Vaginal pain may be caused by insufficient lubrication resulting from low estrogen levels or inadequate foreplay. Inflammation, infection, skin problems or reaction to a birth control product, injury, trauma, irritation, episiotomy or pelvic surgery can contribute to pain. Vestibulitis (stinging or burning around the opening of the vagina) and vaginismus (involuntary spasms of the vagina) also may lead to vaginal pain.

Treatment may include a topical estrogen cream to provide lubrication and minimize voiding dysfunction and pain. Combinations of medications, creams, lotions and inserts can provide relief. For vaginismus, physical therapy can be effective. We may recommend treatment with a sex therapist as well.