It’s not uncommon to have vulvar discomfort, itching, or pain at some point, especially during your period.

The vulva is the outer part of the genitalia in people with a vagina. It includes the outer labia (labia majora) and inner labia (labia minora). The mound made by the pubic bone, the clitoris, and the openings of the urethra and vagina are also part of the vulvar area.

In this article, we’ll take a look at some causes of vulvar pain, how they’re diagnosed, and what you can do about them.

Common causes of vulvar painLess common causes of vulvar pain
vulvodyniaBartholin’s gland cyst
yeast infectionvaginismus
bacterial infectionvulvar cancer
folliculitischronic pain conditions, such as fibromyalgia, interstitial cystitis, or irritable bowel syndrome
trichomoniasis

Vulvodynia

Vulvodynia is chronic vulvar pain, burning, or other irritation that lasts at least three months. Vulvodynia is idiopathic, meaning there’s no clear cause. Symptoms can be unprovoked or provoked by touch.

Cyclic vulvodynia, or cyclic vulvitis, tends to change according to where you are in your menstrual cycle. The pain may get worse around your period, especially when you try to insert a tampon. In some cases, pain improves during the period.

Although the exact cause of vulvodynia isn’t known, these may be contributing factors:

  • previous vaginal infections
  • allergies and skin sensitivities
  • injury to the nerves around the vulvar
  • hormonal changes
  • pelvic floor weakness
  • certain genetic disorders

Vulvodynia is estimated to affect up to 16 percent of women.

Yeast infection

About 75 percent of women will have at least one vaginal yeast infection in their lifetime. It’s caused by an overgrowth of yeast. Some potential causes are:

  • hormonal changes due to pregnancy or oral contraceptives
  • antibiotics or topical antimicrobial agents
  • douches or harsh feminine hygiene products
  • wearing tight or poorly ventilated underwear or clothing
  • unmanaged diabetes

It can hurt when you urinate, during intercourse, or when you try to insert a tampon. It can also involve a thick, white discharge.

Bacterial infection

A bacterial infection, or bacterial vaginosis, develops when your pH is out of balance. This can happen when you change sexual partners or if you douche. It can also cause foul-smelling discharge and burning during urination.

Folliculitis

Folliculitis is when small red bumps develop from infected hair follicles. It tends to occur on the outer labia.

Bartholin’s gland cyst

A Bartholin’s gland cyst can form on either side of the vagina when a gland becomes blocked. A painful cyst usually indicates infection.

Trichomoniasis

Trichomoniasis is a common sexually transmitted infection (STI) caused by a parasite. Symptoms can include abnormal discharge with a strong odor, painful urination, and pain with intercourse or tampon use. In some cases, there’s also lower abdominal pain.

Vaginismus

Vaginismus is a painful involuntary spasm around the muscles of the vagina. This may happen during sexual intercourse, during a vaginal exam, or when you try to use a tampon. Some potential contributing factors are anxiety or a history of sexual abuse or trauma.

Vulvar cancer

Vulvar cancer is rare and slow-growing. Some risk factors may include having:

Vulvar cancer can cause other symptoms such as:

  • itching
  • bleeding, even outside of your period
  • changes to skin color or thickness
  • lumps, bumps, or ulcers

Chronic pain conditions

In 2012, researchers found that those who have vulvodynia are more likely to have a one or more other chronic pain conditions such as:

Can those in perimenopause and postmenopause experience vulvar pain?

Anyone with a vulva can experience vulvar pain. It’s not uncommon for symptoms to appear in midlife or after menopause and for many of the same reasons it happens earlier.

In addition, vulvar pain in perimenopause or after menopause may have to do with low estrogen levels. Other symptoms can include vaginal dryness and vulvar atrophy.

Treatment for pain during your period depends on the cause.

For vulvodynia

Your doctor can treat vulvodynia with local anesthetics or hormone creams that can be applied directly to the skin. In some cases, antidepressants or antiseizure drugs can help ease symptoms.

For yeast infections

Yeast infections are treated with antifungal medications. Many are available over-the-counter (OTC) in the form of creams, tablets, and suppositories.

If you’ve never had a diagnosed yeast infection, see your doctor before trying OTC medications. Antifungals won’t work on other causes of vulvar pain.

For bacterial infections

Antibiotics are generally used to treat bacterial infections.

Both types of infection can and should be treated during your period. If you’re using vaginal creams or suppositories for a yeast infection, tampons can make the medication less effective, so you should switch to pads.

For folliculitis

Folliculitis usually clears up on its own. Your doctor can drain a troublesome Bartholin’s gland cyst. In the meantime, warm compresses may help ease pain or discomfort.

For trichomoniasis

Trichomoniasis may be treated with a single dose of an oral medication called metronidazole. It’s important that you and your sexual partners are treated to prevent transmitting the disease again.

For vaginismus

Some ways to treat vaginismus include:

  • Kegel exercises to strengthen and help control vaginal muscles
  • using a vaginal dilator to help your muscles become more flexible and to increase your comfort level
  • therapy or counseling with a mental health professional

For vulvar cancer

Vulvar cancer treatment can involve:

  • surgery
  • topical therapies
  • chemotherapy
  • biologic therapy
  • radiation

If you have vulvar pain during your period, try switching from tampons or menstrual cups to pads to see if that helps. If you already use pads, switch brands to see if you have a sensitivity to a specific product.

Here are some other tips for dealing with vulvar pain:

  • Make sure your underwear is loose and has a breathable, cotton crotch.
  • Avoid tight pants or shorts.
  • Use a cold compress or a cool gel pack to lessen pain and itching.
  • Avoid activities like cycling or horseback riding that put pressure on the vulva, particularly if you’re extra sensitive during your period.
  • Don’t use hot baths or hot tubs, which can make matters worse. Instead, soak in a sitz bath. You can do this for 5 to 10 minutes several times a day, even if you’re menstruating.
  • Don’t use douches, genital deodorants, or perfumed feminine hygiene products.
  • Don’t use irritating shampoos or soaps.
  • Wash your genital area with plain water. Gently pat dry.
  • After your shower, you can apply plain petroleum jelly or other emollient with no preservatives. Be sure to only use these on outer areas.
  • You can use a lubricant prior to having sex, but stay away from products that contain harsh ingredients such as alcohol or flavorings. Don’t use products that are designed to get warmer or cooler.

It’s important to see a doctor for vulvar pain, especially if you also have other symptoms. Vulvar pain is often easily treated. But without proper treatment, fungal infections, STIs, and other causes of vulvar pain can lead to serious complications.

After hearing about your symptoms and medical history, your doctor will probably perform a pelvic exam to look for abnormalities. A swabbing of the vagina and vulva can determine if you have a bacterial or yeast infection. The results of these tests will guide the next steps.

While often treatable, chronic vulvar pain may affect your quality of life.

Whether associated with your period or not, you should see your doctor if you experience vulvar pain. It’s likely due to an easily treatable condition, but it’s also important to rule out a few potentially serious causes.