Vaginal swelling, an increase in the size of the labia, clitoris, or vaginal opening, can manifest as puffiness, discomfort, or pain. It can stem from normal physiological responses or underlying medical conditions, making it important to understand its causes.
Normal Causes of Vaginal Swelling
The vaginal area can experience temporary swelling as a natural response to various bodily processes. Sexual arousal increases blood flow (vasocongestion), causing the labia and clitoris to engorge and swell. This normal response typically resolves within an hour.
Hormonal fluctuations throughout the menstrual cycle can also contribute to temporary puffiness. During pregnancy, increased blood volume and elevated hormones like estrogen and progesterone can cause vulvar and labial swelling. The growing uterus also exerts pressure on pelvic blood vessels, contributing to fluid retention.
After childbirth, vaginal tissues may swell due to trauma and the natural healing process. Vigorous exercise or friction from tight clothing can also cause temporary vulvar irritation and swelling. This typically resolves once the irritant is removed.
Medical Conditions Causing Vaginal Swelling
Vaginal swelling can also signal an underlying medical condition, with infections being a frequent cause. Yeast infections (Candida overgrowth) commonly cause swelling, intense itching, burning, and thick, white discharge. Bacterial vaginosis (BV), an imbalance in vaginal bacteria, can also lead to swelling, often accompanied by a grayish discharge and a “fishy” odor.
Sexually transmitted infections (STIs) such as trichomoniasis, herpes, chlamydia, and gonorrhea are other potential infectious causes. Trichomoniasis can cause significant labial swelling, along with a yellow, green, or gray discharge and an unpleasant odor. Genital herpes can cause painful blisters and sores, contributing to localized swelling.
Inflammatory conditions and allergic reactions represent another category of causes. Contact dermatitis occurs when vulvar skin reacts to irritants or allergens in products like soaps, detergents, lubricants, or fabrics, causing redness, itching, and swelling. Lichen sclerosus, a chronic inflammatory skin condition, can also lead to thinning, white patches on the skin that may cause itching, tearing, and swelling of the vulva.
Cysts and growths can also be responsible for localized swelling. Bartholin’s cysts form when glands near the vaginal opening become blocked, accumulating fluid. If infected, they can become painful abscesses with noticeable swelling. Vaginal cysts, such as epidermoid or Gartner’s duct cysts, are less common but can also cause swelling if they grow large or become symptomatic.
Trauma or injury, from direct impact, accidents, or rough sexual activity (especially with insufficient lubrication), can cause immediate swelling, often with pain or discomfort. Less common causes include lymphedema, which involves fluid retention due to lymphatic system issues, or certain systemic conditions that affect fluid balance.
Accompanying Symptoms and When to Seek Medical Care
Pain or discomfort, especially if severe, persistent, or worsening, often indicates a need for medical evaluation. Persistent itching or burning sensations also warrant attention. Changes in vaginal discharge, such as an unusual color, odor, or consistency, are indicators of potential infection or imbalance.
Redness, rash, or the presence of blisters, sores, or lesions on the genital area are concerning symptoms that should prompt a medical visit. Systemic symptoms like fever or chills accompanying vaginal swelling suggest a more widespread infection. Difficulty or pain during urination, or painful sexual intercourse, are also signs that something may be amiss.
Sudden, severe, or rapidly worsening swelling, or any accompanied by abnormal bleeding, requires prompt evaluation. If swelling doesn’t resolve within days, worsens, or includes these concerning symptoms, seek medical care for diagnosis and treatment.
Diagnosis and Management
When seeking medical attention for vaginal swelling, a healthcare provider will begin with a thorough medical history, asking about symptoms, their duration, and any related factors. This is followed by a physical examination, including a pelvic exam, to visually inspect the vulva and vagina for signs of swelling, redness, discharge, or lesions.
To identify the underlying cause, diagnostic tests may be performed. These can include vaginal discharge swabs for infections (yeast, BV), urine tests for UTIs, or blood tests for STIs or systemic conditions. Rarely, a biopsy may be needed for growths or suspicious lesions.
Management of vaginal swelling depends entirely on the identified cause. For infections, medications such as antibiotics, antifungals, or antivirals are commonly prescribed. Inflammatory conditions or allergic reactions may be managed by avoiding irritants and using corticosteroids to reduce inflammation.
Symptom relief often includes sitz baths, cold compresses, and over-the-counter pain relievers. In some instances, such as with large or infected Bartholin’s cysts, surgical intervention may be required for drainage or removal. Lifestyle adjustments, such as wearing breathable cotton underwear or using gentle, fragrance-free hygiene products, can also help prevent irritation and recurrence of swelling.