Pain in the labia area is observed with nonspecific vulvitis and vulvovaginitis, bartholinitis, candidiasis, gardnerellosis, STIs, vulvar kraurosis, vulvodynia. May be constant or intermittent. In most cases, mild or moderate, has a raw or burning character, combined with itching, pathological discharge. Less often strong, pulling, bursting. Sometimes it is supplemented by weakness, general hyperthermia. The cause of the symptom is established according to the data of a gynecological examination, the results of laboratory and hardware techniques. Treatment includes general and local etiotropic therapy, physiotherapy, hormonal agents. Sometimes surgery is indicated.
Pain in the labia area is most often observed in acute and chronic specific and nonspecific infectious diseases. Other possible causes are degenerative and atrophic changes, allergic reactions. With local inflammatory processes, there is a danger of an upward spread of infection with damage to the vagina, cervix and body of the uterus, ovaries and fallopian tubes. Exogenous factors contributing to the development of this group of pathologies are:
Among the endogenous disorders that create favorable conditions for the occurrence of inflammatory and atrophic processes in this area include:
Acute vulvitis is manifested by pain, aggravated by touch, movement, urination. Itching, burning are observed. Labia reddened, edematous, sometimes covered with erosions and sores. With inflammation caused by staphylococcus, the discharge is thick and yellowish, with E. coli - greenish, watery, with an unpleasant odor. Sometimes there is general hyperthermia, inguinal lymphadenitis. With vulvitis in girls, sleep disturbances, increased nervous excitability are possible.
In chronic vulvitis, pain, swelling and hyperemia are detected in separate parts of the labia. Itching, burning, scanty leucorrhoea are noted. The sebaceous glands of the perineal region are hypertrophied. The pathology is characterized by an undulating course with frequent relapses. In girls, against the background of chronic inflammation and ulceration, synechia can form.
It is most often found in menopausal women and girls under 1 year of age. In the acute form, as in the previous case, itching, burning, pain, swelling and redness are found. The area of the perineum and the inner surface of the thighs are often hyperemic, macerated, covered with scratches. The type of whiter is determined by the type of pathogen. In severe cases, general infectious symptoms occur, erosion appears in the affected area. In the chronic course of vulvovaginitis, the signs are less pronounced, itching and pathological discharge predominate.
May be specific or non-specific. Initially, the labia minora on one side turns red and swells, a nodule forms in the region of the duct of the Bartholin gland. Then the lower third of the labia majora also becomes edematous, moderately painful. Itching, slight malaise are noted. Body temperature sometimes rises to subfebrile numbers.
With the development of purulent bartholinitis, one-sided pain increases sharply. Pain sensations acquire a jerking, pulsating, tearing character. The condition worsens, fever, signs of general intoxication are observed. Symptoms are especially pronounced with an abscess of the Bartholin gland.
labial herpes
During a lifetime, thrush is diagnosed at least once in 75% of women. The main symptoms are burning and itching in the vulva, combined with copious, cheesy, milky-white discharge with a foul odor. Unpleasant sensations intensify at night, after taking a bath and urinating, they can be combined with slight soreness. During sexual intercourse, pain and irritation increase.
It is the most common bacterial vaginosis. Along with burning and itching, a woman with gardnerellosis is disturbed by swelling and redness of the labia, abundant homogeneous foamy, watery or pasty grayish discharge with the smell of rotting fish. Soreness of the labia is insignificant, occurs or increases with sexual intercourse and urination. The general condition is not broken.
As with other infectious processes, the predominant symptoms are burning, itching, discharge from the genital tract. Pain syndrome in the initial stages is absent or slightly expressed. Increases with irritation, maceration, the formation of erosive defects, the development of bartholinitis.
Endophytic papillomatosis is latent, a detailed clinical picture is found in exophytic forms. The labia minora are more often affected, on which small gradually growing "papillae" appear. The lesions bleed easily. In the future, the growths turn red, pain, itching, leucorrhea with an unpleasant odor appear. With chronicity, there is an alternation of episodes of exacerbations and remissions.
With genital herpes, pain, paresthesia, itching, dysuria and pathological discharge are detected even at the prodromal stage. When rashes appear, the severity of symptoms decreases somewhat. Then the bubbles open, leaving behind painful ulcers and erosion. During the healing period, the area of defects is covered with crusts and heals, the manifestations gradually disappear.
Pathology is observed mainly in older women. The leading symptom of vulvar kraurosis is unbearable paroxysmal itching, which worsens at night. Combing the genitals causes abrasions, cracks, hemorrhages and foci of inflammation. Itching is complemented by pain. Initially, the labia are edematous, hyperemic, later wrinkled, dry, rough.
This disease is characterized by chronic pain in the labia, clitoris, vaginal vestibule. With vulvodynia proper, the pain is constant, with vulvar vestibulitis it is paroxysmal, provoked by pressure on the vestibule zone. Pathology develops against the background of neuropathy of the pudendal nerve, allergic reactions or individual hypersensitivity to irritants (synthetic underwear, hygiene products, oxalates in the urine, etc.).
The pain can be dull, sharp, aching. Occurs or increases with movement, the introduction of tampons, sexual intercourse, wearing tight or coarse underwear. There may be itching and a feeling of soreness. In some women, objective changes are detected - edema, hyperemia, rashes, whitish areas, ulcers, erosion. In other patients, the external genitalia look normal.
Determining the nature of the pathology is the responsibility of the gynecologist. The primary diagnosis of STIs is carried out as part of the basic examination, if necessary, to clarify the diagnosis and prescribe treatment, the patient is referred to a venereologist. The plan of diagnostic measures for pain in the labia may include the following procedures:
Gynecological examination
The list of general recommendations for most pathologies, accompanied by pain in the labia area, involves a change in hygiene habits, sexual rest, correction of the regimen and nature of nutrition, refusal to use synthetic underwear, highly allergenic or irritating hygiene products. Therapeutic measures for inflammatory and infectious processes include:
Patients with vulvodynia are advised to stop eating foods high in calcium oxalate (celery, strawberries, chocolate) to reduce the amount of this compound in the urine. With mild pain, exercises to strengthen the muscles of the pelvic floor are useful. Balneotherapy and physiotherapy are effective. If there are signs of atrophy, suppositories and creams are used to stimulate regeneration. With ovarian hypofunction, hormonal therapy is prescribed.
Patients with vulvar kraurosis are recommended antihistamines and sedatives. With persistent itching, a blockade of the pudendal nerve is performed. Topically applied hormonal ointments with estrogens, androgens, corticosteroids and progesterone. The type of medication is selected taking into account age and endocrine status. Effective balneotherapy, reflexology, laser therapy, photodynamic therapy, X-ray therapy. It is necessary to take biostimulants, immunocorrectors and vitamin preparations.
In most cases, pain in the area of the labia is eliminated by conservative methods. Operations may be required in the presence of the following pathologies: