Vulvar Pain and Vaginal Disorders

Many women suffer from vulvovaginal pain. This is described as burning, stinging, or throbbing sensations related to the female genitalia. The pain is often chronic, lasting for months without relief. When there is no infection, the condition is sometimes called vulvodynia (vulvar pain) or vaginismus (vaginal pain).

This type of pain can significantly affect your daily life, making even sitting and urinating difficult. It also impacts intimacy and overall well-being. Many women hesitate to seek help – yet most causes of vulvovaginal pain are highly treatable.

Our women’s health specialists are here to listen, support, and provide effective solutions tailored to your needs. Drawing from established clinical guidance, our approach combines expertise, empathy, and a multidisciplinary care model to help you find lasting relief.

By age 40, approximately 7% of American women will experience symptoms consistent with vulvodynia.1

 

What are the signs and symptoms of vulvovaginal pain?

Since there are many possible causes of vulvovaginal pain, there can also be a wide variety of symptoms. If you’re experiencing genital-related pain that’s ongoing and interfering with your daily life or intimacy, it’s time to talk with a provider. Seek help even if symptoms tend to come and go. Many women wait months or even years before seeking help, but early care can dramatically improve outcomes.

  • Burning, rawness, tightness, and throbbing of external genitalia
  • Chronic burning, itching, or irritation of the vagina or vulva
  • Chronic pain of the clitoris
  • Painful intercourse
  • Painful urination
  • Vaginal dryness
  • Urethritis (inflammation of the urethra)
  • Inability to place a tampon or have sexual relations

What causes vulvovaginal pain?

Our women’s health providers diagnose and treat a wide range of conditions that cause vaginal or vulvar pain. Those include:

  • Lichen sclerosus – This appears as thin white patches in the anal and genital region that cause severe itching, pain, burning, and blistering. It’s caused by a chronic inflammatory process that affects post-menopausal women.
  • Lichen planus – An inflammatory condition causing itchy sores and purple bumps on the skin and mucous membranes, including the vagina. It’s often triggered by stress.
  • Lichen simplex chronicus – A type of eczema that leads to thick, dry, and scaly patches caused by constant cycles of itching and scratching. This can happen anywhere on the body, including the vulva and around the anus.
  • Atrophic vaginitis – The drop in estrogen after menopause makes the vaginal walls thinner, dryer, and more inflamed. This can result in burning, itching, and painful intercourse. It also leads to an increased risk of UTIs.
  • Chronic yeast infections – Three or more episodes per year of the itching, soreness, and discharge associated with a vaginal yeast infection.
  • Chronic bacterial vaginosis – A stubborn thin, grayish-white vaginal discharge with odor and itching or irritation that occurs three or more times a year.
  • Vulvar vestibulitis syndrome – Refers to intense burning or pain around the opening of the vagina, usually during penetration but can occur without touch. Its cause is unknown but may be related to overgrown or hypersensitive nerve endings.
  • Vulvodynia – A chronic constant or intermittent pain disorder that involves burning, raw, or throbbing sensations in the vulva.
  • Vaginismus – Sharp, burning pain and involuntary spasms of the pelvic floor. It can make vaginal penetration difficult or impossible.
  

How is vulvar or vaginal pain diagnosed?

Your women’s health provider will use a comprehensive, systematic approach to identify the cause of your pain. Based on your symptoms, your doctor will tailor the evaluation to your specific situation. That may include:

  • Review of your medical and surgical history
  • Pelvic, vulvar, and vaginal examination
  • Vaginal secretion testing
  • Assessment for musculoskeletal or nerve-related contributors
  • Screening for infections, dermatologic conditions, or hormonal factors

How is vulvar or vaginal pain treated?

Because each woman’s experience is unique, we customize care based on your symptoms, physical findings, and personal goals. Treatment may include:

Medical and procedural care

  • Treatment of infections or skin disorders
  • Topical therapies or oral medications
  • Pain modulating medications (e.g., tricyclics)
  • Hormonal therapies when appropriate

Pelvic Floor Physical Therapy

A urogynecology specialist may help with:

  • Muscle relaxation training
  • Internal and external pelvic floor assessment
  • Pain mapping
  • Strength and coordination exercise

Learn more about urogynecology and pelvic floor therapy.

What should you know about vulvar pain?

Many women hesitate to seek treatment for their vulvar pain, even though it impacts their day-to-day lives. If you are suffering from vulvar pain, it's important for you to understand:

  • Vulvar pain is usually not associated with cancer and is most commonly benign.
  • Vulvar pain is not sexually transmitted.
  • Vulvar pain is not due to poor hygiene.
  • Improvement can take weeks to months.
  • Treatment setbacks may occur; they are not necessarily the fault of you or your provider.

What should you know about mental health and vulvar pain?

At SSM Health, we know this pain is real, and it is caused by a medical condition associated with your vulva. You deserve to be heard. Chronic pain can be exhausting and emotionally draining, and proper support plays an important role in healing.

If you are in a relationship, both of you are affected by this condition. You may want to consider couples counseling as a beneficial tool for addressing the issues and concerns you and your partner face. In addition, you may wish to seek more information on your own. The more you know about this condition, the more control you have.

Frequently, patients become depressed. There are treatment options. Our women’s health specialists may offer antidepressants during your treatment to help you better cope with chronic pain.

Common questions about vulvar pain or vaginal disorders:

There are multiple steps you can take to reduce friction and irritation to your vulvovaginal area.

  • Wear 100% cotton underwear and loose-fitting clothes.
  • Use mild, soap-free, fragrance-free, and alcohol-free cleansers and detergents.
  • Try warm sitz baths and/or cool packs to soothe the area.
  • Use alcohol-free, preservative-free lubricants during sexual intercourse.

Since the anus and vagina are located close to each other, hemorrhoids can radiate pain to the vagina. You may feel pressure, itching, or irritation, especially if you have external or large hemorrhoids.

No, sharp or throbbing pain in the genital area is not considered normal and should be evaluated to determine the underlying cause. Infection, inflammation, endometriosis, and pelvic floor issues are among the possible explanations for such pain.

Vulvodynia is often considered to be a neuropathic (nerve) pain syndrome. It’s caused by damage, irritation, or hypersensitivity of the nerves in the vulva. This leads to the chronic pain you can experience even when a current infection or source of inflammation is not detected.

Many women experience soreness, aching, and cramping during menstruation. This is due to hormonal shifts, uterine contractions, and increased blood flow. Symptoms can usually be relieved by over-the-counter pain relief, use of heating pads, or gentle stretching. However, intense pain may indicate a more serious issue like endometriosis or pelvic floor dysfunction. Those conditions may benefit from an examination by a women’s health specialist.

  

Page reviewed by: K.Michael Schraff, MD, February 2026