Pain and cramping in the vulva can have multiple causes. Infections like bacterial vaginosis, trichomonas and a yeast infection (or STI) can cause pain down there. Topical irritation from shaving, certain soaps or lotions or a change in feminine hygiene products can also cause it.
The pelvic muscles are among the most powerful in the body — and they’re also the most sensitive. Any pain or spasm in that area warrants a call to your doctor.
Infections
While mild vaginal cramps are a normal symptom of menstruation as the uterus contracts to shed the uterine lining, pain that occurs outside of this time often has an underlying cause. Infections, whether sexually transmitted or not, can lead to itching and painful sensations in the vaginal area. In addition, viruses can also cause lesions, odor and discharge in the vagina. Yeast infections, urinary tract infections and herpes are common causes of painful itching and discharge.
The inside of a healthy vagina contains many communities of bacterial and fungal microbes that carry out important functions, including keeping the area acidic enough to ward off infection. When these communities are disrupted by hormone changes, irritation or irritants such as scented tampons or douches, the area can become a breeding ground for “bad” bacteria or fungus.
Some types of infections are easy to treat with over-the-counter medication, but others require a prescription to get rid of the bacteria or fungus. Examples of common infections include bacterial vaginosis (swelling and itching of the vagina due to yeast infection), herpes simplex virus or herpes genital warts, and trichomoniasis, which is caused by a bacterial infection called trichomonas.
Infections in the urinary tract are another common cause of vaginal pain, particularly when urinating or having sex. A bladder infection may be due to a viral infection, bacteria or a fungus, and can range in severity from minor to severe. A urologist or primary care physician can prescribe antibiotics to treat the infection.
Uterine Contractions
Women who experience cramping that feels like menstrual contractions should call their doctor, especially if it is accompanied by a severe pelvic pain or blood. A doctor will ask questions and do a pelvic exam to check the vagina, cervix, uterus and fallopian tubes. He or she may also order a pelvic ultrasound to get a clearer picture of what’s happening.
Cramps in the vulva and/or genitals are often caused by inflammation, such as from a urinary tract infection or sexually transmitted infections (STIs) like chlamydia or gonorrhea. These infections put pressure on the uterus, which can cause pain and tenderness.
If the pain is more generalized in the pelvic area, a doctor may suspect fibroids or endometriosis. Fibroids are small, noncancerous growths in the uterus that can contract and bleed during menstruation. They’re more common with age and can be mistaken for period cramps. Endometriosis is a condition where cells resembling uterine tissue grow outside the uterus. This tissue can bleed and form scar tissue, but cannot exit the body like it should during a menstrual period. This pain is called referred pain and can be felt throughout the pelvic region, including in the vagina and vulva.
Mild vaginal pain can be a normal symptom of menstruation, but it’s always worth calling a doctor if the cramping is severe or accompanied by other worrisome symptoms like fever and foul-smelling discharge. It’s particularly important to contact a doctor if the pain is accompanied by a loss of bowel control or ectopic pregnancy, which is when the fertilized egg attaches outside the uterus.
Pregnancy
While muscle spasms in other parts of the body are nothing to be alarmed over, cramps in and around the pelvic area can feel especially distressing. It’s also hard to tell if your discomfort is run of the mill round ligament pain or something more serious, such as an ectopic pregnancy (when a fertilized egg attaches anywhere but inside the uterus).
In general, as the baby grows, it will put direct pressure on your organs and tissue, which can lead to vaginal cramping, according to OB-GYNs. This pain can occur when your cervix is dilating to make room for the baby. It can also be caused by a pelvic disease, such as endometriosis or adenomyosis.
The pain can also be caused by a sexually transmitted infection, such as chlamydia or genital herpes, which are more common in women who are pregnant. In addition to the achy, crampy feeling, these infections can cause vaginal discharge and itching.
The out-of-nowhere pelvic pain you might be experiencing during pregnancy could also be due to varicose veins that pop up on the vulva. This is because the enlarging uterus adds pressure to that area, which can cause blood vessels to dilate. It’s important to talk to your OB-GYN about this, as it’s not healthy for the baby or mom. They may recommend using a lubricant, changing your diet and/or exercising to help ease the pain.
Endometriosis
This condition causes pain when tissue that resembles the lining of your uterus grows outside your pelvic cavity. Often this tissue is found in the ovaries or fallopian tubes. It may also be found in other places, like the outside surface of your abdomen or diaphragm. It can cause pain during menstrual periods, during sex or when using the bathroom, and it can make getting pregnant difficult.
Symptoms of endometriosis include severe pain in the pelvic region, especially during menstrual periods and when sex occurs. Some people who have this condition also experience fatigue, bloating, diarrhea and constipation. Because these symptoms can be similar to those of other conditions, your doctor will need to do a thorough evaluation before making a diagnosis.
If you have vaginal cramps, it is important to see a doctor about them. They will do a physical examination and ask you about your health history. They will then check the severity of your pain and do a pelvic ultrasound to find out what’s causing it.
The team at Maiden Lane Medical is here to help you live a pain-free life with endometriosis. Call us or book an appointment online today to discuss your options for treatment. We have years of training and experience helping women get relief from this painful condition. The sooner you start treatment, the more successful it will be.
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