Definition
Pain at the vaginal entrance is not unknown to many women. Worries about serious illnesses and limitations in everyday life and especially in the partnership are often very stressful. Pain is the symptom of many causes, most of which are easily treatable. The genital area is very sensitive because many nerve endings are located here. Thus, every smallest change can lead to pain.
Causes
Causes for pain at the vaginal entrance are many and varied. Short-term pain can occur after intensive or frequent intercourse due to irritation. Intensive cleaning with aggressive care products can also irritate the vagina.
Longer lasting pain can be caused by inflammation in the genital area. Frequent is Bartholinitis, an inflammation of the excretory duct of the Bartholin gland. Other infections with fungi, viruses, bacteria or parasites can also cause pain.
These diseases often belong to the sexually transmitted diseases. In rare cases, benign and malignant changes can also be the cause of pain. Vulva and vaginal carcinoma and its precursors, vulvar/vaginal intraepithelial neoplasia (VIN/VAIN), can cause chronic pain, especially in advanced stages.
Natural processes can also cause pain. During menopause, but also outside it, many women experience vaginal dryness, which can be painful in some cases. A rare diagnosis is the so-called vulvodynia, chronic pain in the genital area for which there are no obvious physical causes.
Bartholinitis, an infection of the excretory duct of the Bartholin gland, can be caused by various germs. The most common are bacteria such as staphylococci. This leads to a purulent inflammation in which the surrounding tissue swells.
The swelling is usually unilateral in the posterior third of the labia and can become chicken egg sized. It usually causes severe pain. The surrounding tissue can also melt down and an abscess, a cavity filled with pus, can develop.
During pregnancy, varicose veins (varices) can occur more frequently on the vagina. Due to the pressure of the growing uterus and more flexible veins, these can become stronger or more easily re-formed. These varicose veins are recognizable as bluish vessels and can itch or hurt.
Pain during intercourse (dyspareunia) can have both psychological and physical causes. Stress in particular often leads to tense pelvic muscles and an excessively dry vagina. But also inflammations, irritations or allergies in the genital area can lead to pain during sexual intercourse.
Especially during breastfeeding and menopause, the vagina is often dry and can therefore hurt, especially during intercourse. A tight hymen can cause pain during the first sexual act. Both physical and psychological causes can trigger vaginal dryness.
Women of all ages can be affected. In addition to pain, especially during sexual intercourse, vaginal dryness often causes itching, burning of the skin and a burning sensation when urinating. Vaginal dryness also makes it easier for pathogens to colonize the vagina and can thus lead to unpleasant infections.
A frequent cause is an estrogen deficiency, which occurs particularly during the menopause. However, the body’s oestrogen production can also decrease after pregnancy and while breastfeeding, due to certain medications, radiation or chemotherapy and due to stress. Oestrogen plays an important role in the production of vaginal fluid, which keeps the vagina moist and protects against pathogens.
In addition, certain diseases such as diabetes, high blood pressure and autoimmune diseases can cause a dry vagina. Certain contraceptives, the consumption of alcohol, smoking and excessive hygiene of the genital area with aggressive soaps and creams can also cause or aggravate vaginal dryness by changing the pH value of the vagina. Fungal infections of the vagina (genital sores) are a common disease in women.
The most common pathogen is Candida albicans, which is why it is also called candidiasis. Symptoms of genital sores include itching and burning of the vagina, whitish patches, reddened vaginal skin and a crumbly discharge. Candida fungi colonize the skin or mucous membrane of many people in small numbers without causing symptoms.
Infection only occurs when the immune system is disturbed.This can be caused by diseases such as AIDS, cancer, diabetes or alcoholism. Hormonal changes during pregnancy can also disrupt the immune system. Other common causes are drugs. Antibiotics can disturb the balance between fungi and bacteria and lead to an overgrowth of fungi. Immunosuppressants, cortisone or chemotherapy, on the other hand, directly weaken the immune system and increase susceptibility.
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