Sharp pain in the vaginal area can be caused by excessive exercise, pregnancy, vaginismus, varicose veins in the vulva or a sexually transmitted infection.

Depending on their cause, sharp cramps or stabbing in the vagina may be accompanied by other symptoms, such as vaginal bleeding outside of a period, swelling, discharge, and pain during or after sexual intercourse.

In all cases, you should consult your gynecologist for assessment, in order to identify the cause of the sharp pain in the vaginal area. This will help to guide the most appropriate treatment approach.

Main causes

The most common causes of sharp pain in the vaginal area are:

1. Pregnancy

In the last trimester of pregnancy, after the 27th week of pregnancy, the baby a significant amount of weigh. There is also notable increase in the volume of amniotic and circulating fluid in the body, which creates pressure and reduces blood flow in the vaginal area.

Because of this, it is common for pregnant women to feel cramps, burning or swelling in the vagina.

What to do: This situation is common at the end of pregnancy, and does not require any interventions. However, if the sharp pain is accompanied by bleeding, it is important to consult an obstetrician to evaluate the symptoms and start the most appropriate treatment.

Sharp pain in the vagina from pregnancy can be treated by applying a cold compress on the vaginal area. It is also important to avoid standing for a long time and to rest to prevent worsening or flare.ups.

2. Strenuous exercise

Heavy exercising can lead to the appearance of sharp pain in the vagina. This is particularly common with weight lifting, squatting, or movements that work the pelvic floor.

Horse riding and cycling can also cause sharp pain in the vaginal region, due to the pressure that these exercises place on the vulvar region.

What to do: Sharp pain in the vagina caused by physical exercise can be relieved by resting and applying a cold compress to the area. It is also important to wear loose cotton-based clothing to prevent worsening.

3. Vulvodynia

Vulvodynia, also called vulvar vestibulitis, is characterized by at least 3 months of increased nerve sensitivity in the vagina. It is associated with discomfort, burning, irritation and sharp pain.

These symptoms are often triggered when touching internal or external parts of the vulva. Women with vulvodynia feel twinges, pains and discomfort during or after sexual intercourse, as well as pain when inserting tampons or when wearing very tight clothing.

Stinging or cramps in the vagina can also appear during gynecological exams, when riding a bike or even after sitting for a long time.

What to do: Treatment for vulvodynia is guided by a gynecologist together with other specialists such as a neurologist and dermatologist. The exact cause is not always known and a broader approach to treatment is often necessary.

Treatment generally consists of the use of oral medications or ointments to relieve pain, as well as pelvic floor exercises and transcutaneous electrical neurostimulation, also called TENS, performed by a physiotherapist.

4. Sexually transmitted infections

Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, are diseases caused by microorganisms that are transmitted through unprotected intimate contact.

These infections can lead to various symptoms, such as yellow or green discharge, burning, swelling, pain or stinging sensations in the vagina.

When these infections are left untreated, the microorganism causing the infection can remain in the woman's genital system and cause inflammation of the pelvic region, leading to pelvic inflammatory disease (PID).

Learn more about the most common STIs and how they present.

What to do: Consult a gynecologist for testing and diagnosis, as knowing the underlying infection will help to guide the right treatment. Treatment usually involves a course of antibiotics, and further infections can be prevented by using a condom.

5. Genital herpes

Genital herpes is a type of sexually transmitted infection, caused by the Herpes simplex virus. It is transmitted through direct contact with a partner's blisters during unprotected sexual intercourse.

Infection with this virus can lead to the appearance of tingling or a sensation of pins and needles in the vagina a few days before blisters appear. The blisters tend to be itchy and painful, and can rupture and form wounds. Learn more about genital herpes symptoms and how they are managed.

What to do: Treatment for genital herpes treatment typically involves antiviral medications prescribed by the gynecologist, such as acyclovir, valacyclovir or famciclovir. These are taken for about 7 days and help to prevent the virus from multiplying and spreading. They allow the skin to heal and prevent the appearance of new blisters.

6. Vaginismus

Vaginismus is a condition that occurs due to involuntary contractions of the muscles in the pelvic region and vagina. It can be uncomfortable for women to have sex, as they will often experience sharp pain and stabbing sensations in the vaginal canal.

Generally, vaginismus is related to psychological problems, such as sexual aversion, but it can also arise due to complicated births, surgeries and fibromyalgia.

What to do: After the diagnosis is confirmed by a gynecologist, the recommended treatment involves the use of medications, like vasodilators, to reduce vaginal muscle spasms, relaxation techniques and psychotherapy.

7. Varicose veins on the vulva

Varicose veins in the vulva, also known as vulvar varicosity, are characterized by the presence of dilated veins in the labia majora and minora. They can occurs due to increased pressure caused by the baby's weight during pregnancy, venous thrombosis in other parts of the body and vulvodynia.

Varicose veins in the vulva do not always cause symptoms, with only the thickest veins in the vagina being visible. However, some women may experience burning, pain, cramping and stinging. These symptoms can worsen with prolonged periods, during menstruation or after sex.

Women with varicose veins on the vulva may also have other health problems such as endometriosis, fibroids, uterine prolapse or urinary incontinence.

What to do: Treatment for varicose veins on the vulva involves the use of medications to relieve pain and reduce blood clots. The doctor may also prescribe contraceptives to regulate female hormones. Depending on the severity of this condition, your doctor may also recommend varicose vein embolization or surgery to remove the affected veins.

8. Bartholin cyst

Sharp pain in the vagina may arise due to cysts in the Bartholin gland. This gland is responsible for lubricating the vaginal canal during sex.

Cysts can form and obstruct this gland and this means there is no lubrication in the vagina. This can lead to sharp pain, stabbing or cramping sensations in the vagina during and after sexual intercourse.

Bartholin's cysts are considered to be benign tumors, but they can also lead to the appearance of abscesses, which are lumps filled with pus.

What to do: Treatment should be guided by a gynecologist and depends on the size of the Bartholin cyst. The doctor may prescribe antibiotics if an infection is suspected, as well as drainage, cauterization or surgical removal of the cyst.

When to see the doctor

It is important to consult a gynecologist if you feel sharp pain in the vaginal area, especially if it is accompanied by symptoms like:

Pain and burning when urinating
Bleeding outside the menstrual period
Fever
Greenish or yellowish discharge
Vaginal itching
Presence of blisters in the vagina

These symptoms may be a sign of other diseases, such as genital herpes, urinary tract infections and vulvovaginitis. These are conditions that are often sexually transmitted, which is why it is important use condoms during sex.