Vaginal burning is mainly found in vaginal lesions (thrush, nonspecific vaginitis, venereal infections). The cause of discomfort may be herpes infection, genital allergy, HPV infection and pathology of the urinary system. Gynecological examination, microscopic and bacteriological analysis of vaginal secretions, instrumental methods (colposcopy, ultrasound, biopsy) are prescribed for the diagnosis of etiological factors of burning. To relieve symptoms, vaginal suppositories, baths, systemic etiotropic drugs are used.
Causes of vaginal burning
Burning sensation in the intimate area, as a rule, worries women in the menopausal period. Hormonal changes lead to a violation of the secretory activity of the glands, so the vaginal mucosa dries up, which causes discomfort. Burning sensations and aching pain in the perineum occur after rough or too long sexual intercourse, with insufficient production of natural lubrication and the absence of intimate lubricants.
Short-term episodes of burning in the perineum occur after using too aggressive means for intimate hygiene, which cause irritation of the delicate skin and mucous membranes. The symptom is observed in the case of the use of ordinary soap, not intended for sensitive areas. A woman feels a burning sensation immediately after washing, unpleasant signs persist for 1-2 hours and are complemented by dryness in the intimate area.
Vaginal candidiasis is the most common cause of burning in the vagina and perineum. Uncomfortable sensations appear suddenly, disturb women constantly, periodically intensifying or disappearing. Intense burning pain is noted during urination, at the moment of sexual intimacy. The symptom is accompanied by painful itching in the vulva area. For thrush, abundant curd discharge with a sour smell, hyperemia and swelling of the mucous membranes are pathognomonic.
The symptoms of thrush increase after water procedures, motor activity. Manifestations often worsen a few days before the onset of menstruation. Sometimes chronic vaginal candidiasis develops, which is characterized by moderate discomfort in the intimate area and scanty thick discharge. With a prolonged course of the fungal process, mucosal atrophy is observed, as a result of which the patient feels constant burning and dryness.
Inflammation of the vagina is manifested by burning, itching and soreness in the intimate area in women. Symptoms worsen during urination, during hygienic procedures. Unpleasant sensations are complemented by vaginal secretions of various types: with gonorrhea – thick yellow-green, with trichomoniasis — foamy, greenish and fetid, with chlamydia — muco-purulent. For nonspecific vaginitis, abundant yellowish whites with an unpleasant odor are typical.
Due to the proximity, the urinary tract is usually involved in the process, so the patient feels intense burning throughout the intimate area, especially in the urethra and vulva. Sometimes there may be burning pains at the end of urination. Women with vaginitis have dull pulling sensations in the pubic area, lower abdomen, which are intensified by physical activity, sharp turns and tilts of the trunk. Sexual intercourse becomes sharply painful (dyspareunia).
When infected with herpesvirus, a woman feels itching and burning in the genital area even before other signs of infection are added. Symptoms are sometimes combined with paresthesia, the appearance of thick whites and discomfort with urination. After 1-2 days, bubbles with transparent contents form on the genital mucosa, quickly turning into erosion, and as a result, the burning sensation increases sharply.
With inflammation of the gland located in the thickness of the labia majora, there is pain with burning on the side of the lesion. Discomfort becomes more severe when wearing tight underwear, rubbing the skin, intimacy. The affected area becomes hyperemic, the tissues swell and block the entrance to the vagina. When bartholinitis is complicated by an abscess of the gland, women are worried about severe pain and discomfort when walking, fever and general weakness increase.
A painful burning sensation with itching in the intimate area is a common symptom of an allergic reaction in women. Burning sensations are preceded by redness and swelling of the genital mucosa. Constant itching provokes scratching of the affected area, as a result, burning and soreness increase. Sometimes allergic manifestations in the intimate area act as a component of a broader symptom complex (with urticaria, eczema, dermatitis).
Diseases of the genitourinary system
With urethritis and cystitis, women often experience a burning sensation in the perineum. Discomfort reaches its maximum intensity when urinating, often accompanied by painful cuts in the lower abdomen. Burning sensations are accompanied by a change in the type of urine: it becomes cloudy, acquires a fetid smell, sometimes you can see streaks of blood. The mucous membranes of the perineum are hyperemic and swollen, when touched, there is a strong burning sensation.
Condylomas in women cause burning in the perineal area with accidental touching, rubbing with underwear, sexual intercourse and penetration of foreign objects into the vagina. With constant traumatization, erosions and bleeding occur, as a result of which the burning soreness increases. Condylomas are more often located on the labia minora and on the eve of the vagina, so a woman can detect them on her own.
- Gynecological diseases: endocervicitis, vulvar vestibulitis.
- Surgical pathology: vaginal fistulas, female hypospadias.
- Precancerous conditions: kraurosis and leukoplakia of the vulva.
- Psychoemotional factors: severe stress, neurosis, depression.
- Somatic diseases: diabetes mellitus, hypothyroidism, chronic liver failure.
Examination of women complaining of vaginal burning begins with a standard gynecological examination. The doctor assesses the condition of the external genitalia, performs vaginal examination in mirrors, bimanual palpation. To understand the causes of the pathological condition, the information obtained during physical examination is usually insufficient, therefore instrumental and laboratory methods are used:
- Ultrasound of the pelvic organs. Sonography of the genital and urinary organs in women is carried out if complaints of burning are accompanied by pain in the lower abdominal cavity, dysuric disorders or fever. On ultrasound, an obstetrician-gynecologist finds signs of an inflammatory process, neoplasms, foreign bodies.
- Colposcopy. A targeted examination of the cervix is indicated if precancerous processes are suspected. With leukoplakia, foci of white or yellowish color with an unexpressed vascular pattern are detected. To confirm the diagnosis, a Schiller test is performed, with the help of which areas of the altered epithelium are visualized. Additionally, vulvoscopy is performed.
- Analysis of secretions. Microscopic examination of a smear in women reveals a large number of epithelium and leukocytes, an increase in the pH of the secretion of more than 6.5, the presence of pathogenic bacterial flora. To identify possible pathogens of inflammation, secretions are seeded on nutrient media, where specific colonies of bacteria or fungi are found.
- Blood tests. Serological reactions to the main pathogens of STDs (gonococci, chlamydia, pale treponema) are necessary. To exclude allergic causes of burning, a hemogram is performed to determine the level of eosinophilia, an extended immunogram with IgE measurement.
Help before diagnosis
To reduce the burning sensation, a woman needs to carefully monitor the hygiene of the genitals, use special means for intimate areas. It is best to choose natural underwear that does not cause excessive sweating and does not compress the skin. With vaginitis, it is worth regularly changing sanitary pads, which will absorb secretions and reduce maceration of the skin around the vulva.
Vaginal burning is often caused by the proliferation of pathogenic microbes. To destroy them, you can irrigate the external genitals of women with a weak solution of chlorhexidine, a decoction of chamomile. It is not recommended to perform vaginal douching without the appointment of a gynecologist. It is impossible to effectively eliminate burning in the perineum area without etiotropic treatment, so a woman should consult a doctor.
With uncomplicated forms of diseases in women, local treatment is often sufficient. Therapeutic measures include the appointment of suppositories with antibacterial or antifungal action, which depends on the etiology of the pathogen. To eliminate discomfort, local baths with disinfectant solutions are shown. Ointments with topical corticosteroids help to stop severe burning and itching.
With specific acute vaginitis, therapy is selected based on the sensitivity of the pathogen: gonorrhea infection is treated with penicillins, tetracyclines, chlamydia and mycoplasma – macrolides, fluoroquinolones, trichomonas – nitroimidazoles. Systemic antimycotics are effective in chronic candidiasis vaginitis. For the treatment of herpes in women, acyclovir group drugs are used.
Gynecological diseases are accompanied by vaginal dysbiosis, which increases burning and discomfort, so pathogenetic treatment is aimed at normalizing the microflora. Vaginal candles with lactobacilli, as well as oral combined probiotics, work effectively. Immunomodulators are recommended for chronic diseases.
Excision of genital warts is carried out for medical and cosmetic reasons. To minimize mucosal damage in women, laser or radio wave removal method is practiced. With the ineffectiveness of conservative treatment of precancerous conditions in modern gynecology, minimally invasive interventions are used: removal of pathological foci by laser, radionoge or cryodestruction. With an extensive process, extirpation of the vulva is recommended.