Vaginal Burning

Generality

Vaginal burning is a fairly common female intimate disorder, which can be determined by various causes.

In most cases, this symptom is found during an irritation, an inflammatory state or an infection of the vagina (muscle-membranous duct that extends from the vulva to the cervix).

Furthermore, considering the anatomy of the female genitals, the burning could also derive from a pathological process affecting the vulva or urinary tract .

The severity of vaginal burning varies depending on the underlying cause and the individual factors that contribute to its appearance (eg irritative reactions, hormonal alterations and other situations that contribute to change the vaginal ecosystem). In any case, the burning is a particularly annoying symptom, as it involves a very sensitive area.

The burning sensation can be constant or occur only during certain activities, such as, for example, during sexual intercourse or after urination (for example, when urine comes into contact with inflamed or damaged areas of the genital region).

Vaginal burning can occur suddenly or gradually, over weeks or months. Furthermore, depending on the etiology, this disorder can be associated with itching, erythema and tenderness, sometimes with vaginal discharge.

The evaluation of the burning - fundamental to establish the correct therapy directed to the triggering cause - must be performed by the gynecologist and usually includes anamnesis, physical examination and analysis of vaginal secretions.

Early diagnosis and treatment of the pathological condition underlying vaginal burning reduces the risk of possible complications.

Causes and risk factors

Vaginal burning is a symptom that can occur from childhood and can have different causes.

Vaginitis

Inflammation of the vagina (vaginitis) is a disorder that recognizes numerous causes.

Often, this condition is favored by an increase in local pH (due, for example, to menstrual blood or sperm in the post-coitus) and by alteration of the vaginal microbial flora (reduction of lactobacilli secondary to poor personal hygiene or use of drugs, such as antibiotics or corticosteroids).

These conditions predispose to the proliferation of pathogenic microorganisms and make the vaginal mucosa more vulnerable to infectious attacks . The agents responsible for vaginitis can be fungi (such as Candida albicans ), bacteria ( Gardnerella vaginalis, streptococci, staphylococci, etc.), protozoa (eg Trichomonas vaginalis ) and, more rarely, viruses (eg Herpes simplex).

Vaginitis can also result from hypersensitivity reactions and irritations of the vaginal mucosa. Among the factors that can induce this disorder include excessive use of intimate cleansers, vaginal cleansers, hygienic sprays or perfumes, softeners and laundry detergents. Occasionally, irritation can result from the use of latex lubricants or prophylactics.

Vaginitis can also be caused by physical causes, such as abrasions due to inadequate lubrication during sexual intercourse or rubbing against too tight clothing, especially if made of a synthetic material. Even prolonged contact with a foreign body (eg internal absorbents, toilet paper residues or grains of sand) can cause inflammation of the vagina.

Bacterial vaginosis

Normally, in women of reproductive age, lactobacilli are the predominant constituents of the vaginal microbial flora. Colonization by these bacteria is normally protective, as it keeps the vaginal pH at normal values ​​(between 3.8 and 4.2) and prevents the excessive growth of pathogenic microorganisms. However, in situations that can alter the vaginal ecosystem, the genitals can be vulnerable.

Bacterial vaginosis is a very common genital infection, characterized by a vaginal dismicrobism that causes the increase of pathogenic bacteria. Often, its presence is signaled by itching, burning and increased vaginal discharge (homogeneous white-greyish secretions, characterized by bad smell). If neglected, bacterial vaginosis can cause gynecological complications, as well as favoring the transmission of diseases spread through sexual relations.

Sexually transmitted diseases

Vaginal burning is often the first sign of a sexually transmitted infection, such as genital herpes, gonorrhea, trichomoniasis and chlamydia .

Menopause

In women of reproductive age, high levels of estrogen maintain the thickness of the vaginal mucosa, reinforcing the local defenses. Upon reaching menopause, the physiological drop in the production of these hormones causes the walls of the vagina to thin and can lead to problems such as dryness, itching and irritation ( atrophic vaginitis ).

Hormonal changes that occur after childbirth or during breastfeeding may also promote vaginal burning. The reduction of estrogen can also be induced by some treatments, such as surgical removal of the ovaries, pelvic irradiation and chemotherapy.

Hypersensitivity reactions or allergy to certain substances

Vaginal burning can occur as a result of certain chemicals, which can cause irritation of the genital area . This reaction can result from the excessive use of intimate cleansers and vaginal lavages.

In susceptible people, the risk of suffering from the disorder can also be associated with the use of intimate deodorants, depilatory creams, soaps, shower gel, perfumed toilet paper, fabric softeners and residues of laundry detergents.

The category of potential sensitizing agents also includes vaginal lubricants or creams, latex condoms, spermicides, vaginal contraceptive rings, diaphragms or intrauterine devices.

Other predisposing factors

Vaginal burning can be caused by a number of other disorders involving the vagina, cervix, external genitalia and urinary tract, including:

  • Repeated episodes of cystitis ;
  • Parasitosis, including scabies or pediculosis of the pubis;
  • Neurological lesions (eg Tarlov cysts, post-traumatic outcomes of the pudendal nerve, etc.);
  • Scratch- induced micro-trauma due to local itching, abrasions due to inadequate lubrication during sexual intercourse, rubbing against too tight clothing and use of internal absorbents for long periods of time.

Vaginal burning may also depend on states of immunodepression and systemic diseases, such as diabetes. In some cases, this burning sensation may be associated with dermatological diseases (including seborrheic dermatitis, lichen sclerosus and psoriasis) and psychosomatic disorders .

Associated signs and symptoms

When the burning occurs in a sensitive area like the vagina or the vulva, it can be particularly annoying. The disorder can manifest itself as a burning sensation in the genital area during urination, with contact or without any kind of stress.

Depending on the cause, this manifestation may occur simultaneously with other symptoms, such as itching, leucorrhoea (vaginal discharge), edema, tenderness and redness. This symptom may also be associated with mild bleeding, burning pain during sexual intercourse (dyspareunia), dysuria (pain on urination) and vaginal dryness.

In some cases, there may also be excoriations, small blisters and ulcerations.

Vaginal burning can last from a few days to several weeks.

Diagnosis

In the presence of vaginal burning, the evaluation generally involves the collection of anamnestic data (complete medical history of the patient) and the gynecological examination, during which the lower part of the female genitalia is examined.

Upon inspection, symptoms and suggestive signs may be found regarding the possible causes involved. To define the etiology of vaginal burning, the doctor can take samples of vaginal secretions: the pH measurement and the microscopic examination of this material allow to collect a first clue on the condition that caused the burning sensation. If the results of these preliminary analyzes are inconclusive, the samples taken may be placed in culture, in order to determine which organism is responsible for the symptoms.

The doctor can also use a swab to take a sample of secretions from the cervix, check for sexually transmitted infections and collect a urine sample.

Treatment and prevention

Once the diagnosis is made, the treatment is aimed at the specific causes of vaginal burning.

  • If a vaginitis of bacterial origin is present, the therapy involves the use of antibiotics, to be taken orally or applied topically, for a few days.
  • In the presence of fungal infections, however, the use of antifungal drugs is indicated.
  • In case of allergic or irritative phenomena, it is necessary to suspend the use of the sensitizing substance that caused the reaction. If the symptoms are moderate or intense, the doctor may prescribe a pharmacological treatment based on antiseptic and anti-inflammatory products, such as benzidamine.

In addition to scrupulously following the therapy indicated by the gynecologist, it is important to correct the predisposing factors and to adopt some precautions, such as:

  • Avoid vaginal lavages if not necessary: ​​subjecting the vagina to intense hygienic practices can upset the balance of the bacteria present in it, and increase the risk of infections. Even the use of intimate cleansers should not be carried out excessively: this habit could alter the natural vaginal immune defenses and the saprophytic microbial flora.
  • After using the toilet, it is a good idea to clean yourself from the front to the back: in this way you avoid the spread of fecal bacteria to the vagina. Furthermore, care must be taken to adopt correct hygiene measures, such as remembering to wash your hands after each evacuation and urination.
  • When washing, prefer the shower to the bathroom: rinse the detergent used well and dry well to avoid moisture stagnation. Do not use too harsh soaps and avoid the continuous use of intimate deodorant wipes, pantiliners, internal absorbents and acid pH soaps.
  • Choose undergarments that ensure proper transpiration and do not irritate the genital area. Therefore, the use of pure cotton linens should be preferred, preferably white; this natural tissue allows a correct tissue oxygenation and limits the stagnation of secretions.
  • Using condoms during sexual intercourse helps to avoid sexually transmitted infections.
  • Respect the food standards for a correct and balanced diet.

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