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Menstrual pain is a symptom that many women experience, but it can be a cause for concern if the pain is in the vulva (the outer part of the vagina). Not much is talked about about this type of pain, but it can be very uncomfortable. It’s important to understand what is causing this pain and whether it’s normal or indicates an underlying problem. 

Vulvar pain during menstruation is not at all uncommon, but not everyone experiences it. Some women may experience mild discomfort or sensitivity in the vulva due to hormonal changes, irritation from menstrual products, or swelling associated with menstruation. However, if the pain is severe, persistent, or accompanied by other symptoms, it may indicate an underlying health issue that requires attention. In general, mild vaginal discomfort during menstruation is normal, but it’s important to understand when to be concerned in order to diagnose and treat any underlying medical conditions early.

To understand more about vulvar pain during menstruation, OnlyMyHealth  spoke to Dr Sadhna Singhal Vishnoi, Senior Consultant, Obstetrics and Gynaecology, Cloudnine Group of Hospitals, New Delhi.

Why does vaginal pain occur during menstruation?

The vulva is the outer part of the female genitalia, which includes the labia majora, clitoris, and vaginal opening. “Hormonal changes during the menstrual cycle can affect blood flow, leading to increased sensitivity and swelling in the area. Some women may also feel irritation from menstrual products like pads and tampons, which can cause discomfort,” explains Dr Singhal. 

“During menstruation, estrogen and progesterone levels fluctuate, which can cause a variety of symptoms,” she adds. Some women may experience pain or discomfort in the vulva, especially if the tissue around the vulva becomes sensitive or inflamed. “Tampons and other menstrual products can cause friction, especially if used for long periods of time or if the material is not breathable, which can lead to irritation and skin damage in sensitive areas.”

Read more: What causes acne on the labia majora? How to get rid of it?

What causes vulvar pain?

Pain in the vulva during menstruation can be caused by a number of underlying conditions, including:

Vulvodynia: Chronic vulvar pain of unknown cause. 

Vaginal infections: This includes yeast infections and bacterial vaginosis. 

Sexually transmitted infections (STIs): Such as herpes and chlamydia can cause pain and discomfort. 

Endometriosis: A condition in which uterus-like tissue grows outside the uterus, causing pain during menstruation and sometimes throughout the entire menstrual cycle. 

Pelvic inflammatory disease (PID): A serious infection of the reproductive tract. 

When is vulvar pain normal?

Mild vaginal discomfort, such as mild irritation or pain, can be considered a normal symptom that occurs during menstruation. It’s usually caused by the hormonal changes mentioned above and irritation from menstrual products. Dr. Singhal says this type of pain usually goes away as the cycle progresses, or when some women switch to other products that are less irritating, such as menstrual cups or organic cotton pads.

Other factors such as tight clothing, poor hygiene and prolonged use of sanitary napkins or tampons can also cause mild vaginal discomfort. Practicing good hygiene and wearing loose, breathable clothing can reduce the risk of irritation.

Read more: Period acne: 5 ways to ease the pain

When to worry about vulvar pain

While mild discomfort may not be a cause for concern, more severe or persistent vulvar pain is uncommon and may indicate a more serious problem. It’s important to see a medical professional if you experience any of the following symptoms:

Severe pain

If the pain in your vulva is severe or sharp, it could be a sign of an underlying condition, such as vulvodynia (chronic vulvodynia) or pelvic inflammatory disease (PID), a serious infection of the reproductive tract, says Dr. Singhal. Endometriosis, a condition in which uterine tissue grows outside the uterus, can also cause pain in the area.

Pain that continues after menstruation

Persistent pain in the vulva before or after menstruation could be due to vulvovaginitis, a vaginal infection, or a skin condition such as lichen sclerosus, a rare condition that causes patchy white, thin skin around the genitals. Endometriosis and other pelvic floor disorders can also cause persistent pain.

Pain accompanied by other symptoms

If vulvar pain is accompanied by other symptoms, like itching, burning, abnormal discharge, or pain, it could be a sign of an infection. “Sexually transmitted infections (STIs) like yeast infections, bacterial vaginosis, or even herpes can cause vulvar pain and discomfort along with these other symptoms,” says Dr. Singhal. These conditions should be treated promptly to prevent complications.

Pain during sexual intercourse

“If vulvar pain worsens during or after intercourse, it could be a sign of conditions like vaginismus (involuntary contractions of the vaginal muscles), endometriosis, or infection,” explains Dr. Singhal. If pain during intercourse is persistent or debilitating, it’s essential to seek medical attention.

Unexplained swelling or redness 

Unusual swelling, redness, or soreness in the vulva could indicate a dermatitis, contact allergy, or infection that requires medical intervention. “Allergic reactions to ingredients in feminine hygiene products, scented soaps, detergents, etc. can also lead to vulvar discomfort,” points out Dr. Singhal. 

When to see a doctor

If vulvar pain is affecting your daily life, it’s important to consult a medical professional. Signs that you should see a doctor include:

• Severe or persistent pain that is not relieved by over-the-counter pain medications.
• Any abnormal discharge, itching, or pain may be a sign of infection.
• If the pain continues beyond your menstrual period or after you have tried home remedies or changed your feminine hygiene products.