Young woman with a laptop learning about common causes of vaginal burning and treatments

Common Causes of Vaginal Burning and Treatments

Updated on April 11, 2024. Previously written on May 17, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Vaginal burning is one unwelcome health symptom with many possible causes. Explanations of causes range from treatments that are easily resolved, like swapping out your household’s laundry detergent, to more stubborn treatments, like contending with a urinary tract infection (UTI).

While the possible explanations for vaginal burning can feel overwhelming, it’s important not to ignore uncomfortable sensations around your sexual anatomy. In some cases, vaginal burning can be an early sign of sexually transmitted infections (STIs), or other infections that can pose higher health risks if left untreated.

If you’ve noticed vaginal burning that persists, it’s important to stay apprised of the symptom and the possible root causes. Below, some of the most common reasons why people experience vaginal burning are detailed so that you can identify your symptoms, book a women's health appointment online, and begin a course of treatment to find relief.

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Bacterial Vaginosis

Is bacterial vaginosis a sexually transmitted disease? Bacterial vaginosis (BV) is the single most prevalent vaginal infection in reproductive-aged women. [1] However, it is not a sexually transmitted disease (STD). Instead, it affects the balance of bacteria in the vagina, where certain strains grow out of proportion to others. [1] These strains are not abnormal, however. Rather, bacterial vaginosis is characterized as an overgrowth of normal vaginal flora. This imbalance typically involves [2]:

  • Excess anaerobic bacteria
  • A decrease in Lactobacilli

While the exact mechanisms behind bacterial vaginosis are still being studied, it’s believed that sexual activity with multiple partners and inconsistent condom use may contribute to this imbalance. [2]

In addition to vaginal burning, BV can cause symptoms like: [2, 3]

  • In some cases, an itchy sensation during urination
  • Vaginal discharge, which can appear thin and whiter or grayer in hue
  • Vaginal odor

It’s also possible to have BV with no observable symptoms. [3]

Treatment Options for Bacterial Vaginosis

Taking antibiotics, using an intrauterine device (IUD) for birth control, and/or having unprotected sex can all lead to BV. [3] If your healthcare provider diagnoses you with BV, they may prescribe a round of antibiotics—typically oral antibiotics or a gel or cream—to correct the bacterial imbalance. [1]

That said, 30% of BV cases may resolve without treatment. [2] In patients who do undergo a round of antibiotics, 10 to 15% of women may not see improvements. Additionally, 80% of women may experience a recurrence of BV following treatment. [2] In both cases, additional treatment may be required. [2]

Women who are pregnant are safe to undergo antibiotic treatment as well. [2]

Chemical Irritants

In other cases, BV may occur as a result of an allergic reaction to different products and materials, such as [4]:

  • Bath soap or body wash
  • Body lotion or sprays
  • Douches
  • Laundry detergent
  • Perfumed sanitary napkins or soft paper goods
  • Lubricants and toys
  • Spermicide
  • Non-cotton pants or underwear
  • Damp clothing or bathing suits

Similarly, tight-fitting underwear, leggings, or hosiery can be abrasive to the genital area. This may lead to a burning feeling. However, you can easily relieve this burning sensation by retiring the item and allowing the affected area to heal.

Treatment Options for Chemical Irritation

The best way to relieve vaginal burning from chemical irritants is to stop using the product that brought it on. [4] If you’re unsure which self-care or household product might be responsible, try removing all potential irritants from your routine and re-introducing them one at a time to see how the genital area responds.

UTI

A burning or vaginal itching sensation is one of the most apparent symptoms associated with a UTI, or urinary tract infection. However, this typically affects the urethra—the passageway for urine located inside the vagina.

These types of infections are very common and occur when bacteria—like E. coli—enter the urethra. If left untreated, the infection can travel to and infect the bladder and the kidneys. Other factors that may cause a UTI are changes in vaginal flora, pregnancy, sexual activity, age, and poor hygiene. [5]

Additional symptoms that can accompany a UTI include: [6]

  • A sense of pressure in the lower abdomen
  • Burning or vaginal pain during urination
  • Feeling the need to urinate with increased frequency
  • Mild fever, dizziness, or fatigue
  • Urine that appears murky, has a rust color, or carries an odor

Treatment Options for a UTI

UTIs are relatively common, but they’re nevertheless important to treat. If left undiagnosed or unaddressed, the infection can venture further into the urinary system and affect the ureters or kidneys. [6]

If you identify a burning sensation near your urethra, contact your healthcare provider. Depending on their assessment, they may prescribe a round of antibiotics or let the infection heal on its own. [6]

Yeast Infection

A “yeast” infection is the informal term for Candida, a type of fungus that can occur in the tissues of the vagina and vulva. [6] Yeast infections are quite common and are estimated to affect as many as 75% of women in their lifetimes. [6]

Common symptoms include [6]:

  • A sensation of vaginal itching and vaginal irritation
  • A burning sensation, most notably felt during sexual intercourse or when urinating
  • Experiencing pain and soreness in the vaginal region
  • Development of a rash in the vaginal area
  • Presence of thick, white discharge resembling cottage cheese, which is odorless
  • Noticing watery discharge from the vagina

If you have a yeast infection, you may also notice swelling, soreness, or a rash around the vagina. [6] This is because an overgrowth of Candida can result in vaginitis, which is an inflammation response affecting the vagina. [7]

That said, there are certain reasons why you may be more susceptible to yeast infections, including [6]:

  • Being pregnant
  • Depressed immune function
  • Excessive use of antibiotics
  • Hormone therapy
  • Oral contraceptives
  • Sexual activity, especially oral sex or engaging in sex for the first time

Treatment Options for a Yeast Infection

Treatments for yeast infections depend on the severity and (if applicable) recurrence of the vaginal infection. The most common treatment options include: [6]

  • Antifungal medicines – A healthcare provider may recommend a topical antibiotic, like a cream or an ointment, to clear up a yeast infection. Typically, you’d apply the antibiotic for three days to one week to promote recovery. The most common medications for yeast infections are miconazole and terconazole.
  • Fluconazole (oral route) – As a more aggressive approach to treating yeast infections, a healthcare provider may prescribe one or two doses of fluconazole. This is an oral medication that’s not suitable for pregnant women or people with mild cases of Candida.

Boric acid is another modality for treating yeast infections. However, this is only prescribed for infections that occur multiple times within a few months or that demonstrate resistance to antifungal agents. Due to its potential toxicity, it may only be administered via the vagina (never orally) and under the supervision of a healthcare provider. [6]

Going Through Menopause

Menopause, a natural biological transition that marks the end of menstruation and fertility in women, is often accompanied by a myriad of symptoms, some more commonly recognized than others. [11]

While hot flashes, mood swings, and the loss of menstruation (amenorrhea) are frequently discussed, vaginal burning is another discomfort that some women may experience during this phase of life. The sensation of vaginal burning amidst menopause is not uncommon, yet it may not receive as much attention as other symptoms. [11]

Unlike hot flashes or mood swings, which can be overt and disruptive, vaginal burning may also manifest more subtly, particularly during sexual activity, prompting discomfort and sometimes even vaginal pain. The most common underlying cause of vaginal burning in menopause is vaginal dryness. This dryness is due to hormonal changes, particularly decreases in estrogen levels. [11]

Treatment Options During Menopause

It’s important to recognize that vaginal dryness and burning can be a non-pathological side effect of menopause—a normal, healthy stage of life. [11] To relieve these symptoms, a healthcare provider might recommend [11]:

  • A water-based lubricant to use before having penetrative sex. Limiting the use of oil or silicone-containing lubricants can help you avoid chemicals that may irritate the vagina.
  • Prescription hormones, locally administered via a ring, cream, or oral medication. These emit a low dose of estrogen directly into the vagina, which may help to restore vaginal moisture.
  • Non-hormonal medication, specifically ospemifene (oral route) or the steroid prasterone (vaginal route). Like prescription hormones, these medications mimic the effects of estrogen, working against dryness to minimize pain during sex. [12, 13]

STDs/STIs

Several STDs (sexually transmitted diseases) can be accompanied by vaginal burning. These include:

  • HPV, or human papillomavirus – The single most common sexually transmitted infection, some strains of HPV cause genital warts and may be accompanied by a burning sensation around the vagina. Other symptoms include bleeding, itchiness, and rough skin around the genitals.
  • Gonorrhea – A bacterial infection. In its early stages, gonorrhea in women and those assigned female at birth (AFAB) may appear with no observable symptoms (including vaginal burning). In more advanced cases, you may notice a burning sensation during urination, higher-than-normal amounts of vaginal discharge, and spotting between symptoms. [14]
  • Trichomoniasis – A parasitic infection. Like people with gonorrhea, people who contract “trich” may be asymptomatic. However, those who do have symptoms may experience burning or irritation around the vagina, excessive vaginal discharge (or discharge that appears off-color or carries an odor), and pain or discomfort during urination. [15]
  • Chlamydia – A bacterial infection that is most predominant in reproductive-aged women. Some people who contract chlamydia do not exhibit symptoms, while others experience dyspareunia (pain during sex), excessive vaginal urination, and spotting between menstrual cycles. [16]
  • Genital herpes – A viral infection. Many people with genital herpes experience mild or no symptoms. If you exhibit symptoms, you may notice burning around the genitals, excessive vaginal discharge, pain during urination, and the appearance of bumps around the genitals. [17]

Some people have a more severe reaction when they first contract herpes. These reactions can include a persistent headache, fever, chills or body aches, and other flu-like symptoms. [17]

Treatment Options for STDs/STIs

Some STDs aren’t reversible, while others are treatable and even curable. If you’re sexually active, it’s important to screen for STDs regularly. This can help identify any new infections that may exhibit no symptoms and prevent the advancement of any existing infections you might have.

If an STD goes undiagnosed or untreated, it can progress and may cause more severe adverse health effects.

Curable STDs include:

  • Gonorrhea – Gonorrhea requires antibiotic medication to treat.15 People who have been infected with gonorrhea are advised to get tested three months after fulfilling their medication protocol. [14]
  • Trichomoniasis – The recommended treatment for trichomoniasis is oral antibiotics. [16] These are administered in either one large dose or in several smaller doses. [16] If you’re partnered, your sexual partner will also need to undergo treatment to prevent reinfection.16 Avoid having sexual intercourse while undergoing treatment to avoid passing the infection on to others. [15]
  • Chlamydia – For most people, oral antibiotics can cure chlamydia. While undergoing treatment, it’s important to abstain from sex to prevent partners from contracting the infection. Reinfection rates are high for people who’ve contracted chlamydia, so it’s also critical you complete your treatment protocol. If reinfected multiple times, chlamydia can result in severe complications, like pelvic inflammatory disease. [16]

There is currently no cure for HPV or genital herpes, but you can manage these conditions with careful treatment [21, 22, 23]:

  • HPV – Genital warts are the primary irritant that leads to genital burning with HPV. You can treat warts with:
    • Salicylic acid, an over-the-counter medicine that can help clear up genital warts.
    • Podofilox, a prescription medicine that’s topically applied to warts. This medication works by breaking down the tough skin of the warts, though it can lead to more burning or irritation directly after application.
    • Imiquimod, a prescription ointment that can help boost the immune system’s ability to relieve warts naturally. However, this medicine may also result in more vaginal irritation upon application.
  • Genital herpes – Herpes is most commonly treated with oral antiviral medication. Combatting the virus may assist with the symptoms it causes, including a burning sensation. Over time, it can also alleviate the appearance of warts and lessen the severity and frequency of outbreaks.

Lichen Sclerosus

Lichen sclerosus is an uncommon dermatological condition characterized by the development of white patches on the skin, often affecting sensitive areas such as the genitals. These patches exhibit various characteristics, including itching, a smooth or wrinkled appearance, and a tendency to bleed when irritated or scratched. Most commonly, they will appear along the vulva. [24]

In addition to itching, possible symptoms include [25]:

  • Soreness
  • Burning sensations
  • Changes in urine flow
  • Blistering
  • Painful sex

While the causes aren’t certain, healthcare providers theorize that lichen sclerosis may arise as a result of genetics, skin damage, or an overactive immune system. The condition most commonly affects women over the age of 50. [24, 25]

Treatment Options for Lichen Sclerosus

Unfortunately, lichen sclerosus is not curable. However, a healthcare provider may prescribe a steroid cream to help relieve itchiness and discomfort. [24]

Everlywell: Keep Up with Your Sexual Health Conveniently

Many conditions can cause a burning sensation in vagina, from bacterial imbalances to STDS. No matter the condition, noticing that something feels “off” with your sexual health can be understandably alarming. Reproductive health conditions aren’t widely discussed, and learning more about them can be one of the most effective ways of keeping your health care in check.

If you’ve been experiencing vaginal burning or related symptoms, speak with a healthcare provider through Everlywell. Through our telehealth services, you can get online STI treatment for prevalent STDs like gonorrhea, chlamydia, and more. We also offer specific online women's health visits so you can meet with an experienced healthcare provider who understands your concerns.

Book a virtual health visit today to receive a diagnosis and treatment.

Is Bacterial Vaginosis an STD?

Can a Urinary Tract Infection (UTI) Go Away On Its Own?

What Antibiotics Treat Pelvic Inflammatory Disease?

References
  1. Bacterial vaginosis. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Medical Citation URL. Accessed April 7, 2024.
  2. Kairys N. Bacterial Vaginosis. NIH. Medical Citation URL. Accessed April 7, 2024.
  3. What are the symptoms of bacterial vaginosis (BV)? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Medical Citation URL. Accessed April 7, 2024.
  4. Vaginitis. Planned Parenthood. Medical Citation URL. Accessed April 7, 2024.
  5. Urinary Tract Infection. CDC. Medical Citation URL. Accessed April 7, 2024.
  6. Yeast infection (vaginal). Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  7. Urinary tract infections | UTI | UTI symptoms. MedlinePlus. Medical Citation URL. Accessed April 7, 2024.
  8. What causes vaginitis? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Medical Citation URL. Accessed April 7, 2024.
  9. Vaginitis. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  10. Yeast infection (vaginal). Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  11. Sex and menopause: Treatment for symptoms. National Institute on Aging. Medical Citation URL. Accessed April 7, 2024.
  12. Ospemifene (oral route) side effects. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  13. Prasterone (vaginal route) side effects. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  14. Std facts - gonorrhea. Centers for Disease Control and Prevention. Medical Citation URL. Accessed April 7, 2024.
  15. Std Facts - Trichomoniasis. Centers for Disease Control and Prevention. Medical Citation URL. Accessed April 7, 2024.
  16. Chlamydia trachomatis. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  17. Genital herpes. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  18. Gonorrhea. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  19. Trichomoniasis. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  20. CDC – Chlamydia treatment. Centers for Disease Control and Prevention. Medical Citation URL. Accessed April 7, 2024.
  21. HPV infection. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  22. Genital herpes. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  23. Genital herpes - Diagnosis and treatment. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
  24. Lichen sclerosus. NHS. Medical Citation URL. Accessed April 7, 2024.
  25. Lichen sclerosus. Mayo Clinic. Medical Citation URL. Accessed April 7, 2024.
Jordan Stachel, M.S., RDN, CPT is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions, and has written for publications such as Innerbody. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.

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