Sharp pain in the vulva or vaginal opening, clitoris or labia is usually caused by an underlying condition. These conditions can include:
Any unexplained pain is a good idea to get checked out. It is always better to be safe than sorry. Stabbing pain in the vulva or vaginal area is no exception.
Infections
Sharp, stabbing pain in the vulva and vagina can be caused by infections or irritations. This can include bacterial and viral infections such as those caused by sexually transmitted infections (STIs) like gonorrhea and chlamydia. It can also be due to topical irritation such as shaving or the use of harsh soaps and lotions. Other causes of vulva pain can be due to pregnancy, menstrual cycles, ovarian cysts, or medical issues such as diabetes.
If you are experiencing sharp vulva pain and conservative treatments like over-the-counter medications don’t help, we recommend making an appointment with your GP to discuss the issue. If possible, keep a pain diary where you record when your pain occurs, its intensity, and any other symptoms that are occurring such as itchiness or abnormal discharge.
A diagnosis of a genital infection can be made using a pelvic exam, blood tests, or an ultrasound scan. Imaging is usually the most reliable way to identify the cause of the pain, as it can show things such as endometriosis and adenomyosis, which are both conditions in which tissue from the uterus grows outside the uterus. These can be detected using a transvaginal ultrasound or a magnetic resonance imaging test such as a CT scan or MRI. These tests can be done in a hospital or a gynaecologist clinic, such as Jean Hailes.
Endometriosis
Endometriosis is a painful condition that happens when tissue similar to the lining of your uterus grows outside your pelvic area. Most often, the endometrial cells grow on your ovaries or fallopian tubes, but it can also occur on your bowels and pelvic organs. The pain from endometriosis can be severe and lasts for a long time, especially during menstrual periods. The pain can also be worse during sex, when using the toilet or when having a baby. It can also cause infertility.
Over time, the endometrial tissue bleeds and causes cysts and scarring inside your body. Because the cells can’t leave your body through your uterus, it can irritate surrounding tissue and lead to symptoms like chronic pelvic pain, heavy periods, infertility and urinary or bowel problems.
The pain caused by endometriosis can feel sharp and stabbing, similar to menstrual cramping. But it may also feel like a burning, gnawing or throbbing feeling. It might happen during your period or up to 2 days before it comes. It can happen when you’re having sex or during other times as well. It can also happen when you poop, especially if the tissue is in your intestines.
Symptoms of endometriosis are often misdiagnosed because the symptoms can be similar to those of other conditions, such as pelvic inflammatory disease or Irritable Bowel Syndrome (IBS). It can take 4 to 11 years for a person with endometriosis to get a diagnosis.
Adenomyosis
Adenomyosis (ad-en-o-my-OH-sis) happens when tissue that lines the uterus (endometrial tissue) grows into the muscular walls of the uterus. The displaced endometrial tissue continues to act as it normally would, thickening and bleeding during each menstrual cycle, which leads to an enlarged uterus and heavy periods.
A gynecologist can diagnose the condition by doing a pelvic exam and asking about your past periods. They will also check for an enlarged or tender uterus. They will take a sample of the tissue to test for the presence of endometrial cells.
In some cases, a gynecologist may prescribe hormone therapy to control the condition. This can include birth control pills, progestin intrauterine devices or vaginal rings, or a drug that induces menopause. If this doesn’t help, a doctor can recommend a hysterectomy to remove the uterus.
Adenomyosis doesn’t cause any life-threatening problems, but it can lead to problems such as infertility and heavy bleeding during periods. It can also cause anemia, which can make you feel cold and fatigued. If your symptoms don’t improve with medication, your gynecologist can use a procedure called uterine artery embolization to cut off the blood supply to the uterus, which reduces bleeding and pain.
Pelvic Inflammatory Disease
Sharp pain in the pelvic area can be due to pregnancy, menstruation or a serious medical condition such as PID. Pelvic inflammatory disease is an infection of the organs in and around a woman’s reproductive system, including her uterus, fallopian tubes and ovaries. This infection can be caused by a sexually transmitted disease (STI) like chlamydia or gonorrhea but it may also develop from bacterial infections that are not sexually transmitted. If untreated, PID can cause permanent damage to the uterus and fallopian tubes and prevent women from getting pregnant.
Symptoms of PID include heavy vaginal discharge with an unpleasant odor and bleeding between periods. Women who experience these symptoms should seek medical attention immediately because without treatment, the condition can lead to ectopic pregnancy (a pregnancy that occurs outside of the womb) or ruptured abscesses.
To diagnose PID, a health care provider will perform a pelvic exam. You will need to wear a hospital gown for this exam, which involves the health care provider pressing on your abdomen and inside of your vagina and vulva. They will also take a sample of your vaginal secretions to test for chlamydia and gonorrhea. They may also need to perform a pelvic ultrasound or CT scan to see what is causing the pain. If a pelvic abscess is diagnosed, a doctor will need to drain it using a needle.
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