rather than on the head directly.

Be Gentle With The Clitoris

Most clits don’t enjoy the DJ treatment right off the bat: rubbing hard and fast like you’re scratching a record. Go slow, go easy, and increase the pressure and tempo only if you feel like it.

If you’re someone that chooses partnered sex, it’s a lot easier to tell a partner what you like if you’ve already figured it out for yourself. Bodies are different, and not every clitoris likes the same treatment. You get to figure out what feels good to you.

Use Lube On The Clit

The clitoris doesn’t produce lubricant, like the vagina does, so you’ve got to bring your own! Dryness increases friction, which causes pain. Use your own natural wetness, or a store-bought variety of lubricant (our fave is Good Clean Love’s Almost Naked Organic Personal Lubricant) to make fingers glide across the clit.

Most clits don’t enjoy the DJ treatment right off the bat: rubbing hard and fast like you’re scratching a record. Go slow, go easy, increase the pressure and tempo only if you feel like it.

If lube and gentle touch take care of the problem, then congratulations! If you’re still experiencing pain, though, or even hurting when you’re not having sexy time, there are some other things to check:

Itchy Clit?

Tight clothing can rub uncomfortably, so try looser pants and underwear for a while. Because clitoral tissue is sensitive, it is easily irritated.

Laundry detergents can be irritating, so check what you’re using to wash your underwear. Avoid scented soaps or sprays on the vulva and vagina. Many of the products marketed as vulva cleaning products contain ingredients that can be irritating to the delicate skin. Your clitoris (and the rest of your vulva) only need warm water and your hand for effective cleaning.

Seek Medical Advice

There are also health conditions that can cause a clitoris to feel pain, some which mimic allergic reactions. Urinary tract infections, yeast infections, and some sexually transmitted infections can make clitorises feel sore, itchy, or burning. And remember, it’s important to see a health care provider for an accurate diagnosis before self-treating.

There are also health conditions that can cause a clitoris to feel pain… urinary tract infections, yeast infections, and some sexually transmitted infections can make clitorises feel sore, itchy, or burning.

Pain is common, but it is the body’s way of saying that something is wrong. Listen to your body and stop when it hurts. You don’t have to suffer through the pain.

What Is The Clit?

Why Is My Vagina Dry?

Why Am I Having Pain During Sex?

Vaginismus, Pelvic Muscle Tension, And Painful Sex

Best Masturbation Techniques For Clitoral Orgasm

Tips For Stimulating Your Clit To Orgasm

What Is The Best Lube?

What causes vulvar pain?

Vulvar pain has many possible causes, including:

Infections

Chronic yeast infections and bacterial infections can both cause pain that ranges from mild discomfort and itching to severe burning or throbbing.

Viral and bacterial infections, such as bacterial vaginosis and the herpes simplex virus, can also cause vulvar pain or discomfort.

Tissue and nerve damage

The vulva contains sensitive tissues and nerve endings. Childbirth, sexual activity, and riding a bicycle or horse can all damage these nerve endings, possibly resulting in pain and discomfort.

Neurologic disorders

Some other potential causes of vulvar pain include nerve injury, neuropathy, and Tarlov cysts.

Tarlov cysts occur at the base of the spine, where they either affect or involve nerve roots. They can also cause vulvar pain.

Chronic pain conditions

Research suggests that women who have vulvodynia are more likely to also have another chronic pain condition.

Examples of co-occurring conditions include fibromyalgia, interstitial cystitis, and irritable bowel syndrome.

Allergies

Allergies to soaps or hygiene products can cause pain, discomfort, and irritation in the genital area. Inflammation may also occur.

Hormonal changes

Share on PinterestHormonal changes are a possible cause of vulvar pain.

Hormonal changes occur with menopause and menstruation. These changes can cause sensitive tissues to become swollen, inflamed, or dry and uncomfortable.

Some females may also develop genitourinary syndrome after menopause. Symptoms of this condition include a dry vagina, vulvar pain, pain during sex, and bladder problems.

What makes sex painful? Find out more here.

Skin disorders

A number of skin problems can also lead to vulvar pain.

They include:

Folliculitis: When bacteria infect a hair follicle, small, red, painful bumps can develop.

Contact dermatitis: Itching, stinging, and pain can result from using some soaps, fabrics, and perfumes.

Bartholin gland cyst: A blockage in one of these glands can cause a cyst, which may be painful.

Lichen simplex chronicus: A person with long term contact dermatitis or another skin condition can develop plaques of thickened, scaly skin that can be very itchy.

Lichen sclerosus: This can cause the skin to change in color and texture. There may also be pain during sex, and the skin may tear easily.

Lichen planus: The skin may develop a white surface or white streaks, and there may be pink bumps or lumps.

Cancer

Vulvar cancer occurs when abnormal cells grow in the tissues of the vulva. This cancer can cause pain in the area.

Symptoms of vulvar cancer include:

  • itching, burning, and pain
  • inflammation
  • lumps, which may have a wart-like or raw surface
  • open sores that last for a month or more
  • changes in skin color
  • thickening of the skin

Depending on the type of cancer, there may also be:

  • discharge
  • changes in the shape, size, or color of a mole
  • red, scaly skin, which may indicate Paget’s disease

Various conditions can give rise to genital warts. These are usually benign, but some can be cancerous. Anyone with new or unexplained changes to the skin of the vulva should see a doctor to find out what is causing them.

Vulvar cancer accounts for 0.7% of all cancers in the United States, and 1 female in 333 will develop it at some point in their lives.

Find out more about the symptoms, causes, and treatment of vulvar cancer here.

Vulvar intraepithelial neoplasia

Vulvar intraepithelial neoplasia refers to cell changes that are not cancer but could become cancerous in the future.

The condition can cause itching, burning, and changes in skin color and texture. A healthcare provider will likely treat these to prevent cancer from developing in the future.

Sharp pain in clitoris?

Rosie, This can be pretty common and it is not always something you did, You could try this HERE but if it continues to bother you please don’t take any chances and call your doctor to make sure this is all it is. Here you go and when you are at the Pharmacy you could ask the Pharmacist on duty. Here you go.
If it’s swollen after you cut it then it’s likely infected and unless after 24 hours it’s getting better you should call your doctor and ask for an appointment or other signs or symptoms to watch for. Another option that is safe even if you do need to see your doctor later would be a sitz bath – these are easily purchased at your pharmacy without a need of a prescription and they’re usually pretty cheap. You will put it on the toilet to sit on warm water (and you can also add something to fight infection – ask your pharmacist for a good product if you don’t know what to buy). These feel relieving to many people and really help with the swelling of the entire area. If your not comfortable call and get some medical advice.

What Is Vulvodynia (Vaginal Pain)?

This condition involves pain in the area around the opening of the vagina.

Vulvodynia is persistent pain of the vulva, the area around the opening of the vagina.

The vulva includes the opening of the vagina, the pubic mound, the inner and outer labia (vaginal lips), and the clitoris.

In people with vulvodynia, there’s no identifiable cause for the pain, such as a cut or infection.

An estimated 9 to 18 percent of women between ages 18 and 64 experience vulvar pain at some point, according to the National Institutes of Health.

Vulvodynia Symptoms

Vulvar pain can feel different for different people.

Symptoms of vulvodynia may include:

  • Burning or stabbing pain
  • Vaginal itching
  • Soreness or rawness (feeling like something rough is rubbing on the area)
  • Painful intercourse
  • Throbbing pain

Some women have pain in a specific area of the vulva, such as the clitoris or the vaginal opening. Others experience pain all over the vulva.

The pain may be constant for some women, while others may feel pain only when something touches the area. Some women feel pain when washing the area or having sex.

Vulvodynia Treatment

No one treatment works for everyone with vulvodynia. If you’re experiencing vulvar pain, talk to your doctor about what treatments might work best for you.

Treatment options include:

  • Prescription skin ointments or hormone creams
  • Medications, including antidepressants, anticonvulsants, and pain relievers
  • Injections of anesthetic (numbing) medications
  • Physical therapy (exercises to strengthen the pelvic muscles, or electrical stimulation)
  • Complementary treatments (such as acupuncture and massage)

Surgery may be an option for people with some types of vaginal pain. During the surgery, your doctor will remove tissue from the painful area of the vulva.

Surgery isn’t recommended for most people with vulvodynia.

Home Remedies

There are a number of steps you can take at home to help ease vaginal or vulvar pain:

  • Avoid tight-fitting underwear, pantyhose, and pants
  • Wear 100-percent cotton underwear
  • Don’t douche
  • Clean the vulva with water only (avoid vaginal wipes, deodorants, bubble baths, and scented soaps)
  • Use lubrication during sex
  • Apply cool packs to the vulvar area to reduce pain and itching
  • Avoid exercises or activities that put pressure directly on the vulva, such as bicycling and horseback riding
  • Take 5- to 10-minute sitz baths in warm water, followed by moisturizing the area

What Is Vulvar Vestibulitis?

Vulvar vestibulitis is persistent vaginal pain located in the vulvar vestibule. The vulvar vestibule is the area around the opening of the vagina.

Vulvar vestibulitis is sometimes referred to as localized vulvar pain syndrome. Usually there’s no obvious cause of the vaginal pain.

People with vulvar vestibulitis may have vaginal pain in the following situations:

  • Vaginal intercourse
  • Tampon insertion
  • Prolonged sitting
  • Wearing tight clothing
  • Bicycling

People with vulvar vestibulitis often describe the condition as a burning sensation in the area around the outside of the vagina.

Vaginal Pain During Pregnancy

Many women complain of vaginal or vulvar pain during pregnancy.

Vaginal yeast infections are a common cause of vaginal pain during pregnancy.

Symptoms of a yeast infection include:

  • Vaginal itching or burning
  • White, chunky vaginal discharge

Other causes of vaginal pain during pregnancy may include:

  • Varicose (enlarged) veins in the vulva
  • Increased pressure on the pudendal nerve (the main nerve that runs between the genitals and the anus)

What is normal?

Each woman’s vulva is unique in size and appearance including differences between the right and left labia. There is also variation in the size, shape and length. These differences and variations are normal.

Because it is difficult for women to see their own vulva, many women do not know what their vulva looks like and/or what is normal for them. If you don’t know what your vulva looks like, it is a good idea to use a mirror so you can look and become familiar with what is normal for you. It is then easier to detect any changes in appearance, such as changes in colour, bumps, thickening or thinning of the skin or dry, cracked skin.

Irritation

The skin of the vulva is extremely delicate, making it vulnerable to a wide range of conditions.

Vulval irritation and vulvitis (inflammation) are common terms used to describe the irritation. Sometimes part of the vulva, or sometimes the entire vulva, has some of the following:

  • redness
  • swelling
  • burning
  • itching
  • skin cracking or splitting (fissuring)
  • whitening of skin (leukoplakia)
  • associated vaginal inflammation or discharge

Causes of vulva irritation

Vulval irritation can be caused by any of the following:

  • sweating
  • vaginal secretions
  • skin conditions such as:
    • dermatitis
    • eczema
    • lichen sclerosus (skin is often pale or whitish)
  • fungal, bacterial or viral infections such as:
    • candidiasis (thrush)
    • trichomonas
    • genital herpes
  • some medications, preservatives and local anaesthetics
  • tight clothing, pantyhose, G-strings
  • allergies to substances such as:
    • soaps, bath and hair products
    • synthetic underwear
    • feminine hygiene products
    • perfumes
    • laundry detergents
    • scented or coloured toilet paper
    • wax
    • spermicides
    • condoms
    • lubricants used for intercourse
    • douches (vaginal irrigation – this is never advised)

Diagnosis

Sometimes there is a cycle of itch, scratch, skin tearing or splitting and then a secondary infection. Many women are embarrassed to discuss their problem and symptoms can occur for many years before seeking help.

Rather than try to treat the problem yourself, it is important to see your doctor.

Investigations such as blood tests, urine tests, vulval or vaginal swab tests or a vulval biopsy may be necessary.

Management & treatment

The treatment of vulval irritation will depend on the cause and your doctor will help you decide which is the right treatment.

In this video Dr Elizabeth Farrell gives some tips for treatment or refer to the table below:

Treatment What to do
Cortisone creams/ointments Follow the instructions which may include washing prior to applying the cream/ointment
Bathing in bicarbonate of soda
  • Bathe your vulva once or twice a day for 5-10 minutes in a basin or bath:
    • add 2 tablespoons of bicarbonate of soda to a basin of water
    • add 1 cup of bicarbonate of soda to a bath
  • Pat dry then apply any cream/ointment prescribed by your doctor
  • See your doctor if your symptoms do not improve
Only use water or non-soap substitutes to wash your vulva Don’t use perfumed soaps and bath products.
Wear cotton underwear
  • Avoid nylon underwear
  • Wash cotton underwear in pure/unscented soap
Avoid talcum powder Never use talcum powder on your vulva.
Swim in salt water Avoid swimming in chlorinated water if you can.
After swimming change straight away
  • Change out of bathers and shower to remove any chlorine or salt from your vulva
  • Avoid wet clothing next to your vulva
Wear loose fitting pants Avoid tight fitting jeans, pants, G-strings, and if you have to wear pantyhose try those with a cotton gusset.
Lean forward when passing urine This helps to avoid burning and always wipe or pat from front to back.
Choose period products carefully
  • Use 100% cotton sanitary pads and tampons
  • Change frequently
Use natural lubricants Use natural oils such as olive or almond oil instead of commercial lubricants

Secretions or discharge

All women have vaginal discharge or secretions which help to keep the vagina and vulva moist and remove bacteria and dead cells. Normal secretions vary throughout the menstrual cycle, from thin and slippery during ovulation to thick and white just before your period. It’s common for discharge to be discoloured red or brown a day or two before or after your period.

Some vulval and vaginal secretions change in colour and consistency with an infection.

Dryness

Sometimes women find their vulva and vagina feels dry and lubrication is poor. The hormonal changes at menopause can make the vagina dry and thin. This can make sex painful and it can make insertion of a tampon painful as well.

Try using a natural lubricant like olive or almond oil.

Odour

It is normal for your vulva to have a smell that may vary at different times in your menstrual cycle.

There are a number of different fluids and secretions associated with the vulva, including urine, sweat, menstrual blood, skin oils and vaginal and gland secretions all of which can affect the smell.

If the odour is unpleasant, yeasty or fishy smelling this may be a sign of an infection. Other causes of odour may be a sexually transmissible infection (STI), a tampon left in the vaginal canal too long or the presence of urine or faeces.

If you are worried about the odour of your vulva and vagina, and/or have other symptoms such as itching, burning, irritation, soreness, painful sex or painful urination, you should see your doctor.

After menopause, odour may change as the normal bacteria also changes. The odour will be different compared to when still having periods.

‘Good bacteria’ versus ‘bad bacteria’ in the vagina

There are many different types of micro-organisms (tiny living organisms that are invisible to the naked eye) that are found in the vagina. They include bacteria and fungi, however the main types can be generally called ‘good bacteria’ and ‘bad bacteria’. Healthy vaginas are rich in good bacteria and these friendly micro-organisms help to protect the vagina from infections and keep the populations of bad bacteria in check.

An imbalance or overgrowth of bad bacteria and other unfriendly micro-organisms in the vagina can cause symptoms such as vaginal discharge, redness and itch. They can make you more prone to the common conditions of fungal infections such as vaginal candidiasis (thrush) or bacterial infections such as bacterial vaginosis (BV). It’s important to note that not all vulval irritation is due to an imbalance of vaginal bacteria.

Your vaginal bacteria is closely connected to the bacteria in your digestive system, and what you eat and digest can affect the health and populations of bacteria in both your gut and your vagina.

Live cultured yoghurt and other fermented foods, such as kimchi, sauerkraut and kefir, contain good bacteria as an ingredient. Eating these foods regularly can help to maintain healthy populations of good bacteria, introducing the right types to your digestive system and your vagina.

High sugar foods, soft drinks, too much alcohol and too many refined carbohydrates in your diet (such as white breads, biscuits and white pasta) can help the bad bacteria to grow and flourish in place of the good.

Probiotics

Some women who have thrush, bacterial vaginosis or vulval irritation may benefit from taking a probiotic supplement. Probiotics can be taken orally as a capsule and contain good bacteria in much higher quantities than what you would get from fermented foods alone. There are many different kinds of probiotic supplements available and research has found that only specific strains of bacteria are effective in treating infections such as BV. These strains include:

  • Lactobacillus rhamnosus Lcr 35
  • Lactobacillus rhamnosus GR-1
  • Lactobacillus reuteri RC-14 (also known as Lactobacillus fermentum RC-14)

Note: the numbers and letters at the end of each probiotic name are very important and identifies the exact strain of probiotic. Research suggests that a dose of 10 billion CFU/day (colony forming units) of both Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 for at least 2 months is most beneficial for BV, with some women requiring longer treatment of up to 6 months. As always, inform your health practitioner of any medicines you are taking.

Other natural therapies

Other commonly used natural therapies for vulval and vaginal irritation including special diets, vinegar treatments, tea tree oil and garlic. There are no high quality clinical research trials on these treatments so it is difficult to say whether these treatments are effective, safe or otherwise. However, it is important to remember that if you are experiencing vulval or vaginal irritation and it isn’t getting better, make an appointment with your doctor or qualified health professional.

What is the vulva?

Vulva is the general name given to the external parts of the female genitals.

The parts of the vulva include:

Mons pubis

The pad of fatty tissue covered with pubic hair.

Labia majora

The outer lips, which are covered with pubic hair.

Labia minora

The inner lips, which are hairless.

Clitoris and its hood or covering

Positioned at the front of the genital area.

Vestibule

Immediately surrounds the vaginal opening and the urinary opening.

Urinary opening

Above the vaginal opening.

Vaginal opening

Below the urinary opening.

Perineum

The area of skin between the vagina and the anus.

We have just released a new booklet for women – The vulva: irritation, diagnosis & treatment (PDF). Download it to learn more about this important area of health.

  1. Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo controlled trial. Micobes Infect. 2006 8(6):1450-4.

    Homayouni A, Bastani P, Ziyadi S, et al. Effects of probiotics on the recurrence of bacterial vaginosis: a review. J Low Genit Trct Dis. 2014 18(1):79-86.

    Martinez RC, Franceschini SA, Patta MC, et al. Improved cure of bacterial vaginosis with singledose of tinidazole (2g), Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo controlled trial. Can J Microbiol. 2009 55(2):133-8.

Last updated 11 November 2019 — Last reviewed 24 February 2014

** Currently under review **

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at February 2014.

Vulvodynia (vulval pain)

Treatments for vulvodynia

A combination of treatments can often help relieve the symptoms of vulvodynia and reduce its impact on your life.

Vulval gels and lubricants you can buy

Apply an anaesthetic gel, such as lidocaine, up to 20 minutes before sex. This may make sex more comfortable.

To stop the gel getting on your partner, either wipe it off just before having sex or ask your partner to wear a condom (if using condoms, use latex-free ones as latex condoms can be damaged by lidocaine).

If your pain is more constant, apply lidocaine regularly throughout the day. You can also use it overnight.

You can buy tubes of 5% lidocaine gel, cream or ointment over the counter from a pharmacy, although it’s a good idea to get a doctor’s advice before trying it.

Read the instructions carefully before you use it.

Vaginal lubricants and aqueous cream (also available over the counter from pharmacies and supermarkets) may soothe the area and help moisturise the vulva if it’s dry.

Speak to a pharmacist about these treatments.

Prescription medicine from a doctor

Conventional painkillers like paracetamol will not usually relieve the pain of vulvodynia.

But several prescription medicines may help, including:

  • antidepressants called amitriptyline and nortriptyline – possible side effects include drowsiness, weight gain and dry mouth
  • anti-epilepsy medicines called gabapentin and pregabalin – possible side effects include dizziness, drowsiness and weight gain

Your doctor will probably start you on a low dose and gradually increase it until your pain subsides.

You may need to take the medicine for several months.

If you have pain in a specific area of your vulva, injections of local anaesthetic and steroids into a nearby nerve may provide temporary pain relief.

Physiotherapy

A physiotherapist can teach you some pelvic floor exercises (such as squeezing and releasing your pelvic floor muscles) to help relax the muscles around your vagina.

Another technique to relax the muscles in the vagina and desensitise it involves using vaginal trainers.

These are smooth cones of gradually increasing size and length that can be inserted into your vagina in the privacy of your own home.

Some physiotherapists may also suggest trying TENS (transcutaneous electrical nerve stimulation) to reduce your pain.

This is where a machine is used to deliver a mild electrical current to the painful area.

Therapy and counselling

Cognitive behavioural therapy (CBT) is a type of therapy that aims to help you manage your problems by changing how you think and act.

It can often help women cope with the impact that vulvodynia has on their life.

CBT focuses on the problems and difficulties you have, and looks for practical ways you can improve your state of mind on a daily basis.

Psychosexual counselling is helpful when pain is affecting intimacy between you and your partner.

This is a type of therapy that aims to address problems such as fear and anxiety about sex, and restore a physical relationship with your partner.

Surgery

Surgery to remove part of the vulva is done in very rare cases.

But the pain can come back and it’s usually not recommended.

How to feel better now: Abdur-Rahman says your best bet is a warm bath, heating pad, or over-the-counter pain reliever (like Motrin or Ibuprofen). All of these things have anti-inflammatory effects, which can relieve some of the pain. In addition to that, just give it time. It shouldn’t take too long for the pain to subside, and if it doesn’t, talk to your doctor.

How to prevent pain in the future: Foreplay is a great first step. According to Abdur-Rahman, the vagina expands (becoming larger, longer, and wider) during foreplay, which allows for deeper, more comfortable penetration. Foreplay also increases lubrication, which will make penetration a little easier. Adding lube as needed will also help.

From there, you should be thoughtful about your positioning. Abdur-Rahman says any position that puts the vagina owner in control of the penetration is a safe bet. Think: you on top. Avoid positions that maximize penetration—like doggy style or anything where the vagina owner’s legs are in the air. Those positions are more likely to lead to a sore vagina.

Finally, take your time. Be slow and gentle, and communicate with your partner about any discomfort you experience. And if you’re using a dildo, consider sizing down.

3. The sex you had was super rough or fast.

Friction can be great! It often is! But too much friction can definitely make your vagina hurt after sex, mostly likely because there wasn’t enough lubrication.

How to feel better now: If your vulva (or the opening to your vagina) really hurts or is swollen after sex, Abdur-Rahman says you can try putting an ice cube or two in a thick washcloth or in a plastic bag and resting that on the outside of your underwear for 10 to 15 minutes. Don’t put the ice inside your vagina—that will only irritate it more. Again, give it time, and talk to your doctor if you still have a sore vagina after a few days.

How to prevent pain in the future: Take whatever steps you can to ensure adequate lubrication. Foreplay is a great way to give the vagina time to warm up, and lube helps too. It’s also important to take things slow—at least at first. Start gently and slowly, and then transition into rougher, faster sex (assuming that’s what you’re into).

4. You’re sensitive to latex.

Some people are allergic (or sensitive) to latex. If you’re one of these people and you’ve been using latex condoms, you might end up irritating your vagina, Miriam Greene, M.D., ob/gyn at NYU Langone Health, tells SELF.

How to feel better now: Placing an ice pack outside your underwear to soothe your vulva for 10 to 15 minutes is your best bet, as well as giving it time.

How to prevent pain in the future: Talk to your gynecologist to confirm your suspicion that you’re allergic or sensitive to latex (and that there’s not something else going on). If you are, avoid latex condoms in the future. That doesn’t mean giving up on condoms altogether—there are plenty of alternatives, like polyurethane condoms, that you can still use to prevent disease and pregnancy.

Quick note: Though polyurethane condoms are non-latex and help prevent both disease and pregnancy, they have higher slippage and breakage rates than latex condoms, according to the Centers for Disease Control and Prevention (CDC). The female condom is also latex-free, but it’s slightly less effective at preventing pregnancy than latex condoms. You can work with your gynecologist to find something that works for both you and your partner.

5. You have an infection.

If you’re experiencing discomfort that goes beyond slight soreness—like itching, burning, or abnormal discharge—you might have an infection. It could be a yeast infection, bacterial vaginosis, an STI, or something else entirely, and the best course of action is talking to your gynecologist.

Specialty Gynecology

The physicians at the Good Samaritan Women’s Center for Specialized Care regularly treat these conditions:

  • Vulvodynia
  • Vulvo disorders
  • Vulvitis
  • Pelvic pain
  • Painful intercourse
  • Vaginal infections
  • Vaginal cysts
  • Congenital disorders
  • Uterine fibroids
  • Genital warts
  • Genital herpes
  • Uterine bleeding
  • Abnormal Pap tests

Vulvodynia

Vulvodynia means “painful vulva,” a lasting pain in the area around the opening of your vagina. The pain can be constant or intermittent and described as:

  • Burning
  • Soreness
  • Itching
  • Stinging
  • Rawness
  • Painful intercourse (dyspareunia)
  • Throbbing

A similar condition is called vulvar vestibulitis, which may cause pain only when pressure is applied to the area surrounding your vaginal opening. Another condition, called pudendal neuralgia, causes pain in the buttocks, vulva, urethra and the area between your anus and genitals.
Experts believe that as many as one in six women experience vulvodynia, yet many never report it to their doctor. Your doctor has many options for treating this condition. They include medication, physical therapy, biofeedback and estrogen cream. After a thorough examination and discussion, your doctor will recommend the treatment that is best for you.

Vulvo Vaginal Disorders

There are numerous disorders associated with the vulva – the area where your external genitals are located. The most common symptoms of disorders in this area are:

  • Burning
  • Itching
  • Soreness
  • Throbbing
  • Extreme tenderness
  • Lesions in the vulva

The symptoms you experience will help your doctor determine the vulvo vaginal disorder that is present. The discomfort from these disorders can be unbearable. Your doctor will be able to determine if your condition is being caused by something that is easily treatable. If so, the appropriate treatment will be prescribed.
Sometimes the reason for vulvar disorders cannot be determined. Possibilities include a damaged nerve, hormonal changes, allergy or muscle tightness. If your doctor is unable to treat the cause, he will show you how to manage your pain.

Vulvitis

Vulvitis is an inflammation of the outer genitals. It can be caused by allergies, long-term skin conditions, or infections. Symptoms may include:

  • Burning or itching
  • Cracked skin
  • Vaginal discharge
  • Redness and swelling
  • Thickening of the skin

Your doctor will examine the affected area and may test for infection. If prescribed medication is not effective, a biopsy of the skin may be needed to rule out other conditions.

Pelvic Pain

Pain in a broad area below your abdomen is called pelvic pain. You may have it during your period, during intercourse or bowel movement, or whenever you are seated. The pain can be intermittent or steady; severe or a dull ache. It can feel like a pressure deep within your pelvic area.
If the pain is severe enough to disrupt your day, you should see your doctor. Finding the cause of pelvic pain is tricky. If the reason for the pain is found, treatment will focus on eliminating the cause. If not, treatment will focus on managing the pain.

Painful Intercourse

If you experience pain during or soon after sexual intercourse (called dyspareunia), you are not alone. There are many possible reasons for the pain. Your doctor can help you pinpoint the cause. Possibilities include:

  • Intercourse too soon after surgery or childbirth
  • Vaginal dryness or infection
  • Menopause
  • Reaction from a latex condom or diaphragm
  • Irritation from soaps, douches or other hygiene products
  • Sexually transmitted diseases
  • Urinary tract infections
  • Endometriosis
  • Involuntary contraction of the vaginal muscles
  • Diaphragm that fits poorly
  • Hemorrhoids
  • History of sexual abuse
  • Certain medications

Depending on the cause, your doctor may recommend treatments that you can administer at home. Other treatment options include medications and/or therapy. Be sure to notify your doctor if the pain is accompanied by bleeding, vaginal discharge, genital lesions or irregular periods.

Vaginal Infections

Most women experience an inflammation of the vagina at some point during their lifetime. The inflammation can be accompanied by one or more of these symptoms:

  • Vaginal itching or irritation
  • Foul-smelling vaginal discharge
  • White, thick or greenish-yellow discharge
  • Pain during intercourse
  • Painful urination
  • Abnormal bleeding

There are several types of vaginal infections. A pelvic exam often can help your doctor determine the type of infection. Your doctor also may take a sample of your discharge in order to confirm the diagnosis. Treatment – usually a medication – will depend on the type of infection you have.
If you suffer repeatedly from infections, a discussion with your doctor can help. All of the following can play a role:

  • Sexual habits
  • Soaps, douches
  • Medications
  • Diabetes
  • Hormonal changes
  • Damp or tight-fitting clothing

By exploring the reasons for your infections, your doctor can help you determine why they occur, and how to prevent future infections.

Vaginal Cysts

A sac of fluid on or under the lining of the vagina is a vaginal cyst. These cysts can be as small as a pea or as large as an orange. They can result from trauma to the vagina, or following an obstetric or gynecologic procedure.
Other than a soft lump within or protruding from the vagina, cysts often have no symptoms. Their presence can cause pain during sexual intercourse or when inserting a tampon.
Upon examination, your doctor may want to take a biopsy of the cyst to rule out cancer. Depending on the location of the cyst, an x-ray may be needed to confirm its presence. Once confirmed, your doctor may simply want to watch the cyst for changes. Removing the cyst via surgery usually is not necessary unless the cyst is causing severe discomfort.

Vaginal Congenital Disorders

Our physicians are experienced at treating all types of vaginal congenital disorders, including:

  • Gartner duct cysts
  • Adenosis – mucus secreting glands in the vagina
  • Vaginal septum
  • Absence of the vagina

Uterine Fibroids

Fibroids are tumors that grow in the wall of the uterus, usually during middle age. They can grow as a single tumor, or there can be many of them in the uterus. They can be very tiny or as large as a grapefruit. Rarely are they cancerous.Most fibroids are harmless and cause no problems. Sometimes fibroids can cause:

  • Heavy bleeding or painful periods
  • Full or heavy feeling in the pelvis
  • Frequent urination
  • Painful intercourse
  • Lower back pain
  • Complications during pregnancy
  • Infertility (rare)

Treatment options for fibroids range from drugs that shrink fibroids to surgery. Your doctor will recommend a treatment plan that is best for you.

Genital Warts

Genital warts can itch or bleed and interfere with bowel movements, urination, and sexual intimacy. Removing warts reduces the risk of passing the virus to partners.
Genital warts are caused by the human papilloma virus (HPV). They usually are sexually transmitted. They also can be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts. These warts may appear externally in the vaginal area, or inside the vagina or anus. By removing a wart and examining it in a lab, your doctor can confirm diagnosis.
Treatment options include:

  • Surgical removal of warts (with laser, by freezing with liquid nitrogen, simple excision or removal with electric needle)
  • Chemical application over multiple visits to destroy warts
  • Medication

Your doctor will determine the best treatment for you based on the number of warts, their specific location, and other factors. Recurrences are always possible. New treatments are continually being investigated. Ask your doctor about the latest findings.

Genital Herpes (Herpes Simplex)

Genital herpes is a viral infection that can be spread through sexual contact. It causes sores and blisters around the genitals, or anus. It can be spread through direct contact with thesesores, but also can be spread even if you do not see a sore.

You may have painful attacks with many sores, or only mild symptoms. In addition to sores and blisters, symptoms may include:

  • Swollen glands
  • Fever
  • Chills
  • Muscle aches
  • Fatigue
  • Nausea
  • Stinging feeling during urination

The first bout with genital herpes may last two to four weeks. Recurrent infections usually are less painful and heal more quickly.
Oral medications can shorten the length of an outbreak and reduce discomfort. Daily oral medications can reduce the frequency of outbreaks, and the chance of spreading the disease to someone else. Your doctor can help determine the treatment that is best.

Abnormal Uterine Bleeding

There are many reasons why you may experience abnormal bleeding. It can be caused by a hormone imbalance, changes in ovulation, thickening of the uterus, or cancer.
To determine the cause, your doctor likely will order tests. Your age will help determine which tests are needed. Treatment will depend on tests results. It can range from medications to surgery.

Abnormal Pap Tests

An abnormal Pap test sometimes detects cancer cells in the lining of the vagina. If a repeat Pap test also is abnormal, your doctor likely will want to conduct further tests to identify the reason.
For information on cancers of female organs, go to the Gynecologic Oncology (please link to this section) section of this Web site.

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