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Urology

My Vagina Burns After Sex, What Can I Do?

Dr. Joe Pazona

You finally met that special someone. Someone who treats you right in and out of the bedroom. It’s magic. Then after a spiritual intimate experience . . . “owwweee!!! It hurts down there!”

Vaginal burning after sex is the last thing that you need. It’s hard enough dealing with normal lady business issues. Now what’s going on?

The causes of vagina burns after sex are numerous. Trying to sort through all of them can be overwhelming. But fear not! We are here to help.

VirtuCare specialists are experts of the urinary tract and lady business. Let’s walk you through a practical way to approach vaginal burning after sex, so you can have a speedy recovery.

Option 1: If you suspect an infection, receive an examination and urine check.

Common things being common, an infection should be considered the number one cause of vaginal burning after sex. Bacterial, viral and fungal infections are all possibilities. Now not everyone has to run off to the doctor, but if your situation sounds similar to any of the following, then don’t delay and seek in-person medical attention.

Urinary tract infection

A UTI or bladder infection is commonly seen after sexual intercourse. Bacteria live around the vaginal opening, even if you’re a neat freak. Vaginal intercourse increases the likelihood of these little buggers working their way up the urethra and into the bladder.

UTIs typically present with urinary frequency, urgency and burning. Since everything down there hurts, it can be difficult to discern from vaginal burning.

A point-of-care urine dipstick is the first step. Another option is at-home urine test strips like these from Utiva Health . A self-diagnosis will allow you to avoid an urgent care visit. Unfortunately all urine test strips have a limitation in their ability to definitively rule in or rule out a UTI.

A follow up urine culture, which takes up to 72 hours to result, may be necessary to know for certain if you have a bladder infection.

If you’re placed on the correct antibiotics, then vaginal burning should resolve within 1-2 days. If it doesn’t, then maybe you have a resistant bacteria or something else going on.

Yeast infection

When there is an imbalance in bacteria around the vagina, yeast can overtake the territory. This often occurs after a course of antibiotics or change in hormone levels. A yeast infection should be suspected if you notice vaginal burning, itchiness, redness of the labia/vaginal opening, and burning with urination.

Yeast infections usually respond to topical, over-the-counter (OTC) anti-fungal creams like clotrimazole. If your vagina continues to burn, then you may need a stronger anti-fungal oral medication and/or consideration of other causes.

Herpes infection

Herpes is caused by the herpes simplex virus (HSV) which is transmitted through sexual activity. Once you’ve been exposed to HSV, you are at risk for lifelong recurrences (sorry). Herpes causes painful ulcers and/or blisters anywhere in the private area.

Vaginal burning from HSV can occur any time after sex. Treatment with an anti-viral medication (e.g. acyclovir) can shorten the length of a HSV outbreak. There are also maintenance medications if you have flare-ups often.

Gonococcal or chlamydial infection

Another sexually transmitted infection is caused by gonorrhea or chlamydia. These unwelcome visitors can infect the cervix, and less commonly, the urethra in women. Chlamydia infections tend to be more subtle in women. Gonorrhea can present with a thick vaginal discharge in addition to vaginal burning after sex.

Gonorrhea and chlamydia infections are typically diagnosed with a culture from a cervical swab. While awaiting a diagnosis, you’ll usually be placed on antibiotics that treat both bacteria. It’s not uncommon to be co-infected with both bacteria at the same time.

When left untreated, or in more severe cases, these infections can progress into pelvic inflammatory disease (PID). This means the infection has spread to the uterus and fallopian tubes. In addition to vaginal burning after sex, you may experience worsening pelvic pain and fevers. This can be a serious medical situation, so don’t delay evaluation if PID is suspected.

Option 2: Give it some rest.

Now that you’ve been evaluated for an infection, it’s time to give your lady friend some rest if your vagina still burns after sex. There are a number of non-infectious reasons for vaginal burning burning after sex that will improve with a break.

Physical trauma

Let’s be honest. Vaginal intercourse is a form of physical trauma to the vagina. Although the goal is for intercourse to be enjoyable for a woman, too much of a good thing can lead to some discomfort.

Prolonged or excessive (if there’s such a thing) intercourse can be the sole cause of why the vagina burns after sex. Taking a break may be all that is necessary. If you’re feeling frisky, get creative and focus on other forms of physical intimacy not involving vaginal penetration.

Allergies

Maybe you don’t need a break from sex itself. It’s possible the condom, lubricant or sex toy you recently used is the source for your vaginal burning after sex. If you’ve introduced a new product in the bedroom, this should raise your suspicion of an allergy.

Typically an allergy will present with vaginal burning, redness/hives, and itchiness. If you ever experience difficulty breathing, then head to the ER ASAP.

To prevent future allergic reactions, we recommend using non-latex condoms if necessary. However you should realize that non-latex condoms may not prevent pregnancy or STIs as reliably. Water-based lubricants seem to be the best tolerated lube if an allergy is suspected.

Treatment of a mild allergic reaction, other than rest, may involve using an antihistamine like Benadryl or a steroid (topical OTC vs. oral).

Increase lubrication

We have a saying in the urology world: “you can never use too much lube.” Although this can lead to messy sheets in the bedroom, plenty of lube will prevent vagina burns after sex (and friction burns of the penis for those with male partners). Personally, I choose the messy sheets as a painless alternative (and as a man I hate doing laundry . . . I know surprise).

This piece of advice is pretty self-explanatory. Don’t be shy about using lubrication. It’s also normal for women to have a decrease in her natural vaginal lubrication with age (more on this to come).

It’s beyond the scope of this article to do a deep dive on lube. If you need a suggestion however, then why not combine lubrication with a little CBD to improve the sensation of your lady friend. There’s plenty of evidence to suggest, along with a few hundred testimonials, that sex with CBD oils is not only safe and legal, but just feels better.

Option 3: Relax your pelvic floor.

The vagina sits in the pelvis surrounded by the urethra/bladder, uterus and anus/rectum. All of these structures are supported by the pelvic floor muscles. During vaginal intercourse, all of these areas are also being stressed in one way or another (there’s only so much room down there).

pelvic floor illustration

 

If the pelvic muscles are tight, then vaginal intercourse is going to be a challenge and may lead to vagina burns after sex. Every woman holds the tension in their body in different places. For some it’s the head and neck (headaches), others it’s the lower back (back pain), and for others it’s in the pelvic floor (pelvic pain and sex hurts!).

Treating pelvic floor pain can be a challenge and is beyond the scope of this article. We recommend finding a pelvic floor specialist who may suggest one or many of the following:

  • Counseling (previous sexual trauma, depression, anxiety are real things that need to be talked about with an expert)
  • Pelvic physical therapy
  • Muscle relaxants (oral vs. vaginal suppository)

Option 4: Talk to your gynecologist.

There are a couple more medical conditions that should be ruled out as potential causes of vagina burns after sex:

Premenopausal – endometriosis

Endometriosis can be a terrible medical issue. It affects up to 10% of women aged 25-40 years old and leads to a variety of symptoms in pre-menopausal women including:

  • Heavy menstrual periods
  • Back pain
  • Pelvic pain
  • Pain during or after sex
  • Infertility

 

Endometriosis is best evaluated by a gynecologist, the expert who only deals with the lady business.

Postmenopausal – atrophic vaginitis

Estrogen is an essential female hormone that keeps all of the lady parts youthful. During menopause, the ovaries stop producing estrogen, leading to a number of postmenopausal symptoms. In the private area this includes:

  • Vaginal dryness
  • Vaginal atrophy (scarring or narrowing of the vagina and its opening)
  • Pain during and after sex

 

Hormone replacement therapy in women is controversial, and poorly understood by most medical professionals in my opinion. Needless to say, most women would see an improvement in these vaginal symptoms with some form of estrogen replacement therapy.

Most healthcare professionals would agree that vaginal estrogen cream is safe and most likely to improve symptoms of vaginal dryness, scarring and pain during sex. So if you’re over the age of 50 and vagina burns after sex are becoming commonplace, then you probably need a little estrogen to remedy the situation.

Option 5: Have a virtual visit with a telemedicine expert.

Hopefully by now you’ve found the help you need to treat the fire beneath your panties.

If not, and you need help finding the best medical expert, then a good place to start would be a telemedicine evaluation with a VirtuCare specialist . Not only can we prescribe medications, but we can guide you to the best in-person expert within our nationwide network of colleagues. At $89 for a consultation from home, you are a few clicks away from an affordable solution to a painful problem.

Remember, you’re not alone. Don’t suffer longer than you have to with a burning vagina after sex. Allow us to help you get busy in the bedroom once again.

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts.
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