Do you have chronic vaginal burning?
It’s never fun to feel like your vagina is on fire. And wondering what could be causing this stinging, irritated, raw sensation is just as stressful. Burning in or around your vaginal opening can have many different causes, including a yeast or bacterial infection, hormone-related dryness, irritation from things like soaps or detergents, and skin conditions. And often (luckily), the cause is easy to find and treat.
But if your burning keeps coming back, lingers after treatment, or comes with other symptoms like unusual discharge or bleeding, odor, sores, or pelvic pain, it’s best to check in with your doctor to see what could be causing your symptoms.
And if your burning sticks around for 3 months or longer without any identifiable cause, you could be dealing with a chronic pain condition known as vulvodynia.
What is the vulva vs. vagina?
Before diving into the specifics of vulvodynia, it may help to get a really specific understanding of your anatomy down there.
The parts of your vulva include the labia, the clitoris, the vaginal opening, and the urethral opening.
The vulvar vestibule is an anatomical region of your body. You’ll find it between your labia majora, the outer lips of your vulva. It contains several organs and structures important for female function and sexual pleasure.
The vulvar vestibule is the area at the entrance of your vagina, which can be affected by vulvodynia. It encompasses two major structures: Bartholin’s glands and Skene’s glands. These glands are responsible for producing lubrication during sexual intercourse. They are frequently affected in cases of vulvodynia.
To learn even more about your vulva (and pelvic floor), join the V-Hive. Members have access to live, members-only Q&As with Dr. Sara and other women’s health experts.
What are the most common causes of vaginal burning?
Below are the most common causes of vaginal and vulvar burning.
Vaginal or urinary infection
One of the most common causes of vaginal burning is a vaginal or urinary infection, including:
- Urinary tract infection (UTI): A UTI is when bacteria cause an infection somewhere in your urinary tract. It can cause pelvic, abdominal, and vulvar pain. It can also cause symptoms like burning with urination, urinary frequency and urgency, and blood in the urine.
- Yeast infection: This happens when there’s an overgrowth of yeast in the vaginal area. A yeast infection can cause intense vulvar itching, burning, vulvar and vaginal redness and swelling, and thick, white discharge.1
- Bacterial vaginosis (BV): This is an overgrowth of the bacteria that normally lives in your vagina. In addition to pain, BV can cause unusual discharge and a fishy vaginal odor.2
- Sexually transmitted infection (STI): Infections like gonorrhea, chlamydia, and genital herpes can cause vulvar and vaginal burning, as well as other symptoms like burning with urination, pain with sex, and sores in the vulvar area.
Contact dermatitis
The skin around your vulva is very sensitive. Sometimes, chemicals in the soaps, detergents, and other products you use on your clothes or skin can cause irritation, redness, and pain. Certain fabrics and friction from your clothes can also irritate sensitive vulvar skin and cause a burning sensation.
Low estrogen
Estrogen is a very important hormone for helping to keep your vulvar and vaginal tissues healthy, plump, and moisturized. But when estrogen levels are low — like during menopause, postpartum, breastfeeding, or cancer treatment — these tissues can become thin, dry, and painful.
Lichen sclerosus
This is an inflammatory, autoimmune skin condition that can affect the skin around your vulva and anus.3 It can cause the affected skin to become thin, pale, and fragile, leading to burning, pain, and itching. Fragile skin can also tear and crack. Over time, lichen sclerosus can cause scarring and even changes in your vulvar anatomy.
Pelvic floor tension
Sometimes, your pelvic floor muscles can become too tight. This muscle tension can cause feelings of pain, pressure, and tension in the vulvar area. Pelvic floor muscle tension can also reduce blood flow and irritate nearby nerves, which can also lead to pain, burning, and discomfort in the vulva and vaginal. Moving or touching these tight muscles can also be painful.
Pudendal neuralgia
The pudendal nerve is an important nerve that helps control the movement and sensation in your pelvic floor area, including your vulva. When this nerve gets irritated, inflamed or compressed it can cause burning, tingling, or aching pain in the vulva.
Vulvodynia
Vulvodynia is long-lasting discomfort or pain in your vulva that lasts for 3 months or longer and doesn’t have an identifiable cause.4 Vulvodynia can show up without any obvious cause, or it can develop after a recent yeast infection or injury.
What Causes Vulvodynia?
Experts don’t know exactly what causes vulvodynia. It’s likely caused by a combination of things, rather than one single factor. The possible causes may include:5
- Irritation and injury to the nerves of the vulva
- Hormonal changes
- Genetic inclination, allergies, or skin sensitivities
- Muscle spasm or dysfunctions of the pelvic floor
- Long term reaction to infections or increased inflammation
- Psychological factors like anxiety, depression, or a history of sexual abuse
There are also different types of vulvodynia.6 These are usually described based on where or when you feel the pain:
- Generalized vulvodynia: This is when symptoms affect multiple areas or your entire vulva. It may be constant or occur intermittently.
- Localized vulvodynia: this is when pain is limited to one specific part of your vulva, like your clitoris or vestibule.
- Vestibulodynia: this is when pain is localized to the skin that surrounds your vaginal opening, the vestibule. It may be especially noticeable when touched, like during sex or when inserting a tampon.
- Clitorodynia: This is when pain is localized to your clitoris.5 It may feel like burning, stinking, or rawness and can be aggravated by touch, pressure, or sex.
How is Vulvodynia Diagnosed?
Vulvodynia is considered a “diagnosis of exclusion.” This means your doctor will first look for identifiable causes of vulvar discomfort or burning, like an infection or allergic skin reaction, before making this diagnosis.
But this doesn’t mean nothing is causing your pain or that it’s all “in your head.” Vulvodynia is a complex pain condition that can’t be diagnosed with a simple lab test or visual exam. Instead, it’s usually diagnosed based on your symptoms, health history, and a physical pelvic exam.
During the exam, your doctor or pelvic floor physical therapist may perform a cotton swab test. This involves gently touching different areas of your vulva with the tip of a cotton swab to see where you feel pain and sensitivity. This will help them figure out exactly where your pain is coming from and rule out other possible causes. They may also do a pelvic floor muscle examination to see if your muscles are contributing to your symptoms.
Be sure to tell your doctor about your symptoms and health history, including any ongoing vaginal dryness, pain, itching, or burning. You should also tell them about any past surgeries or other treatments related to your vulvar pain.
What Does Vulvodynia Feel Like?
Vulvodynia can feel different from person to person, but it’s often described as a chronic burning, stinging, or irritated sensation in or around the vulva. Vulvar pain can occur across the entire vulvar region or be localized to a specific area. Other symptoms of vulvodynia may include:4
- Throbbing or aching pain
- Pressure or tenderness around your vulva
- Itching or increased sensitivity
- Swelling or a raw, irritated sensation
The pain may be constant or come and go and it can vary in intensity and the location of the symptoms. Many people noticed increased symptoms:
- During or after intercourse
- When wiping after urination
- With certain activities, such as biking and prolonged sitting
How to help vulvodynia?
Folks with vulvodynia should seek help from their healthcare provider. It can be a challenging condition to deal with alone. Various vulvodynia treatments can be helpful, depending on the severity of the pain, including:
- Antidepressants
- Anticonvulsants
- Pain relievers
- Avoiding wearing tight clothing
- Avoiding irritation from chemicals or soaps
- Practicing good hygiene
- Nerve block injections (for severe cases)
- Surgical procedures (for severe cases)
PT and Vulvodynia
Treatment for vulvodynia typically includes a multidisciplinary approach. Physical therapy can often play a major role in relieving pain. Your therapist will perform a thorough evaluation and create a care plan tailored to you. Your pelvic floor physical therapist may consider the following treatment modalities.
#1 Manual Therapy
Also known as manipulative therapy. This treatment modality addresses the mobility of your muscles, joints, and connective tissues.
#2 Pelvic Floor Muscle Coordination
Coordinate your pelvic floor muscles to contract and relax at the appropriate times.
#3 Hygiene Best Practices
Practice good general hygiene to keep you happy and healthy downstairs. Wearing cotton underwear, avoiding scented laundry detergents, and cleansing only with water or a ph-balanced clean vulvar wash is best practice.
#4 Modified Motion
Learn to modify activities to promote reduced pain and improve pelvic floor functionality.
#5 Behavioral Strategies
Learn behavioral strategies to make pain management easier for everyday activities (including sex).
#6 Desensitization
Strategies can decrease tissue sensitivity and help relax your pelvic floor muscles.
#7 Stretch and Relax
A physical therapist will likely prescribe exercises. Some of those may include stretching and relaxation, nerve gliding, or strengthening exercises, depending on what your body needs.
If you’re interested in finding short workouts that can be done from the comfort of your home, check out the different exercise programs in the V-Hive.
Cool vulvar burning with the V-Hive
From infection and skin conditions to hormone changes and pelvic floor tension, vulvar and vaginal burning can have many different causes. Many of these conditions are treatable. But if you have burning that continues for 3 months or longer, without an identifiable cause, it may be vulvodynia.
Vulvodynia is a complex, chronic pain condition that can cause burning, stinging, itching, or rawness in your vulva. And while there isn’t a known cause, or a simple test to help diagnose it, treatment is available. Along with medications and lifestyle changes, pelvic floor physical therapy is key to easing your pain.
Work with a pelvic health therapist or take our quiz to get a personalized pelvic floor roadmap to help you get pain relief and improve your quality of life. And join the V-Hive for hundreds of expert-guided pelvic floor and core workouts to help you reach your pelvic health goals.
For more information on vulvodynia, check out The National Vulvodynia Association or International Society for Women’s Sexual Health.
References
- Jeanmonod, R., et al. (2024). Vaginal candidiasis. StatPearls.
- Carlson, K., et al. (2025). Bacterial vaginosis. StatPearls.
- Chamli, A., et al. (2023). Lichen sclerosis. StatPearls.
- Women’s Health Research at the National Institutes of Health. (2026). Vulvodynia and NIH Women’s Health Research.
- Faye, R. B., et al. (2025). Vulvodynia. StatPearls.
- Schlaeger, J. M., et al. (2023). Evaluation and treatment of vulvodynia: State of the science. Journal of Midwifery & Women’s Health.
