A burning sensation in the vaginal area, often accompanied by itching, is a common complaint. Medically known as vulvovaginitis, this discomfort is a symptom, not a diagnosis, meaning the underlying cause varies widely. The feeling can range from a mild sting to persistent inflammation that affects daily life. Understanding the potential origins is the first step toward finding relief and appropriate treatment.
Causes Related to Infection
Acute vaginal burning often results from an imbalance in the vaginal microbiome, leading to infections that require medical intervention. The most recognized cause is a yeast infection (candidiasis), involving an overgrowth of the Candida fungus. This typically presents with intense burning and itching, along with a thick, white, odorless discharge often described as cottage cheese-like.
Bacterial vaginosis (BV) results from an imbalance where protective Lactobacillus bacteria decrease. BV-related burning is often milder and is accompanied by a thin, grayish discharge with a distinct, strong “fishy” odor, which may worsen after intercourse. Unlike yeast infections, BV usually does not cause significant external inflammation.
Sexually transmitted infections (STIs) also cause burning and irritation, sometimes with unique symptoms. Trichomoniasis produces a profuse, frothy, greenish-yellow discharge with a foul odor and can cause painful urination. Genital herpes causes painful blisters or sores, often preceded by a burning or tingling sensation. Gonorrhea and chlamydia are frequently asymptomatic but may occasionally cause burning during urination. These infectious conditions require professional medical testing for accurate diagnosis and prescription treatment.
Environmental and Contact Irritation
The delicate skin of the vulva and vagina can react to external substances, causing non-infectious vulvovaginitis. This is often an allergic reaction to chemicals in personal care and household products. Exposure to irritants like perfumed soaps, body washes, bubble baths, and laundry detergents can strip the skin’s protective barrier, causing inflammation and stinging.
Products used near the vagina, such as feminine sprays, douches, and scented sanitary products, contain fragrances or dyes that trigger contact reactions. Spermicides and latex in barrier contraceptives can also cause localized allergic sensitivity, resulting in immediate or delayed burning after sexual activity. Identifying and eliminating the specific offending product is the most effective treatment strategy.
Physical irritants, friction, and moisture also lead to burning. Tight-fitting or synthetic fabrics trap heat and moisture, creating an environment conducive to irritation. Excessive wiping or friction during intercourse without sufficient lubrication can cause micro-abrasions in the sensitive tissues. Switching to loose-fitting cotton underwear and using a water-based lubricant during sex helps prevent this mechanical irritation.
Hormonal Changes and Chronic Skin Conditions
Long-term physiological changes, particularly hormone levels and chronic dermatological conditions, form another category of causes. Genitourinary Syndrome of Menopause (GSM) is a chronic cause of burning related to the decline in estrogen, typically occurring during and after menopause. Low estrogen causes vaginal and vulvar tissues to become thin, dry, and less elastic. This atrophy results in chronic burning, soreness, and pain, especially during sexual activity, making the area susceptible to inflammation and micro-tears.
Chronic dermatological issues can cause persistent burning unresponsive to standard infection treatments. Lichen Sclerosus (LS) is a chronic inflammatory skin condition affecting the vulva, causing intense itching and burning. LS is characterized by white, patchy skin changes and can lead to scarring and changes in vulvar architecture if untreated. Management requires specialized care, often involving high-potency topical steroid ointments to control inflammation and prevent long-term damage.
Lichen Simplex Chronicus develops from a cycle of persistent scratching in response to an initial irritant, leading to thickened, leathery skin. Systemic conditions like poorly controlled diabetes also increase the likelihood of recurrent yeast infections, as high blood sugar favors fungal growth. These chronic causes require a thorough medical evaluation, as their treatment is distinct from acute infections.
Understanding Diagnosis and When to See a Doctor
While mild burning may be temporary, certain “red flag” symptoms indicate the need for prompt medical attention.
When to Seek Medical Attention
Burning accompanied by a fever, severe lower abdominal or pelvic pain, large sores or blisters, or a foul-smelling or unusual discharge warrants an immediate visit to a healthcare provider. If the burning sensation lasts for more than 48 hours despite attempts to eliminate irritants and practice gentle hygiene, a medical consultation is necessary.
The Diagnostic Process
A healthcare professional determines the precise cause by starting with a detailed medical history, asking about the duration, severity, and associated symptoms. The physical examination includes a pelvic exam to look for signs of inflammation or skin changes. A crucial diagnostic step is the collection of a vaginal fluid sample for a “wet mount,” which is examined under a microscope to identify yeast, bacteria, or parasites.
The acidity of the vagina is also tested by measuring the vaginal pH level. BV and trichomoniasis often raise the pH above the normal acidic range of 3.8 to 4.5, while yeast infections typically do not affect it. Self-treating a suspected yeast infection when the actual cause is BV or a chronic condition can delay the correct diagnosis and potentially worsen symptoms. A professional diagnosis ensures the prescribed treatment is effective for the specific underlying condition.