What causes a red and painful vulva after sexual intercourse?

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Last updated: April 27, 2025View editorial policy

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Differential Diagnosis for Red Painful Vulva after Intercourse

  • Single most likely diagnosis
    • Vulvovaginal candidiasis (yeast infection): This is a common condition that can cause redness, itching, and pain in the vulvar area, especially after intercourse. The friction and potential disruption of the natural vaginal flora during intercourse can exacerbate symptoms.
  • Other Likely diagnoses
    • Bacterial vaginosis: An imbalance of the natural bacterial flora in the vagina can lead to symptoms like redness, discharge, and pain, which may be more noticeable after intercourse.
    • Trichomoniasis: A sexually transmitted infection that can cause inflammation, redness, and pain in the vulvar and vaginal areas.
    • Contact dermatitis: Irritation from condoms, lubricants, or other products used during intercourse can cause a red, painful vulva.
    • Vulvar vestibulitis: A condition characterized by chronic pain and inflammation of the vulvar vestibule, which can be exacerbated by intercourse.
  • Do Not Miss diagnoses
    • Herpes simplex virus (HSV) infection: Although less common, HSV can cause severe pain, redness, and vesicles or ulcers on the vulva, and it's crucial to diagnose and treat to prevent complications and transmission.
    • Syphilis: A sexually transmitted infection that can cause a wide range of symptoms, including pain and redness in the genital area, and is critical to diagnose due to its potential for serious complications if left untreated.
    • Pelvic inflammatory disease (PID): An infection of the female reproductive organs that can cause severe pain, redness, and other symptoms, and requires prompt treatment to prevent long-term damage.
  • Rare diagnoses
    • Lichen planus: A chronic inflammatory condition that can affect the vulva, causing redness, itching, and pain, though it's less common in this context.
    • Lichen sclerosus: A rare condition that can cause thinning and patchy skin on the vulva, leading to redness, pain, and discomfort.
    • Vulvar cancer: Although extremely rare, any persistent or severe symptoms should be evaluated to rule out cancer, as early detection is crucial for effective treatment.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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