Function of the vaginal entrance

During the period, the menstrual blood flows out through the vaginal entrance, as it is the external opening to the woman’s internal sexual organs. If a fertilized egg does not settle in the uterine wall, the wall of the uterus is rejected by the body during menstruation. It then flows out via the cervix, the vagina and thus also via the vaginal entrance.

If the entrance to the vagina is blocked by a hymen (hymenal atresia), discomfort can occur during the first menstrual period because the blood cannot drain. During sexual intercourse the member is inserted into the vagina through the vaginal opening. The hymen, which frames or partially covers the entrance, can tear during the first intercourse and cause pain.

The entrance to the vagina is thus slightly stretched and enlarged. However, the hymen may tear before this happens when tampons are inserted or during movements during sports. The Bartholin glands, which are located on both sides of the entrance, produce more fluid during intercourse to moisten the vagina and the vaginal entrance and reduce friction. When a baby is born, the baby is pressed out of the womb by the uterus through the vagina and the vaginal entrance. During this process, the vaginal entrance is stretched considerably and can tear.A so-called perineal tear during birth usually occurs at the weakest point of the tissue, i.e. in the middle from the vaginal entrance to the anus.

Diseases of the vaginal entrance

The Bartholin glands are located on both sides of the vaginal entrance at the labia. They produce a mucilaginous fluid to moisten the vagina and vaginal entrance. If these glandular ducts become inflamed, this leads to so-called Bartholinitis.

Inflammation can occur when the mucilaginous secretion of the glands closes the opening. The secretion accumulates behind it and a bartholinitis cyst forms. In this cyst, bacteria can multiply well and an inflammatory process develops.

Bacteria can also migrate into the glandular ducts from the outside, as the glandular openings are anatomically close to the germ-colonized vagina and anus. Triggering bacteria can be intestinal bacteria, such as Escherichia coli, or staphylococci. In most cases, one of the two glandular ducts is affected by an inflammation, only in rare cases are the glands themselves inflamed.

There is usually a painful swelling and redness in the posterior third of the labia. If the inflammation is not treated, it may spread to surrounding tissue and abscesses or chronic cysts may develop. It is therefore recommended to consult a doctor for clarification in case of painful swellings in this area.

An inflammation of the vaginal entrance can have various causes. Depending on the pathogen, the symptoms can vary. Itching or a burning sensation may occur and the vaginal discharge may change in color and consistency.

Due to the anatomical proximity of the anus, intestinal bacteria can cause an inflammation of the vaginal entrance. However, the vagina of a woman has protective measures that protect her from inflammation. On the one hand, bacteria (Döderlein bacteria) belong to the natural vaginal flora and protect against other bacteria.
On the other hand, an acidic environment prevails in the vagina, which prevents the reproduction of harmful bacteria.
Not only bacteria can be the trigger of inflammation of the vaginal entrance and the vagina. Vaginal fungi, mainly Candida albicans, can also be responsible for inflammatory processes in this area.
Furthermore, infections by parasites and viruses are possible. The most common viruses that cause vaginal infections are herpes genitalis and human papilloma viruses.
A cause of inflammation of the vaginal entrance can also be an oestrogen deficiency or other hormonal changes, for example during pregnancy or puberty.
Oestrogen deficiency can reduce the vagina’s own protective mechanisms.

A burning sensation in the vaginal entrance, which often occurs together with itching, can be very unpleasant for those affected. There can be many reasons for this.

Despite the protective mechanisms of the vagina (vaginal flora and acidic environment) bacteria can penetrate and multiply there.
Bacteria can be transmitted during sexual intercourse or migrate into the vagina from outside, for example from the anus. In the case of a bacterial infection, the vaginal discharge can take on a fishy odor and become whitish and grayish.
Another common cause of burning in the vaginal entrance can be fungal infections. 80 percent of vaginal fungal infections are caused by Candida albicans.
After a smear test by the doctor, fungi can be easily identified under the microscope and the appropriate therapy can be initiated.
Other pathogens can be viruses. In most cases these are genital herpes viruses or human papilloma viruses.
Infections caused by so-called flagellates (Trichomonas genitales) can also be a reason for a burning sensation in the vaginal entrance.
In addition to infections caused by the above-mentioned intruders, a burning sensation in the vaginal entrance can also come from incorrect intimate hygiene. This can be caused by excessive washing or strongly perfumed care products that bring the natural vaginal flora and the acidic environment out of balance.
Burning after sexual intercourse can be caused by latex allergy.
In this case, however, condoms containing latex should not be avoided, as many condoms without latex are now available.

Itching in the vaginal entrance can have many different causes. In most cases a short itch in the vaginal entrance is completely harmless.However, if the itching lasts longer and swelling or redness in the genital area is possibly observed, it is recommended to consult a doctor for clarification. Even if there is pain while urinating, the cause should be clarified by a doctor.

There are various approaches for the treatment of itching in the vaginal entrance. Both ointments and sitz baths can help to improve the symptoms.

Itching can be a symptom of allergic reactions, for example to latex, which is found in condoms.
Other causes can be hormonal changes or infections caused by sexually or non-sexually transmitted pathogens.
The most common cause of prolonged itching in women is a fungal infection.
Mostly the fungus “Candida albicans” is responsible for it. In the case of hormonal changes or if the immune system is weakened, e.g. by prolonged stress situations, the fungus can proliferate strongly and be the cause of itching in the vaginal entrance. In most cases an increased whitish discharge from the vagina can be observed in addition to the itching.
Sexually transmitted pathogens, such as gonococcus or chlamydia (chlamydial infection), usually also cause itching.
Genital herpes viruses can also be triggers for such complaints.
Itching can be favored by both inadequate and excessive intimate hygiene.
The most common cause of swelling in the vaginal entrance is Bartholinitis, an inflammation of the Bartholin glands. The gland openings are located on the side of the vaginal entrance at the inner labia. They form a mucous fluid to moisten the vagina and vaginal entrance.
If the openings are blocked by the secretion, a cyst may form behind them. Fluid accumulates in this cyst and bacteria can multiply well in it. A painful swelling and redness can be observed from the outside.

The swelling is usually located in the back third of the labia minora.
Other inflammations caused by bacteria, fungi, viruses or parasites can also cause swelling in the vaginal entrance.
Far less frequent are benign or malignant changes in the area of the vaginal entrance.

Pain in the vaginal entrance can have different causes. In case of pain it is recommended to consult a doctor to clarify the cause and to receive the right treatment.

Pain may occur due to inflammation. Such infections can be caused by bacteria, fungi, viruses or parasites.
If pain occurs after sexual intercourse, the reason may be a sensitive vaginal mucosa.
Small injuries at the vaginal entrance can also cause pain. In addition, there may be pain when urinating.