Pain in the vagina: what are the possible causes?

Many causes may explain pain in the vulva and vagina. These are sometimes accompanied by other symptoms such as itching or white discharge. Explanations with Dr. Felicia Joinau-Zoulovits, gynecologist-obstetrician, Dr. Philippe Deruelle, professor in gynecology-obstetrics and Dr. Christine Levêque, gynecological surgeon, mammary and pelvi-perineal at the Center l'Avancée in Aix-en-Provence *.

Causes of acute pain

Vaginal dryness is caused by a hormonal fall in the body. It can occur after childbirth or during menopause. Women with gynecological cancer are taking anti-hormonal treatments and are also experiencing severe drought. When pain occurs during intercourse, this disorder may reflect a lack of desire or poor lubrication of the female sex.

Most of the pain in the vagina or vulva is explained by the presence of mycosis, a vaginal infection caused by a germ (Candida albicans). The infection can also be caused by certain bacteria (Chlamydia, streptococci ...), a virus (genital herpes) or a parasite (Trichomonas). This is known as sexually transmitted infection.

The pain can come from a simple irritation. If it is localized in the vaginal mucosa, it may be due to bad habits of personal hygiene (use of chemicals, douching) or reaction to certain products such as lubricating gel, contraceptives or antimycotic treatment.

Vulvovaginal irritation is caused by synthetic underwear, too tight or to sanitary napkins. Much rarer, it can be a skin condition (psoriasis, lichen, eczema) that has spread from the vulva to the vagina.

• A traumatic vaginal injury

If during intercourse, penetration has been too abrupt, a vaginal injury may occur. "This is called a classic wound, during the report, the penetration brings a lot of air into the vagina, there is a lot of pressure, which hurts", Says Dr. Felicia Joinau-Zulovits, Obstetrician Gynecologist.

Pains in the vagina can be related to a pregnancy where the baby's weight is felt on the nerves and sends a feeling of "electric shock", says Dr. Philippe Deruelle. Pregnancy often results in a feeling of pelvic heaviness due to the volume of the uterus on the vagina. After childbirth, tears and episiotomy may explain pain in the vagina.

Pains can only occur during sexual intercourse, we speak of dyspareunia. If the ailments occur during the introduction of the penis, dyspareunia is related to contraction of the vaginal muscle or poor lubrication. The pain can be deeper and felt when the male touches the bottom of the vagina.

Causes of chronic pain

Affecting one in 10 women, the disease causes severe pelvic pain that is deep, spasmodic or diffuse. They can occur during a report and / or outside. Depending on the locality of the endometriosis, the ailments can spread to other organs and / or be felt during defecation or when the person is urinating.

• Central pelvic hypersensitivity

Central pelvic hypersensitivity is responsible for pain that occurs, such as for endometriosis, filling the bladder, expulsion of the saddle, sexual intercourse or even the introduction of a tampon.

It is a neurological condition that affects the pudendal nerve located in the pelvic area, says Dr. Christine Levêque. The disease causes severe pain in the clitoris and anus that occur when the patient is seated. The pains are similar to a burning sensation and / or discharge.

• A dimi vulva vestibule caused

The pains are felt on the inner side of the labia minora and orifices until the hymen. They are sharp during a contact: sexual intercourse, friction etc. This disease affects 10 to 16% of women.

* The multidisciplinary center specializes in pelvic-perineal pain and perineal reconstruction.

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