Pain in the vagina or technically vulvodynia is a common problem among women of all ages and races. In most cases, there is no clear cause of the pain, so it is not even considered as a painful syndrome at times. The exact reason for the pain is very tough to decipher and many women are left without a diagnosis.

Vaginal pain can severely affect your life by limiting your capacity to perform daily activities. It can impair your ability to exercise or socialize, as well as decrease your desire to have sex. A National Institutes of Health (NIH) study showed that most women with sharp vaginal pain feel "out of control" and unable to have sexual intercourse, and are unable to fully enjoy life. If you feel this way due to vaginal pain, seek medical consult.

Types of sharp pain in vagina

Vaginal pain usually causes sharp pain in the vulva as well as other genital areas such as the labia, clitoris, and vaginal opening. There are two different types of vaginal pain:

1. Generalized pain can be felt in different parts of the vulva at different times. This pain can be present constantly or can come and go sporadically. The pain may or may not be triggered by touching, though this may increase the intensity of the pain.
2. Vulvar vestibulitis syndrome or pain in the vaginal opening is a different type of vaginal pain that is usually felt as a "burning" or "cutting" sensation in the vaginal opening. This uncomfortable sensation is most often caused by physical action like touching or intercourse. The syndrome affects approximately 10-15% of women who seek gynaecological care.

Causes of sharp pain in the vagina

There is no known direct cause of sharp vaginal pain in most patients. However, in 50-85% of cases, it is caused by an underlying medical condition that may or may not have any direct connection with the female genitalia. More often, the pain is associated with psychological issues such as depression or issues regarding a person's sexual identity. Possible causes of vaginal pain include the following:

• Nerve injury, which can be caused by trauma or infections in the vulva, can lead to sharp stabbing pain sensations. If the damage is bad enough, then there will be a chronic pain that remains, even after the original source of the pain is gone.
• Aggressive intercourse or sexual abuse. In case of sexual abuse, the psychological aftermath is a more prominent cause of sharp vaginal pain.
• Infection or trauma can cause the vulvar cells to respond abnormally, leading to a sharp painful sensation.
• Genetic factors in which the vulva responds poorly to chronic inflammation.
• Muscle spasms can also cause a sharp pain in and around the genitalia.
• Hormonal changes that can be caused by Menopause or another medical condition.
• Cancer or other growths (cysts or polyps) near the vagina.
• Yeast infection in the vagina can also cause sharp pain in this region, which can be felt sporadically. Frequent antibiotic use can sometimes lead to yeast infection.
• In some few cases, genital surgery or labiectomy may cause the problem.

Symptoms of sharp pain in vagina

The main symptom is pain in the genital area, but it can also be accompanied by one or more of the following:

• Burning sensation
• Stinging
• Painful intercourse
• Itchiness
• Irritation of the skin surface
• Sharp cutting pain in vulva, which includes labia and vaginal opening

These symptoms can be constant or occur intermittently; it can get worse with physical contact such as intercourse or tampon insertion. The symptoms can last from months to years. The location of the symptoms can vary greatly. Pain might be present in a specific area or can be felt across the entire vulva. Daily activities like sitting, biking, or horseback riding can also trigger or exacerbate the symptoms.

Preparation and treatments

There is no standard treatment available for sharp vaginal pain. Each woman is usually given a different treatment according to her individual symptoms. Some get partial or complete relief; others do not get any relief.

The type and length of treatment varies greatly and depends on factors including intensity of symptoms and the patient's medical history. A single patient might undergo multiple treatments over the course of many months to find the most efficient one. Type of treatment also depends on its affordability. Usually you will end up seeing a gynaecologist, a doctor who specializes in the female reproductive tract. While visiting your doctor, feel free and comfortable to discuss everything that you think might be relevant. This greatly helps the doctor to narrow down the possible causes for the problem. Here are some of the things-to-do before you visit your doctor:

• Write down the symptoms that you experience, including when they occur.
• Ask the clinic about any pre-appointment precautions that you need to take, because some lab tests require strict guidelines to be followed.
• Write down your medications and supplements (if you take any), such as vitamin supplements that you have taken in the past or are currently taking.

As mentioned previously, the treatment options vary greatly depending on each individual's needs. Following are some of the common treatment options:

• Medications: Tricyclic antidepressants and anticonvulsants have been shown to reduce chronic pain. Antihistamines are prescribed if the patient also complains of itching
• Biofeedback, relaxation and physical therapy: Sharp pains in the vulva are often associated with tensed muscles, which can be reduced if the muscles are able to relax. Biofeedback therapy basically teaches you to control your specific body responses, in this case the pelvic muscles. The therapy involves inserting a vaginal sensor, which measures the strength of the muscles and can give you an idea of contraction and relaxation. The therapy allows the patient to feel a decreased pain sensation.
• Local anesthetics: Medication ointments like lidocaine are prescribed to provide temporary relief. To have a pleasurable intercourse experience, it is usually recommended that you apply the ointment 30 minutes before engaging in sexual activity. One of the effective methods is to gently insert ointment soaked cotton rounds in the opening of vagina. Beware that your partner might feel temporary numbness after intercourse.
• Injection: This course of treatment is used in cases when the woman does not respond to the other forms of treatment. This injection basically numbs the pudendal nerve, a sensory nerve in the pelvic region that essentially controls all other nerve roots in the external genitalia. Since nerves are directly associated with the sensation of pain, you are left with a decreased senstion or no painful sensation at all. In cases where the symptoms are severe, the nerve is ablated.
• Surgery: In some cases, when a specific region of pain can be identified, the affected tissue can be surgically removed to relieve pain.
• Pelvic floor therapy: This therapy allows women with pelvic floor muscle problems to strengthen them. This method is shown to help relieve pain to an extent.

Home Remedies and Self-care

The following home tips can help you to manage your vaginal pain symptoms:

• Use unscented and soft toilet paper.
• Wear pure cotton panties, pads, and tampons to avoid any skin irritation. Avoid wearing panty hoses.
• Avoid activities like biking or horseback riding that put pressure on the vulva.
• Avoid hot baths and instead try taking lukewarm/cool water baths for around 10 minutes 2-3 times a day.
• Avoid getting shampoo or any other synthetic substance in the vulvar area.
• Rinse the vulva with comfortably cool water after urination and intercourse.
• Avoid food items like beans, berries, nuts, and chocolates that lead to uncomfortable urination.
• Use lubrication before engaging in sexual intercourse.
• Apply preservative-free plain petroleum jelly on the vulva after a bath to create a protective barrier.