Vaginal Pain: Many Causes, Many Treatment Options

Many women will suffer from vaginal pain at some point in their lives, whether they have laxity caused by childbirth, dryness caused by menopause or a common vaginal infection. If you have vaginal pain, it's important to seek treatment from your urogynecologist as some conditions that cause vaginal pain can cause long-term damage to your reproductive and overall health.

There is no reason to live with the daily discomfort of vaginal pain or to have intimate relationships suffer because of pain or fear. Vaginal pain is not uncommon, there are many causes and there is help available. Here are some of the most common causes of vaginal pain and discomfort.

Vaginal Dryness

Dryness of the vagina causes pain, burning and discomfort during and after sexual intercourse. Vaginal dryness can also cause everyday discomfort and irritation caused by genital friction. Vaginal dryness can usually be traced to a hormone imbalance, more specifically, a drop in estrogen. Topical estrogen and other estrogen replacement can help alleviate symptoms. Vaginal rejuvenation can also offer long-term relief even for those who are not able to use hormone therapies.

Vaginal Infection

The common yeast infection can often be misinterpreted as vaginal pain because of the degree of discomfort it causes. Nonetheless, it needs to be adequately treated for the symptoms to be relieved and will generally require the use of anti-fungal cream.

Vaginal Atrophy

Vaginal atrophy is the thinning, drying and inflammation of the vaginal walls, due to a drop in estrogen production, causing vaginal irritation, pain and urinary issues. An estimated 10 to 40 percent of postmenopausal women have signs of vaginal atrophy, but only about 25 percent of these women seek medical help for their vaginal pain. Women often incorrectly assume that the symptoms of vaginal atrophy are just symptoms of menopause or aging and that there are no treatments. Others are too embarrassed to bring up the topic with their doctors.

But the symptoms of vaginal atrophy can be ongoing and disruptive to daily life and intimate relationships. The condition is commonly caused by low estrogen levels, which lead to thinner and less elastic vaginal walls and vaginal dryness.

Symptoms may appear alone, but it is not uncommon for women to suffer from a combination of several vaginal issues, including: 

  • Painful intercourse
  • Vaginal dryness
  • Vaginal discharge
  • Urinary incontinence
  • Burning with urination
  • More frequent urinary tract infections
  • Genital itching
  • Bleeding after intercourse
  • Discomfort or pain during intercourse
  • Lack of vaginal lubrication during sexual activity

One new and effective non-surgical treatment for stress incontinence and overall vaginal health is diVa® Laser Vaginal Therapy. diVa® uses two separate, penetrating lasers to resurface and tone the vaginal walls. This, in turn, strengthens pelvic structures and helps aid in controlling mild to moderate incontinence. The safe and effective treatment takes only a few minutes to perform in your urogynecologist’s office, and there is no downtime after the procedure other than we recommend no intercourse for 7-10 days.

Hormonal Imbalance

A drop in estrogen levels can occur naturally with menopause or be triggered by reproductive health issues or medical procedures that impact the function of the ovaries or require the removal of the ovaries. This fluctuation causes the thinning and drying of vaginal tissues, which can lead to vaginal pain.

Some common causes include:  

  • Menopause and peri-menopause
  • Medications such as aromatase inhibitors for breast cancer treatment
  • Breastfeeding
  • Postpartum hormone adjustments
  • Immune disorders
  • Full hysterectomy
  • Removal of the ovaries
  • Radiation therapy 
  • Chemotherapy

Vaginal Laxity

Vaginal laxity or looseness occurs when the vaginal tissues stretch during vaginal childbirth or lose their resilience because of aging or a drop in estrogen levels, especially during menopause. The condition causes a loss of lubrication, weakened sexual response and the inability to experience orgasm.

Fortunately, there are ways to address vaginal laxity. Kegel exercises strengthen the pelvic floor muscles, which can help better support the vaginal and help with urinary incontinence. Vaginal laser rejuvenation, such as diVa®, can help rebuild and “plump” vaginal walls and improve lubrication, counteracting the symptoms of vaginal laxity.


Endometriosis occurs when the lining of the uterus grows outside of the uterus, even attaching to other pelvic organs. This condition can cause vaginal pain during intercourse, pelvic pain during the menstrual cycle. Effective treatments include hormone therapies and in some cases, surgery.

Pelvic Inflammatory Disease

Pelvic inflammatory disease or PID is an infection of the vagina and the surrounding reproductive organs, causing pain during sexual penetration and menstruation. Prompt treatment is vital as PID can jeopardize fertility.


Women who experience vaginal pain during sexual penetration or at the insertion of a tampon may be diagnosed with vulvodynia. This unusual condition can occur even without any penetration or stimulation of the vagina. A full assessment can help determine the cause of the pain, which often can be alleviated with a topical painkiller.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs), such as herpes or chlamydia, can cause vaginal pain and irritation. If you suspect that you have been exposed to an STD it's important to seek treatment as soon as possible to mitigate any long-term effects from the infection.

Vaginal pain should be taken seriously. Your vaginal health is important to your overall physical and emotional health. If you are experiencing everyday pain, pain during intercourse, painful urination or vaginal dryness, contact the expert and compassionate team at Coyle Institute to schedule your consultation.