Why Does My Vagina Hurt on My Period?

Pain in the vulva during menstruation is not normal and could be a sign of underlying conditions such as endometriosis, adenomyosis or pelvic inflammatory disease. If over-the-counter pain medicines don’t help, you should see a doctor or nurse.

Learn about your vulva anatomy in order to understand why your vagina hurts on your period.

Causes

The uterus is basically one big muscle, and when it contracts to shed the lining that starts your period, it causes cramps. These cramps are normal and can be accompanied by pain in the lower abdomen or back passage, as well as bloody, heavy vaginal discharge.

However, there are times when period pain can indicate a more serious issue. If the pain interferes with your daily life or can’t be eased by over-the-counter medication, it is best to book an appointment with your GP. The gynaecologist will take a detailed medical history and do a pelvic examination to identify the cause of your symptoms.

For example, if you have been experiencing pain in your pelvic area outside of your period, it could be a sign of endometriosis, a condition where tissue similar to the uterine lining grows on other organs in the body. This can lead to inflammation, bloating and pain. It can also affect your bowel movements, making them erratic.

Other causes of pelvic pain can include a yeast infection, which leads to itching and painful sores that worsen with contact with water. It can also be a sign of sexually transmitted infections, including herpes and chlamydia.

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Symptoms

While some of the pain that you experience during your period is normal (like cramping from your uterus cramping as it prepares to push out menstrual blood), other pain can signal a problem. If the pain is persistent and not just during your period, or if you’re experiencing other symptoms like vaginal discharge or itching, visit your doctor.

For example, if your pain is accompanied by sores on the vulva or an unusually thick and/or smelly vaginal discharge, it may be a sign of bacterial vaginosis. Other symptom of this condition include itching of the vulva and a burning sensation.

If you’re having trouble inserting tampons, or you’re suffering from pelvic floor spasm, this can also be a problem and can be a sign of a congenital condition called a vaginal septum. This condition is a separation of tissue in the vaginal wall that doesn’t fully form at birth.

You can also try using lubricants or ointments to soothe the area, as well as opting for loose, cotton underwear that’s comfortable on your vulva. Taking ibuprofen to help reduce prostaglandin levels can be helpful, as can a TENS machine, which applies a mild electrical current to the vulva to reduce pain. Talk to a gynaecologist for more advice and a personalised treatment plan. They’ll be able to provide you with prevention tips too.

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Treatment

If you’re experiencing pain during your period and conservative measures like over-the-counter pain relievers don’t help, consult a doctor. They’ll figure out what the underlying cause is and provide you with a treatment plan to get you feeling better again.

For instance, if your pain is caused by inflammation of the vagina, known as vaginitis, your doctor will probably prescribe antibiotics to clear it up. In some cases, your doctor may also recommend that you use a vaginal lubricant or ointment to keep the area moisturised.

Another common cause of painful periods is pelvic floor disorders. These are conditions that cause pain, cramping and other symptoms in the muscles that support your bladder, rectum and uterus. These can often be treated with a combination of exercises, medication and physiotherapy.

For example, a physiotherapist can teach you pelvic floor muscle exercises that can help relax the muscles and desensitise the area. Your doctor can also prescribe medicine to control the contractions of your uterus and to reduce the pain that comes with them. They may also recommend a 5% lidocaine gel, cream or ointment that you can apply to the affected area to help reduce pain. They may also recommend pelvic massage therapy. This involves rubbing the affected area with your hands or having a friend or significant other massage it.

Prevention

A bit of pain is OK and normal, but it’s important to talk to your doctor if the pain is significant or interferes with your daily life. There could be an underlying cause for the pain, like endometriosis, pelvic inflammatory disease, or uterine fibroids.

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Most women feel a bit of cramping before and during their periods. These are called primary dysmenorrhea, and are triggered by contractions of the uterus as it sheds its lining. These contractions release chemicals called prostaglandins, which trigger the pain you’re feeling. You can help reduce your period pain by taking NSAIDs such as Ibuprofen. NSAIDs decrease the production of prostaglandins and can also block inflammation.

If you don’t get relief from NSAIDs, talk to your provider. They may want to do an exam of your vagina and cervix, inserting a gloved finger into your vagina or a tool called a speculum. Your provider might also order an ultrasound, which uses sound waves to create a picture of your uterus and cervix.

Another common cause of vulvar pain during your period is a condition called folliculitis, which is the inflammation or infection of a hair follicle. Symptoms of folliculitis include itching or burning, especially when you pee or have sex.

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