Vaginal & Vulval Pain: What’s the Difference?

“Vaginal & vulval pain can compass mild to severe symptoms; could be temporary or chronic, & can be brought on by a broad spectrum of conditions – from the not very serious to the severe. The vital thing to do is to visit a Pain Specialist. He/she will diagnose your condition when they examine your vagina & vulva, & then put you on a treatment plan”

It is not surprising that many people do not know the difference between the vagina (VAG) and the vulva, as these parts of the body are a somewhat taboo subject. It is however, important to know that women can experience pain in either the vagina, vulva, or both, so to that end, if you are experiencing any pain down there, it is crucial to understand which of your body parts is emanating the pain. So here we go:

• The VAG describes the internal tube which links the womb (uterus), to the outside of the body

• The vulva is the general terminology which describes the outside regions of a woman’s genitals. These include: the vaginal opening, the urethral opening (where the urine flows out of the body), the clitoris, and the labia (the inner and outer lips) [1].

Frequent Causes of Vulval & Vaginal Pain, & How to Distinguish Them

Irritation of the Vulva

“If the vulval skin is irritated, it can become red & swollen. There may also be signs of inflammation or vaginal discharge”

Symptoms include: discomfort, burning, and/or itching. – This could be down to a skin condition, infection, product allergy, issues with personal hygiene, dermatitis/eczema, sweating, or wearing tight clothing [1].


Various different infections (e.g. candida or bacterial vaginosis, also known as BV), can impact the vulva/vagina. They can generate pain, itchiness, vaginal discharge, a strong odour, swelling and inflammation, and in some cases, a feeling of heat [1].

Sexually Transmissible Infections (STIs )

STIs can generate vulval and/or vaginal pain. Common infections include: herpes, trichomoniasis, chlamydia and gonorrhoea. Note: a number of sexually transmitted infections are not just painless (initially), there may not be any symptoms [1].


This is a condition whereby the pelvic floor muscles clamp up, thus narrowing the lower part of the vagina. Vaginismus can prevent a woman’s ability to have intercourse, and can make sex extremely painful. This state can also cause issues for women who wear tampons; and cervical tests can be hard to tolerate [1].

Dryness of the Vulva & Vagina

This unwelcome state is particularly common in post-menopausal woman, and is down to reduced oestrogen levels. The tissues in these regions can become drier, and thin out, thus making them more susceptible to irritation and damage [1].


This long-term pain condition (which may or may not be triggered by touch), generates discomfort and a burning pain in the vulva. This can be confined to one area, or can be widespread across the entire vulva. Of note, there are no symptoms of inflammation or irritation, which is just one of the reasons why booking an appointment with an experienced Pain Specialist is strongly recommended [1].

Lichen sclerosus

“This condition can generate perpetual transformations to the vulva. These include the disappearance & shrinking of the the inner lips (labia minora)”

Generally speaking, this condition usually impacts the skin surrounding the vulva and anus. It is more widespread in post-menopausal women. Affected regions can be painful and itchy, and they look crinkly and thickened [1].


[1]. Jenner, Christopher (2021). “Viva la Vulva.”