Acute Vaginal Pain: Lifestyle Changes, Causes and Treatments

Acute vaginal pain is an alarming that can arise suddenly, causing significant discomfort and affecting daily life. 

Understanding its causes, proper diagnosis, and available treatments is essential for effective management. 

This article delves into the different causes of acute vaginal pain, how they are diagnosed and treated, and whether their treatment is different while pregnant or postpartum.

Causes of Acute Vaginal Pain

Acute vaginal pain can result from various medical conditions, infections, injuries, or hormonal changes. Some common causes include:

Infections and Inflammatory Conditions

• Yeast infections: An overgrowth of candida can cause a burning sensation, itching and swelling.
• Bacterial vaginosis: An imbalance of vaginal bacteria leading to irritation, discharge, and discomfort.
• Sexually transmitted infections (STIs): Conditions like herpes, chlamydia, and gonorrhoea may cause acute pain, ulcers, or inflammation.

Pelvic and Gynecological Disorders

• Vaginal atrophy: A common issue with menopause, causing dryness and pain due to declining estrogen levels.
• Endometriosis: The tissue that lines the uterus grows outside the uterus, can cause sharp vaginal pain, particularly during menstruation.
• Pelvic inflammatory disease (PID): An infection that spreads to reproductive organs, leading to pain and tenderness.

Physical Trauma or Injury

• Postpartum vaginal tears: Childbirth-related trauma can lead to chronic vaginal pain after childbirth.
• Sexual activity: Rough intercourse, insufficient lubrication , or particular positions may lead to acute discomfort.
• Foreign body insertion: Forgotten tampons or contraceptive devices can cause pain and infection.

Neurological and Musculoskeletal Causes

• Pudendal neuralgia: Nerve compression leading to sudden stabbing pain in the vagina.
• Pelvic floor dysfunction: Tight or weak muscles contributing to chronic or sharp pain.
• Interstitial cystitis: A bladder condition that can cause pelvic and vaginal discomfort.

How to Diagnose Acute Vaginal Pain

Acute vaginal pain requires a complete medical evaluation to identify what is behind the pain. Diagnosis typically involves:

• Medical History and Symptom Review: The doctor will ask about the nature, severity, duration, and triggers of the pain.
• Physical and Pelvic Examination: A gynaecological exam helps assess for infections, inflammation, or structural abnormalities.
• Laboratory Tests: Vaginal swabs, urine tests, or blood tests help identify infections or hormonal imbalances.
• Imaging Studies: Ultrasound or MRI studies might be suggested if pelvic disorders such as endometriosis or cysts are suspected.
• Nerve Function Tests: In cases of alleged neurological involvement, nerve studies may be performed.

Treatment Options for Vaginal Pain

The treatment of acute vaginal pain depends on its cause. Some of the most effective approaches include:

Medications

• Antibiotics or antifungals: Prescribed for bacterial or yeast infections.
• Pain relievers: Over-the-counter or prescription analgesics for symptom relief.
• Topical estrogen: Helps alleviate pain due to vaginal atrophy.
• Neuropathic pain medications: Used for conditions like pudendal neuralgia.

Lifestyle and Home Remedies

• Warm baths or sitz baths: Help relieve irritation and inflammation.
• Pelvic floor exercises: Strengthening or relaxing pelvic muscles can reduce discomfort.
• Avoiding irritants: Fragranced soaps, feminine washes, or tight clothing may worsen symptoms.

Medical and Surgical Interventions

• Physical therapy: Helps manage pelvic floor dysfunction.
• Laser therapy: Provides relief from pain caused by vaginal atrophy.
• Surgical procedures: In severe cases, such as excision for endometriosis.

Acute Vaginal Pain During Pregnancy

Pregnancy introduces hormonal and physiological changes that may lead to vaginal pain. Causes include:

• Increased blood flow and pressure: The growing uterus can pressure pelvic nerves and blood vessels.
• Round ligament pain: Sudden sharp pain in the lower abdomen and vaginal area.
• Infections or varicose veins: Vaginal infections or swollen veins can contribute to discomfort.

Managing pain during pregnancy involves safe interventions such as warm compresses, pelvic support belts, and physician-approved pain relief options.

Chronic Vaginal Pain After Childbirth

Postpartum vaginal pain may persist due to:

• Perineal tears or episiotomy healing issues.
• Pelvic organ prolapse, leading to pressure and discomfort.
• Hormonal changes cause vaginal dryness and sensitivity.

Treatment includes pelvic floor therapy, lubrication, and medical evaluation for chronic pain.