Written on June 25, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Vulvar pain can be very uncomfortable and severely reduce the quality of life for many women. Not only does vulvar pain hurt, but it also can involve burning, itching, sores, bumps, and irritation in the genital area.[1,2] The lifetime prevalence of vulvar pain is between 16% to 28%. However, reports may be low because 40% of women with vulvar pain do not seek treatment. Read on to understand more about vulvar pain and which STDs cause vulvar pain.
What Is the Vulva?
First, let’s discuss the anatomy. The vulva is the external part of the female genital area. The vulva contains the labia majora (the outer folds of the skin) and the labia minora (the inner folds of the skin). The vestibule is the tissue between the labia minora and the vaginal opening towards the bottom. Where the labia majora meet at the top is the clitoris.
Classification of Vulvar Pain
Vulvar pain is classified based on the specific related disorder or the absence of a relevant cause.[1,4] Vulvar pain due to a particular condition is often acute, though it can also be chronic. Causes of acute vulvar pain can include[1,4]:
- Infectious: vulval candidiasis (yeast infection) and genital herpes
- Inflammatory: lichen sclerosus and lichen planus (long-term skin conditions)
- Neoplastic: squamous cell carcinoma (skin cancer)
- Neurological: herpes neuralgia (nerve pain due to herpes)
Chronic vulvar pain, also known as vulvodynia, is pain around the vulva lasting longer than three months. Vulvodynia is typically not associated with an underlying condition and is categorized as[1,4]:
- Generalized: involving the whole vulva
- Localized: involving parts of the vulva
Sexually Transmitted Diseases (STDs)
Sexually transmitted diseases (STDs) are infections caused by various bacteria, parasites, and viruses that can be transmitted from person to person predominantly through vaginal, oral, or anal sex. An estimated one in five people have a sexually transmitted infection in the United States. Nearly 2.5 million cases were reported in the U.S. in 2021, with the most common being chlamydia, gonorrhea, and syphilis.
STDs do not always cause symptoms.[6,8] If signs and signs and symptoms do present, they may include:
- Painful urination
- Sores or bumps on the genital, oral, or anal areas
- Odorous discharge from the vagina
- Vaginal bleeding
- Penile discharge
- Lower abdominal pain
- Swollen lymph nodes
- Rash on trunk, hands, or feet
STDs That Cause Vulvar Pain
In addition to the above signs and symptoms, some STDs also cause vulvar pain.[1,4] Three STDs that cause vulvar pain are[1,4,9-13]:
- Genital herpes. This STD is caused by the herpes simplex virus type 1 and type 2. Every year, there are about 572,000 new cases of genital herpes in the U.S. When genital herpes symptoms are present, the lesions appear as small vesicles or blisters around the genitals, rectum, or mouth. Painful ulcers form when the blisters break open. The herpes lesions and ulcers around the genital area may lead to vulvar pain. The first outbreak may also include fever, body aches, swollen lymph nodes, and headaches. With each subsequent infection, the symptoms will typically get shorter in duration and be less severe than the first outbreak.
- Chlamydia. This STD is caused by the Chlamydia trachomatis bacterium.[10,11] The majority (up to 70%) of people with chlamydia never notice symptoms of the infection. If you do present with symptoms, you may experience unusual smelly discharge, painful intercourse, abnormal vaginal bleeding, painful or burning urination, and itching or burning around genital areas.[10,11]
- Gonorrhea. This STD is caused by the Neisseria gonorrhoeae bacterium. There were an estimated 1.6 million new gonorrhea infections in the U.S. in 2018. Most people with gonorrhea have no symptoms. When symptoms are present, gonorrhea can result in itching and a rash. In men with gonorrhea, there may be testicular or scrotal pain and unusual penile discharge. In women, there may be nonspecific symptoms similar to vaginal infection. Women can also experience painful urination, vaginal discharge, and vaginal bleeding. Gonorrhea also may infect the rectum and have symptoms like itching, soreness, bleeding, and pain.
At-Home Lab Testing and STD Telehealth Option via Everlywell
If you are experiencing any itching, burning, painful bumps, or sores in your vulva or genital area, it’s essential to consider STD testing and speaking with a healthcare provider. Everlywell offers at-home STD testing for men and STD testing for women. These tests check for six sexually transmitted infections, including chlamydia, gonorrhea, hepatitis C, HIV, syphilis, and trichomoniasis. You can also schedule an on-demand STD appointment via the Everlywell telehealth option to discuss any questions you may have about your sexual health.
What STD Causes Painful Urination?
STDs That Cause Abdominal Pain
Hepatitis C in Pregnancy: What You Need to Know
- Danby CS, Margesson LJ. Approach to the diagnosis and treatment of vulvar pain. Dermatol Ther. 2010;23(5):485-504. doi: 10.1111/j.1529-8019.2010.01352
- Disorders of the vulva: Common causes of vulvar pain, burning, and itching. ACOG. https://www.acog.org/womens-health/faqs/disorders-of-the-vulva-common-causes-of-vulvar-pain-burning-and-itching. Accessed June 23, 2023.
- Judge DE. What you can do about vulvar pain. NEJM Journal Watch. 2002. https://www.jwatch.org/wh200201080000014/2002/01/08/what-you-can-do-about-vulvar-pain. Accessed June 23, 2023.
- Nunns D and Murphy R. Assessment and management of vulval pain. BMJ. 2012;344:e1723 doi: 10.1136/bmj.e1723
- CDC - STD Diseases & Related Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/std/general/default.htm. Last reviewed March 2, 2023. Accessed June 23, 2023.
- STI prevalence, incidence, and cost estimates. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/prevalence-incidence-cost-2020.htm. Last reviewed February 18, 2021. Accessed June 23, 2023.
- Sexually transmitted disease surveillance, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/2021/default.htm. Last reviewed April 11, 2023. Accessed June 23, 2023.
- Sexually transmitted diseases (stds). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240. Last reviewed April 14, 2023. Accessed June 23, 2023.
- Detailed Std Facts - Genital herpes. Centers for Disease Control and Prevention. https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm. Last reviewed July 22, 2021. Accessed June 23, 2023.
- Std Facts - Chlamydia. Centers for Disease Control and Prevention. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm. Last reviewed April 12, 2022. Accessed June 23, 2023.
- Chlamydia: Causes, symptoms, treatment & prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4023-chlamydia. Accessed June 23, 2023.
- Gonorrhea: Causes, symptoms, treatment & prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4217-gonorrhea. Last reviewed Accessed June 23, 2023.
- Detailed std facts - gonorrhea. Centers for Disease Control and Prevention. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm. Last reviewed April 11, 2023. Accessed June 23, 2023.