What's Up, Down There
As women, too often our pain is dismissed or ignored. We’re meant to feel as though our concerns aren’t real. It’s important to know that if you’re experiencing frequent vaginal pain, you don’t have to suffer through it. In the latest edition of our series, What’s Up, Down There, we explore some of the most common causes of vaginal pain and how you can work with your Axia Women’s Health provider to find the right treatment.
For starters, it’s helpful to identify where your pain is coming from. Often, we refer to the vagina as the entire area down there. When in fact, the vagina only refers to a specific part of our internal organs. The vagina is a muscular tube that extends from the vaginal opening to the uterus (the womb). The external female genitalia (including the labia, pubic area, and clitoris) is known as the vulva.
It may be difficult to decipher exactly where the pain is coming from, and that’s okay. Before your next appointment with your Axia Women’s Health provider, try keeping a journal or note on your phone of your symptoms. This will help you have a more productive discussion, and ultimately help your provider better understand what you’re feeling so they can partner with you on the best treatment approach.
While there can be many possible causes of vaginal pain, below are some of the most common forms. Spoiler alert: the good news is, these conditions are often treatable and not cause for major concern.
Vulvodynia is a type of chronic pain that affects your vulva (the external female genitalia) and lasts for 3 months or longer. Often, vulvodynia is described as a feeling of burning, stinging, irritation, and rawness. The pain may be constant, or it may come and go.
Possible causes of vulvodynia can include nerve damage or irritation, sensitivity to certain foods, dysfunction of the pelvic floor muscles, or certain genetic disorders.
Treatment for vulvodynia can range from conservative approaches like pelvic floor physical therapy to medications such as topical creams or oral pills such as antidepressants to quiet the nerves that cause the pain.
Vaginismus is the involuntary tensing or contracting of muscles around the vagina. It is characterized by muscle spasms that can make penetration through sex, a gynecological exam, or even inserting a tampon incredibly painful.
This disorder is common in younger women and may be due to previous sexual abuse, a past painful intercourse experience, trauma during childbirth, or other emotional factors.
One of the most common and effective treatments for vaginismus is pelvic floor physical therapy. Through pelvic floor physical therapy, women can learn breathing techniques, stretches, and exercises that can help relieve stress and relax the pelvic floor muscles.
Dyspareunia is the medical term for pain in the pelvis or genital area specifically during sexual intercourse. This type of pain is often recurring and can be sharp or intense.
Women with dyspareunia may experience sharp pain at the entrance of the vagina during penetration or deep pain in the cervix or lower abdomen during certain sexual positions.
Dyspareunia can often occur during menopause as the vaginal lining can become dry and thin. If this is the case, your provider may recommend a vaginal lubricant, estrogen cream, or other type of prescription medication to aid with lubrication.
Endometriosis is a common condition where tissue grows outside of the uterus and in other areas of the pelvis, such as the ovaries and pelvic walls. This type of pain may be difficult to isolate and may feel like general pain in your pelvic area.
Common symptoms of endometriosis can include irregular, or unusually heavy periods, pain during or after sex, significant menstrual pain that can’t be treated with painkillers, difficulty getting pregnant, pain or discomfort when going to the bathroom, and chronic fatigue.
Endometriosis is a treatable condition. Through a minimally invasive procedure a provider will use a small camera to determine if endometrial lesions are present and can safely remove any visible endometriosis. There are also a variety of treatment options that can help endometriosis symptoms, including birth control, progesterone IUDs, or anti-inflammatory medications.
Sexually transmitted infections (STIs) are very common and can be a very real threat. It’s estimated that about 68 million people in the U.S. are living with an STI.
Certain STIs can cause pain during sexual intercourse, pain or burning when urinating, and vaginal itching or irritation.
If you think you may have been exposed to an STI, it’s important to get tested right away before the infection can progress. The Centers for Disease Control and Prevention (CDC) recommends that any sexually active female under the age of 25 receive at least annual screenings for gonorrhea and chlamydia because a majority of cases in the United States occur in this age group. There are no specific guidelines beyond age 25, but if you are having intercourse outside of a trusted, monogamous relationship or are having symptoms, you should get screened.
Many STIs are treatable through a short course of antibiotics. In the case of STIs caused by viruses like HIV or herpes, you may be prescribed an antiviral drug to keep the infection in check. Though you’ll still carry the virus, this helps to lower the risk.
If you’re experiencing uncomfortable symptoms like unusual discharge, itching, and burning when you urinate, you may have a common vaginal infection such as a yeast infection or bacterial vaginosis. With a yeast infection, you will typically experience thick, white, and lumpy discharge. With bacterial vaginosis, you will notice a thin, grayish-white vaginal discharge and a strong “fishy” odor.
These types of infections occur when there is an unbalance in your vaginal pH which can be caused by a variety of factors from unprotected sex to antibiotics to certain forms of birth control.
Fortunately, these types of infections are easily treated with an over-the-counter antifungal medication like Monistat or an antibiotic called metronidazole.
No matter the source of your pain, it’s important to know that what you’re feeling is real and you don’t have to suffer. If you’re experiencing persistent vaginal pain, it’s important to schedule a check-in with your Axia Women’s Health provider. As partners in your health, we’re here to listen, offer support, and help you feel empowered to take charge of your health.
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