Since the vagina remains hidden in a confined area with poor ventilation, it tends to collect sweat, urine residue, and other secretions over time. Plus, it is near the anus, which can render it unclean and stinky.
The good news is the vagina is a self-cleaning organ, and washing it with plain water regularly is sufficient to get rid of the impurities, germs, and stench. Using soap or other cleansing products that contain harsh chemicals will only irritate the delicate area, disrupt its natural pH balance, and destroy the vaginal flora, paving the way for infections. (1)
Vaginal health and hygiene are extremely important but don’t often get the attention they deserve. This is mainly because the genital area remains covered, and as they say: out of sight, out of mind.
But this negligence can lead to undue problems later, such as foul vaginal odor, vaginal infections, sores on the vulva, excessive vaginal discharge, pain, burning, dryness and itching in the pelvic area, and pain during sex.
In fact, up to 75% of the global female population suffers from vaginal infections at least once in their lives. (2)
This article will list some vaginal symptoms that could be a sign of an underlying problem that requires medical attention.
Warning Signs for an Unhealthy Vagina
Consult your doctor if you notice any of the following symptoms:
1. Itching, burning sensation, and vaginal dryness
Vaginitis refers to vaginal inflammation, which can manifest in the form of itching, dryness, and burning sensation as well as redness and swelling in the mucous lining of the vagina. All these symptoms can cause extreme discomfort while urinating or having sex. (3)
Vaginitis is generally associated with a vaginal infection called bacterial vaginosis.
A healthy vagina should have a pH between 3.8 and 5.0. If the pH rises, the vaginal environment will become too alkaline. This is unfavorable for the growth of certain good bacteria, such as lactobacilli, but triggers the overgrowth of other infection-causing bacteria, such as Gardnerella vaginalis, which is primarily responsible for bacterial vaginosis.
Sexually active women, especially those with multiple partners, run a higher risk of contracting this infection. Moreover, excessive vaginal hygiene as well as hormonal fluctuations can disrupt the vaginal flora and make you more susceptible to bacterial vaginosis. (3)
Women experience a progressive decline in the production of estrogen as they grow older. By the time they reach menopause, the amount of estrogen in the body reduces by as much as 95%.
Low estrogen levels cause your vaginal walls to become thin, dry, and inflamed over time, and this phenomenon is known as vaginal atrophy. Vaginal atrophy can also cause dryness, itching, and burning, especially in perimenopausal (15%) and postmenopausal women (40% to 57%). (4)
Soaps, creams, vaginal douches/sponges, and spermicidal foams contain chemicals and other harsh ingredients that can irritate the sensitive lining of the vagina while also disrupting its natural pH and bacterial balance. All these factors create a conducive environment for vaginal infections. (5)
2. Abnormal vaginal discharge
A yellow or white vaginal discharge that may look like cottage cheese is often a sign of yeast infection. It may also lead to itching and irritation in the vaginal area.
Many contributing factors can trigger an overgrowth of yeast in the vaginal microbiome, such as:
- Antibiotic use
- pH imbalance
- Poor ventilation in the area due to wearing extremely tight underwear or clothing made of nonbreathable and synthetic fabrics
- Leaving your tampon in for extended periods
- Application of chemical irritants found in soaps and other perfumed products
- Unhealthy eating habits, particularly excessive sugar and alcohol intake
Vaginal yeast infections are typically treated with medicated creams, pills, and suppositories that are easily available over the counter. Plus, you will be advised to avoid any of the above-listed causative factors.
If the infection keeps coming back, you will need to make some long-term changes in your diet, mainly limiting the consumption of sugar and alcohol while upping your intake of water and yogurt. (6)
3. Fishy odor
It is completely normal for the vagina to give off a mild musty odor, but you need to worry if it becomes too strong or fishy such that it gets transferred to your undergarments and can be smelt from a distance.
This could be a sign of poor vaginal hygiene, vaginal infections, and urinary tract infections, as well as advanced renal or liver disease. (7)
Bacterial vaginosis is a common infection that is characterized by a foul vaginal odor along with vaginal discharge that usually has a thin consistency and white or gray color.
Women diagnosed with this condition are more prone to other sexually transmitted infections (STI). If you get this infection during pregnancy, there is an increased risk of premature delivery. (8)
If the fishy vaginal odor is accompanied by green vaginal discharge, it could indicate a sexually transmitted disease or trichomoniasis, which warrants immediate medical attention. (9)
4. Abnormal bleeding
Menstruation generally lasts for 7–9 days, occurs after every 24–38 days, and leads to the loss of 5–80 milliliters of blood. Any irregularity in these three parameters is referred to as abnormal uterine bleeding. (10)
Spotting, or vaginal bleeding that occurs on random days when you’re not menstruating, could be triggered by hormonal fluctuations inside the body. Stress and pregnancy are two prime culprits behind such hormonal imbalance.
Abnormal vaginal bleeding can also stem from vaginal infections, among various other anatomical and physiological causes. It can be broadly classified into two categories: bleeding associated with gynecologic causes and bleeding associated with systemic causes. (11)
Almost one-third of the entire female population experiences abnormal uterine bleeding during their lifetime, particularly after the first period and around menopause.
5. Post-coital bleeding
Women tend to experience spotting or mild vaginal bleeding after having sexual intercourse for the first few times. This post-coital bleeding is completely normal, has nothing to do with menstruation, and affects nearly 0.7%–9.0% of reproductive women. (12)
However, it becomes recurrent and continues to occur well beyond your initial sexual encounters, get yourself tested for vaginal infection, STDs such as chlamydia, vaginal tears, endometritis, and cervical cancer. (12)
6. Painful blisters on the vulva
The vulva is the outer part of the vagina, which can develop painful blisters due to a variety of causes, including STIs such as herpes, vaginal infections, autoimmune disorders, contact dermatitis, a side effect of certain medications, and cancer.
The treatment will depend on the underlying cause, which is why you need to get medically tested for a proper diagnosis. Plus, some of these causes are quite serious and require prompt treatment.
So, it’s best to visit your doctor as soon as you notice any such blistering on the vulva. (13)
7. Painful sex
Recurrent or persistent pain and discomfort before, during, or after coitus is medically referred to as dyspareunia.
Most cases of dyspareunia are psychological in nature, but some women develop it due to actual physical reasons such as excess tissue around the vaginal opening, vaginal inflammation, endometriosis, adhesions, vaginal dryness, pelvic congestion, vaginal atrophy, childbirth, and fibroids.
Women suffering from this condition often find it difficult to get proper support and acknowledgment for their pain, which is dismissed as psychological rather than real.
The standard treatment for dyspareunia or painful intercourse involves a noninvasive and multifaceted approach that includes gynecological interventions, physical therapy, mental health counseling, sexual therapy, and pain management.
In rare cases, you may have to undergo surgery, but conservative treatment mostly gets the job done. (14)
8. Burning sensation during urination
The urethra is a short tube that connects the bladder to the vagina. The urine stored in the bladder travels down the urethra and is excreted out of the body from an opening in the frontal area of the vagina.
Any blockage in the passage of urine can lead to the overgrowth of bacteria in the urinary tract, resulting in infection. Urinary tract infections can cause dysuria, which refers to pain, burning, stinging, or itching in the urethra while urinating.
The pain and burning may be accompanied by vaginal inflammation and itching. Please seek medical help if you experience any such symptoms.
The vagina is an extremely sensitive part of the body and should therefore be treated with extra care. If you notice any of the above-mentioned symptoms, seek medical consultation and treatment promptly.
Ignoring the problem can make it worse and can lead to more serious or long-lasting complications. Even in the absence of any such symptoms, it is important to visit your ob-gyn at least once a year for a general checkup. This is because certain asymptomatic conditions can adversely affect your vaginal health without you even realizing it.