Pain Down There? 5 Reasons Your Vagina Hurts

Vaginal pain can be caused by infections, cysts or other conditions
vaginal pain

Menstrual pain is no picnic, but pain and discomfort down there that’s not related to your monthly cycle can be even more upsetting. It might leave you wondering what the heck is causing it and what you should do about it.

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Whether your vagina hurts a little or a lot, you shouldn’t just ignore it. The pain could be coming from your actual vagina (the internal organ) or from the labia and skin that form your vulva (your outside genitalia).

Many women think it’s all the same thing, says Ob-Gyn Jessica Strasburg, MD, Medical Director of Cleveland Clinic’s Chronic Pelvic Pain Program. “To a lot of people, the vagina includes the vagina and the vulva,” she says. “But the cause of these types of pain are very different.”

While your mind may go straight to cancer, that’s rarely a cause, she says. So where does that leave you?


Both yeast and genital herpes infections are vulvar conditions that can cause the kind of vagina pain we’re talking about.

What’s going on? Yeast infections cause swelling, itching and pain, especially during sex or urination. A herpes infection causes raw, painful sores. Contact with urine exacerbates the discomfort.

Other sexually transmitted diseases, including gonorrhea, chlamydia and trichomoniasis, can also cause vaginal pain, itching and burning.

What can you do? In many cases, you can treat a yeast infection with over-the-counter medication. But see your doctor if the problem persists. Sexually transmitted diseases require prescription drugs. If you are diagnosed with an STD, your partner will also need testing and treatment to prevent reinfection.


This condition can make you miserable. Your doctor may diagnose vulvodynia if you have vulvar pain that lasts for at least three months.

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What’s going on? The underlying cause is unknown, but the condition prompts painful intercourse and sensations of rawness, throbbing, burning, stinging and itching.  

“Vulvodynia can cause a lot of disability because you avoid intercourse, and it’s uncomfortable to wear certain types of clothing,” Dr. Strasburg says. “You feel like something is always wrong. It can cause great emotional distress.”

What can you do? Ease symptoms by wearing loose clothing and cotton underwear without seams. Change clothes after exercising; use topical lidocaine to ease pain during intercourse.

Bartholin’s cyst

These common cysts develop when the Bartholin glands responsible for vaginal lubrication become blocked.

What’s going on? These tender lumps at the vaginal opening may become pus-filled and painful with infection. You may notice the pain whether you’re sitting, walking or having sex.

What can you do? Try sitting in a warm bath to ease your discomfort. Talk to your doctor if pain persists. Surgical drainage or antibiotics may be necessary, Dr. Strasburg says.


Endometriosis occurs when your uterine lining grows in other areas of your pelvis.

What’s going on? Not only does this condition cause more painful periods and pain during sex, but it can also cause infertility. Other symptoms include:

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  • Painful bowel movements
  • Painful urination
  • Fatigue
  • Nausea
  • Constipation
  • Diarrhea

Many studies show there is a small but increased risk of ovarian cancer in women with endometriosis. Be aware of the most common symptoms of ovarian cancer, which include:

  • Persistent stomach pain
  • Persistent bloating
  • Urge to urinate more frequently or urgently
  • Difficulty eating, or feeling full more quickly

Notify your physician if you have these symptoms.

What can you do? Over-the-counter pain medications may help ease your symptoms. If problems persist, your doctor may suggest hormone therapy or surgical options, including hysterectomy.

Pelvic floor problems

What’s going on? Pelvic discomfort can cause painful intercourse and lead to urinary and bowel dysfunction.

What can you do? Many things can cause pelvic floor pain, so work with your doctor to pinpoint the culprit. A common cause is pelvic floor dysfunction or levator spasm, where pelvic floor muscles spasm as a reflex to other types of pain.

Pelvic congestion syndrome (similar to varicose veins, but in the pelvis) and irritation of the pudendal nerve (one of the main nerves in the pelvis) can also cause pelvic pain.

Ultimately, identifying whether there’s a pattern to your pain can help your doctor treat you.

“Pay attention to your symptoms and get them evaluated as soon as possible,” Dr. Strasburg says. “The most important thing is visiting the doctor. And, if you’re not seeing improvement, you might need to see a specialist.”

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