What causes vaginal burning? Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer at Bonafide provides insights into the many reasons women may experience vaginal burning, and what to do about it.
A burning sensation in the vagina is not uncommon, especially among those who are in menopause.1
But hormonal shifts experienced during this transitional period aren’t the only cause of vaginal burning. In fact, there can be many, ranging from normal vaginal changes, to irritants, infections, and more.
In this article, we’ll review why vaginal burning occurs during menopause, along with other common causes of vaginal burning, as well as when you should see a healthcare provider about your symptoms.
Is it Normal to Experience Vaginal Burning After Sex?
While it’s not always considered “normal,” vaginal burning after sex is not an uncommon sexual occurrence experienced by women.
Low physical arousal, which can contribute to a lack of lubrication as that is a physical sign of arousal, before engaging in sex, could contribute to the symptom of vaginal burning, especially during menopause when libido tends to drop.2 This sensation may be intensified with longer duration, high-friction intercourse and low levels of vaginal lubrication.3
Incorporating more foreplay to support physical arousal or considering sexual lubricants can help remedy this issue in many cases.4 Be careful when choosing a lubricant, however, especially if you have sensitive skin, as some ingredients and properties my actually exacerbate vaginal burning such as propylene glycol, flavors or scents or spermicides.
According to Dr. Dweck, low arousal can result from not only menopause, but other variables as well.
“Arousal, or vaginal lubrication, the telltale physical sign of sexual excitement in women, is often diminished during perimenopause and menopause due to changes in hormones, like low estrogen, in addition to diminished blood flow, medical conditions, relationship issues, stress and sexual boredom."
She adds that, “Sexual arousal can be enhanced through increased foreplay and vibrator use and facilitated with regular vaginal moisturizers and on demand lubricant use during intimacy. A more proactive approach would include incorporating a vaginal moisturizer, used regularly and having the availability of a lubricant, which can be used in the moment.”
Vaginal burning after sex, however, may indicate other issues, requiring modifications to your vaginal care routine or even a specific medical treatment. Let’s explore a few causes of vaginal burning— whether it’s after sex or during other times of the day and night— below:
What Causes Vaginal Burning?
Vaginal burning has many potential causes. Some of the more common ones are:
Menopause
A decline in estrogen during menopause influences many changes throughout a woman's body— and the vagina is not immune to these hormonal shifts.
Drops in estrogen may lead to thinning of the vaginal walls, otherwise known as vaginal atrophy.5 In many cases, this can contribute to vaginal dryness, vaginal burning, irritation, and pain, especially during or after sex.
According to Dr. Dweck, vaginal atrophy during menopause is not uncommon and can be confirmed by a healthcare provider.
“Vaginal atrophy is extremely common with the majority of menopausal women being affected at some point during the menopausal transition and postmenopause," she explains. “Vaginal atrophy is suspected during times of low estrogen levels, including menopause, and diagnosis can be confirmed by one’s healthcare provider through taking a good history and conducting a physical exam with lab work if needed to rule out other causes. Symptoms of vaginal dryness, irritation and painful sex are typical and a gradual onset of this set of symptoms are not unusual."
Accompanied by hot flashes, weight gain, and other physical and emotional changes,6 vaginal burning caused by menopause can negatively impact a woman’s quality of life. It’s been estimated that up to 90% of women don’t seek treatment for their symptoms of vaginal dryness and irritation associated with menopause, but fortunately effective management options do exist.7
Dr. Dweck also cautions that vaginal atrophy may be a symptom experienced later during menopause.
“Vaginal atrophy is most commonly experienced later in menopause; and unlike hot flashes and night sweats, vaginal atrophy is chronic and progressive over time, if not addressed.”
Products such as vaginal moisturizers, when used consistently, can help to alleviate vaginal burning during menopause, in addition to prescription estrogen creams or vaginal rings.8
Irritation Associated with Vaginal Burning
Irritation is one of the simpler potential causes of vaginal burning, and therefore one of the easiest to remedy. Contact dermatitis, a lengthier name for irritation or a rash caused by direct contact with an external irritant, can affect the vagina in the same way that it can impact other areas of skin on the body.9
Common irritants that may cause or exacerbate vulvar and/or vaginal burning, include:10
- Fragranced Soaps
- Non-breathable Fabrics
- Perfumed wipes (and other heavily scented products)
- Douches
Vaginal burning caused by these types of irritants can be accompanied by “stinging” or “raw” sensations.11
Allergies and Vaginal Burning
Anyone can have allergies to certain personal care products or substances, including condoms, latex, lubricants, and even sperm.12
If your vaginal burning is caused by an allergy, you may also experience the following symptoms:13, 14
- Vaginal redness
- Vaginal swelling
- Vaginal itching
- Hives
- Difficulty breathing
It’s important to check in with your healthcare provider if you experience any of the above symptoms and believe they may be associated with an allergy, so they can provide the appropriate treatment.
Vaginal Burning with Yeast Infections
Yeast infections are not uncommon, affecting nearly 75% of women throughout their lifetime.15
Also known as vaginal candidiasis, yeast infections are a type of fungal infection that causes vaginal burning as well as intense itching, irritation, and an abnormal white, cottage cheese-like discharge.16 Recent (or frequent) antibiotic use, excess moisture in the genital area (think wearing a wet bathing suit for too long), certain contraceptives, and pregnancy can increase a woman’s risk for yeast infections.17
Some women may have trouble distinguishing between infections such as yeast infections, and vaginal atrophy. According to Dr. Dweck, yeast infection symptoms are typically more distinct.
“A yeast infection usually involves a noticeable and acute thick, white vaginal discharge and intense itching,” she says. “Vaginal atrophy is typically a symptom with a more gradual onset that includes vaginal dryness, burning and painful sex noted during times of low estrogen, such as during menopause or perimenopause.”
If you’ve never experienced a yeast infection before, and you think you may be struggling with one, be sure to check in with your provider for proper diagnosis and treatment.
Bacterial Vaginosis and Vaginal Burning
Bacterial vaginosis (BV) may cause pain and discomfort in the vagina and occurs when beneficial and harmful vaginal bacteria levels are off-balance.
Common symptoms of BV can include:18
- Unpleasant and characteristic fishy vaginal odor
- Vaginal itching
- Burning during urination
- Gray, white, or green thin vaginal discharge
It’s always a good idea to check in with your healthcare provider if you’re experiencing any of the above-mentioned symptoms related to BV, as they can properly diagnose you and help treat the infection with the appropriate antibiotics.
Urinary Tract Infections
A urinary tract infection (UTI) is an infection of any part of the urinary system including the bladder, urethra, or kidneys.19
While this type of infection doesn’t originate in the vagina, women with a UTI may experience a burning sensation, called dysuria, when urinating.
Other common symptoms of a UTI include:19
- Cloudy urine
- Foul-smelling urine
- Blood in urine
- Lower abdominal pain
- Fatigue
- Frequent urge to urinate
Again, as with any infection, give your provider a call if you suspect you’re dealing with a UTI. This type of infection requires a course of antibiotics to adequately treat it. It’s also important to treat UTIs promptly, as undiagnosed infections can lead to more serious complications that can be more difficult to address.
Vaginal Burning Due to Sexually Transmitted Diseases
There are many types of sexually transmitted diseases, and vaginal burning is often a common symptom shared among them. The Center for Disease Control and Prevention estimates the occurrence of millions of STDs per year in the United States alone, with chlamydia being the leading STD reported.21
Examples of STDs that may cause vaginal irritation include:22
- Chlamydia
- Gonorrhea
- Trichomoniasis
- Genital Herpes
Left untreated, STDs can lead to more severe illness, further disease spread, and pregnancy complications.23 If you suspect you’re dealing with an STD, it’s important to seek out testing and guidance regarding treatment from a healthcare professional.
How to Stop Vaginal Burning
Learning how to stop vaginal burning requires exploring and determining its underlying cause.
In the case of simple irritation, for example, avoiding products that cause it can often stop vaginal burning altogether. And if vaginal dryness is the root of your issue, — with menopause being the culprit— using lubrication, foreplay, and vaginal moisturizers to your advantage may help.
However, if the cause of vaginal burning is a separate medical issue, such as an infection, allergy, or sexually transmitted disease, you will likely need further diagnosis and treatment from your provider.
When to Talk to a Healthcare Provider About Vaginal Burning
If you’re experiencing uncomfortable symptoms such as vaginal burning, it’s worth exploring its causes with a healthcare provider— no matter your age or menopausal status. Your provider can help to narrow down the root cause of your vaginal burning and suggest treatment options to help you better manage your symptoms.
Resources
- https://jamanetwork.com/journals/jama/fullarticle/2614191#
- https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-sex-changes-after-menopause#
- https://www.medicalnewstoday.com/articles/vagina-burns-after-sex#causes
- https://www.everydayhealth.com/menopause/painful-sex-menopause-solutions/
- https://jamanetwork.com/journals/jama/fullarticle/2614191
- https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
- https://www.health.harvard.edu/womens-health/dont-ignore-vaginal-dryness-and-pain
- https://www.acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know
- https://www.nhs.uk/conditions/contact-dermatitis/#
- https://www.medicalnewstoday.com/articles/vaginal-irritation#noninfectious-vaginitis
- https://www.medicalnewstoday.com/articles/321104#causes
- https://www.medicalnewstoday.com/articles/vagina-burns-after-sex#causes
- https://my.clevelandclinic.org/health/diseases/25024-semen-allergy
- https://www.webmd.com/sex/what-to-know-allergy-latex-condoms
- https://pubmed.ncbi.nlm.nih.gov/33741400/
- https://www.medicalnewstoday.com/articles/151172
- https://my.clevelandclinic.org/health/diseases/5019-vaginal-yeast-infection
- https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279
- https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
- https://www.medicalnewstoday.com/articles/321104#causes
- https://www.cdc.gov/sti/php/communication-resources/the-state-of-stis.html
- https://www.webmd.com/women/vaginal-itching-burning-irritation
- https://asm.org/articles/2022/december/the-dangers-of-undiagnosed-sexually-transmitted-in
