Genital pain typically refers to pain in the pelvic region. In women, genital pain means pain in the region that houses the reproductive organs. Genital pain can be acute or chronic, and it can arise due to various reasons. It can occur due to conditions in the digestive, reproductive, or urinary systems. 

Doctors have found that stresses affecting the pelvic floor tissues can also lead to genital pain in women. Sometimes, bodily stresses like pregnancy, difficult labor, or vaginal childbirth can cause uterine prolapse - a condition in which the uterus is displaced from its original position and slips down the vaginal canal. Uterine prolapse can also cause pain in the genital region. This article will explore the different types of genital pain and their causes and how uterine prolapse comes into the equation.

Causes of genital pain

1. Infectious causes

Pain in the genital region of women occurs most commonly due to yeast infection. In fact, about 75% of women develop yeast infections in their genital regions at some point in their life. The typical symptoms of a yeast infection are itching, a burning sensation, and a thick, white vaginal discharge.

Bacterial infection (bacterial vaginosis) can also cause genital pain. Other symptoms of this infection are itching and burning sensation, a fishy odor, and discomfort during sex. Chlamydia, gonorrhea, and sexually transmitted infections can also lead to genital pain.

2. Physical Trauma

Vaginal pain can also occur due to physical injury to the vagina or the vulva. Physical injury can result from minor causes like cuts from razors or vaginal tearing due to childbirth.

3. Pelvic floor dysfunction

Stress to the body, like pregnancy and childbirth, can affect the muscles and tissues in the genital region. The risk of pelvic floor problems can increase with advancing age, late pregnancy, multiple childbirth, and episiotomy. These factors can cause the pelvic floor muscles to lose their strength resulting pelvic organ prolapse. Pelvic organ prolapse is a condition which pelvic organs fall from their healthy positions down into the vaginal canal. This condition is characterized by:

• Dull pain or a feeling of heaviness in the lower abdomen
• Feeling some tissues bulging out of the vagina
• Inability to empty the bladder
• Urinary incontinence
• Trouble having a bowel movement
• Pain during sex

4. Vulvodynia

Vaginal pain can occur due to a condition called Vulvodynia, a type of chronic. The symptoms of vulvodynia can vary from person to person. Some people experience continuous, burning pain. Some people report that their pain worsens or is triggered by sex. The exact cause behind vulvodynia is not yet known.

5. Bartholin’s Cyst

Bartholin’s cyst develops when the ducts of the Bartholin’s glands located at the vaginal opening are obstructed. The cyst might feel like a hard lump. If infected, the Bartholin’s cyst can cause intense pain, typically on one side of the vagina.

Types of genital pain

1. Burning

Burning sensation in the genital region can result from vaginal yeast and bacterial infections, sexually transmitted infections (STI), etc. Vulvodynia can also cause burning pain.

2. Itching

Though it may not seem to be a type of pain, itching can be very uncomfortable when it is in the genital region. Itchiness usually accompanies vaginal infections. Pelvic floor injuries can damage the surrounding nerves and cause itchiness.

3. Sensitivity or tenderness

The region around the vagina and the vulva can feel tender and painful in case of an infected Bartholin’s cyst. You might also notice the area to be discolored, resulting in a hard lump. Trauma and injury to the genital region can also cause sensitivity and tenderness. Women who had vaginal childbirth can also experience soreness and tenderness in the genital region due to perineal tear.

4. Muscle spasm

Pelvic floor damage can cause tightness and soreness in the muscles in the pelvic region. The condition can also cause pain in the lower back and hip discomfort. Vaginal muscle spasms can also occur in people with vulvodynia while having sexual intercourse.

Possibility of uterine prolapse

According to evidence, about 50% of women giving birth have some degree of uterine or vaginal prolapse. Amongst them, only 10-20% experience symptoms like pain and heaviness. Uterine prolapse is categorized depending on the position of the fallen uterus. At the most advanced stage, the uterus protrudes out of the vagina. The exposed uterus can get infected and cause pain. The risk of uterine prolapse can increase due to various reasons. Let’s look into the causes of uterine prolapse:

Causes of uterine prolapse

Uterine prolapse commonly arises due to the following:

• Multiple childbirth
• Vaginal delivery
• Late first pregnancy
• Advancing age
• Obesity
• Prior pelvic surgery
• Giving birth to a large baby
• Aging
• Obesity
• Prior pelvic surgery.
• Chronic constipation
• Weak connective tissues

Prevention and treatment of uterine prolapse

Uterine prolapse can be prevented by:

• Avoid lifting heavy objects
• Managing chronic cough
• Managing constipation by eating fibrous foods and lots of fluids
• Maintain a healthy weight and lifestyle

Treatment of uterine prolapse includes:

• Kegel exercises to help strengthen the pelvic floor muscles.
• Pessaries to help support the uterus and prevent it from slipping down.
• External support garments
• Surgical treatments in advanced cases to either restore the uterus to its original position or to remove the organ completely.

Lastly, those who cannot opt for surgeries can look into FemiCushion, an external prolapse support device with uses a unique silicone cushion. It is a non-invasive treatment approach that can help manage the symptoms of genital prolapse.

Supervising Doctor of This Article

Koichi Nagao, MD PhD

Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center

Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.

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