Everyone’s vulva is different, but pain in this area can be caused by infection or many other things. In addition, the cervix (the neck-like part that your gyno uses to take a sample for a Pap smear) can hurt when it’s dilated.
Here are some reasons the top of your vagina might hurt: 1. The pain may be from sex.
Endometriosis
A gynecologist can help you figure out what’s causing your pain. They can give you treatment that will ease your symptoms.
Endometriosis is a condition that happens when the tissue that normally lines your uterus grows outside of your body, on other organs in the pelvic area and abdomen. The most common place that this tissue grows is on the ovaries and fallopian tubes, but it can also grow on your bowels and pelvic ligaments. It’s not clear what causes endometriosis, but experts think it may be due to a combination of factors.
The most common symptoms of endometriosis include pelvic pain, fatigue and painful periods. But it can be hard to diagnose because these symptoms are similar to those of other conditions, like pelvic inflammatory disease and ovarian cysts. They can also be confused with irritable bowel syndrome (IBS). This can prolong the time it takes to get a diagnosis.
When you visit your gynecologist, they will likely ask you about your symptoms and do a pelvic exam. They will use a tool called a speculum to see inside your vagina and cervix. They can also feel for cysts or scars on your abdomen or behind your uterus. They may order imaging tests, like an ultrasound or a CT scan. They can also do a procedure called laparoscopy, which involves making a small cut in your belly and inserting a tube with a camera on the end (called a laparoscope). The doctor can then look for signs of endometriosis and take a biopsy to confirm the diagnosis.
Uterine fibroids
A fibroid is a noncancerous tumor made of muscle-like tissue that grows in or around the uterus. They can range in size from the size of an apple seed to a grapefruit. Fibroids often cause heavy bleeding during and between periods, pelvic pain and, in rare cases, exert pressure on other organs. They are most common in women of reproductive age and tend to grow during pregnancy, when estrogen levels are higher, and shrink when a woman goes through menopause when hormone levels drop.
Fibroids are usually discovered during a pelvic exam, when a health care provider feels a firm and irregular lump. They are also sometimes found when a person has an abnormal vaginal ultrasound test. Other symptoms of uterine fibroids include anemia (low iron due to excess bleeding) and abnormal vaginal discharge.
There are several treatments for uterine fibroids. Medicines to control bleeding and pain are generally recommended first. Medicines that regulate the hormones to shrink the fibroids are also an option. Surgical removal of the fibroids is another option and is called myomectomy. Occasionally, a hysterectomy is needed if the fibroids are large or when a woman has severe symptoms, is near or in menopause or does not want children.
To diagnose uterine fibroids, your health care provider will do a pelvic exam and blood tests. They may also use an ultrasound to get a “picture” of your uterus and the location of the fibroids. They might also perform a procedure called a hysteroscopy. During this test, your doctor inserts a small lighted tube into your cervix to look at your uterus and Fallopian tubes.
Adenomyosis
Adenomyosis is a condition in which the tissue that lines the uterus (endometrium) grows into the muscular wall of the uterus, and this enlarges the uterus. It can also cause heavy menstrual bleeding.
Symptoms of adenomyosis can be similar to those of uterine fibroids, so it is important to have your gynecologist examine you and identify the condition. A pelvic exam can reveal adenomyosis by looking for an enlarged uterus that is tender to touch. The doctor may also recommend an ultrasound scan or magnetic resonance imaging (MRI) scan.
With this test, the doctor will place a small probe into your vagina to see the lining of your uterus. This procedure is painless. They will usually ask you to lie down, but they can ask you to move around if you prefer not to do so. You might have a friend or family member sit in the room with you.
The most common treatment for adenomyosis is birth control pills or a progestin intrauterine device (IUD). In addition, anti-inflammatory drugs like ibuprofen can reduce blood flow and relieve cramps. If these medications are ineffective, the doctor may prescribe gonadotropin-releasing hormone agonists or antagonists, but they should only be used for the short term because they can induce early menopause. Surgery to remove the uterus is another option if other treatments do not help.
Menstruation
Sometimes, the pain you experience after sex is just normal. It could be that you didn’t use enough lubricant, or maybe you weren’t properly aroused, and that caused friction in the area. Or it could be a sign of an infection or irritation. Viral infections like herpes or bacterial ones like yeast infections can cause pain, discharge, and itching in the area. You can find at-home tests that detect some infections, and others may require a medical evaluation.
Another common reason the top of your vagina hurts is due to menstruation. Each month, hormones in your body help prepare your uterus for a possible pregnancy. When the time comes to ovulate, a mature egg leaves one of your ovaries and travels down one of your fallopian tubes to the uterus. If you don’t become pregnant, your uterus no longer needs the thick lining, so it breaks down and flows out in what we know as your period.
Women can also experience pain in the days leading up to their periods, which are called premenstrual symptoms. Symptoms can include bloating, spotting, and cramps, but they vary from person to person. If the pain is severe or lasts more than a few days, you should see a doctor. They can prescribe medications to ease the pain and prevent other complications from arising.
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