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Female Genital Problems and Injuries
Most women experience minor vaginal problems from time to time. These problems can be related to menstrual cycles, sex, infection, birth control methods, aging, medicines, or changes after pregnancy.
A change in your normal vaginal discharge may be the first sign of a vaginal problem. Changes in urination, such as having to urinate more frequently or having a burning feeling when you urinate, also may be a symptom of a vaginal problem.
Conditions that may cause a change in your normal vaginal discharge include:
- Infections of the vagina, such as a yeast infection, bacterial vaginosis, trichomoniasis, human papillomavirus (HPV), or herpes.
- Infection of the cervix (cervicitis).
- An object in the vagina, such as a forgotten tampon.
- Sexually transmitted infections (STIs), such as chlamydia or gonorrhea.
- Various sex practices, such as oral-to-vaginal and anal-to-vaginal contact.
- Vaginal medicines or douching.
The exact cause of pelvic pain may be hard to find. The severity of your pain and other symptoms you have may help determine what is causing the pain. For example: A condition, such as functional ovarian cysts, may cause pelvic pain and vaginal bleeding when you are not having your period.
If you think you may have symptoms of an STI:
- Do not have sexual contact or activity while waiting for your appointment. This will prevent the spread of the infection.
- Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an infection up into your uterus or fallopian tubes and cause pelvic inflammatory disease (PID).
The presence or excess growth of yeast cells, bacteria, or viruses can cause a vaginal infection. A vaginal infection may occur when there is a change in the normal balance of organisms in your vagina.
The three most common types of vaginal infections are:
- Candida vulvovaginitis (yeast infections).
- Bacterial infections (bacterial vaginosis).
- Parasitic infections (trichomoniasis).
Common symptoms of vaginal infection include:
- Increase or change in the vaginal discharge, including gray, green, or yellow discharge.
- Vaginal redness, swelling, itching, or pain.
- Vaginal odor.
- Burning with urination.
- Pain or bleeding with sex.
If you are pregnant and have vaginal symptoms, talk with your doctor about your symptoms before considering any home treatment measures. Some home treatment measures may not be appropriate, depending on the cause of your vaginal infection. Conditions such as bacterial vaginosis can affect your pregnancy, so it is important to talk with your doctor and be treated appropriately.
Vaginal infections may increase the risk for pelvic infections, such as pelvic inflammatory disease (PID).
Vaginal or vulvar problems
Other vaginal or vulvar problems may occur from the use of birth control methods, the use of medicines, or aging, or as a result of changes after pregnancy. These problems include:
- Vaginal prolapse, which may cause urination and bowel changes.
- Retained tampon, birth control device, or foreign object. See how to remove an object from the vagina.
- Vulvar or vaginal injury, such as landing on a metal bar such as on a bike or playground equipment or from an object in the vagina.
- Vulvar pain (vulvodynia).
- Pudendal neuralgia, from pressure on the pudendal nerve in the genital area.
- Noninfectious vaginitis. Examples of this include:
A young girl with unusual vaginal symptoms should be evaluated by her doctor to determine the cause. Vaginitis in a young girl may be caused by:
- A ball of toilet paper in her vagina.
- Pinworms that have spread from the anus to the vagina.
- The spread of bacteria from an upper respiratory infection of the ears (otitis media) or throat (tonsillitis) to the vagina by her hands.
A young girl with vaginal symptoms must also be evaluated for possible sexual abuse.
Rashes, sores, blisters, or lumps in the vaginal or vulvar area
Many conditions can cause a rash, sore, blister, or lump in your vaginal area (vulva). One of the most common causes of a rash is genital skin irritation that may occur when soap is not rinsed off the skin or when tight-fitting or wet clothes rub against the skin. A sore, blister, or lump in your vaginal area may require a visit to your doctor.
Treatment of a vaginal problem depends on the cause of the problem, the severity of your symptoms, and your overall health condition.
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Urinary symptoms may include:
- Pain when you urinate.
- Trouble urinating.
- Not being able to urinate at all.
- Blood in your urine.
Symptoms of a vaginal infection may include:
- Vaginal itching.
- Vaginal discharge that is not normal for you.
- Red, irritated skin in the vaginal area.
- Pain when you urinate.
- Pain or bleeding when you have sex.
Many prescription and nonprescription medicines can cause vaginal symptoms. A few examples are:
- Birth control pills.
- Hormone therapy.
- Chemotherapy for cancer.
- Vaginal sprays, douches, and spermicides.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
A vaginal infection may clear up without treatment in 2 or 3 days.
- If you could be pregnant, do a home pregnancy test. Any pregnant woman with abnormal vaginal symptoms should talk with her doctor about her symptoms before considering using any home treatment measures or nonprescription medicines. For more information, see the topic Pregnancy-Related Problems.
- Avoid sex so that irritated vaginal tissues can heal.
- Do not scratch the vaginal area. Relieve itching with a cold water compress or cool baths. Warm baths may also relieve pain and itching.
- Make sure that the cause of your symptoms is not a forgotten tampon or other foreign object that needs to be removed.
- Wear loose-fitting, cotton clothing. Stay away from nylon and synthetics, because they hold heat and moisture close to the skin, which makes it easier for an infection to start. You may want to remove pajama bottoms or underwear when you sleep.
- Do not douche unless your doctor tells you to.
- If you have gone through menopause, try using a vaginal lubricant, such as Astroglide, to reduce irritation caused by having sex.
Vaginal yeast infections
If you have symptoms of a vaginal yeast infection and have been diagnosed and treated by your doctor for this condition in the past, you may want to try treating it at home using a nonprescription medicine, such as tioconazole (for example, Vagistat), clotrimazole (for example, Gyne-Lotrimin), or miconazole (for example, Monistat) to treat your symptoms.
If your symptoms do not improve with home treatment, contact your doctor. Vaginal symptoms that may be related to another type of vaginal infection or a cervical infection need to be evaluated.
Women who take the blood-thinning medicine warfarin (Coumadin) and use a nonprescription vaginal yeast-fighting medicine, such as Monistat, may have increased bruising and abnormal bleeding. Consult with your doctor before using a yeast-fighting medicine if you take warfarin.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Symptoms of a vaginal infection develop.
- Unexpected vaginal bleeding develops.
- A fever develops.
- You have moderate to severe pain.
- Your symptoms become more severe or frequent.
If you practice good genital hygiene, you can also help prevent infection:
- Keep your vaginal area clean. Use mild, unscented soap and water. Rinse well.
- After using the toilet, wipe from front to back to avoid spreading yeast or bacteria from your anus to the vagina or urinary tract.
- Wear underwear that helps keep your genital area dry and doesn't hold in warmth and moisture. One good choice is cotton underwear.
- Avoid tight-fitting clothing, such as panty hose and tight-fitting jeans. These may increase body heat and moisture in your genital area.
- Change out of a wet swimsuit right away. Wearing a wet swimsuit for many hours may keep your genital area warm and moist.
- Change pads or tampons often.
- Don't douche or use deodorant tampons or feminine sprays, powders, or perfumes. These items can change the normal balance of organisms in your vagina.
Take antibiotics when needed, but avoid unnecessary use of antibiotics. Taking antibiotics exposes you to the risks of allergic reactions and antibiotic side effects (such as nausea, vomiting, diarrhea, and yeast infections). Also, antibiotics may kill good bacteria.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- What are your main symptoms?
- How long have you had your symptoms?
- Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
- What does your vaginal discharge look and smell like?
- What was the date of your last menstrual period? If you have been through menopause, how long ago was your last menstrual period?
- Are you currently using any type of birth control method?
- What medicines (especially antibiotics) are you taking or have you taken recently, if any?
- Do you have any symptoms of pelvic inflammatory disease (PID)?
- What home treatment measures have you tried? Did they help?
- What nonprescription medicines have you tried? Did they help?
- Do you have a new sex partner? Do you have more than one sex partner? Does your partner have any symptoms? Have you had sex without using a condom? Do you think you have recently been exposed to a sexually transmitted infection (STI)?
- Have you been diagnosed and treated for a sexually transmitted infection (STI) in the past? If so, what was your diagnosis, and what treatment was done?
- Do you have symptoms of a urinary tract infection, such as pain or burning on urination and a frequent urge to urinate?
- Do you have any health risks?
Current as of: February 26, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
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