From the Guidelines
To treat a red, painful vulva after intercourse, the most effective approach is to use a topical azole antifungal, such as clotrimazole 1% cream 5 g intravaginally for 7-14 days, as recommended by the Centers for Disease Control and Prevention 1. When managing a red, painful vulva after intercourse, it's essential to consider the potential causes, including friction, insufficient lubrication, and sensitivity to products.
- Gently clean the area with warm water (no soap) and pat it dry to reduce irritation.
- Apply a soothing emollient like petroleum jelly or a hypoallergenic moisturizer such as Aquaphor to reduce irritation.
- Take an over-the-counter pain reliever like ibuprofen (400mg every 6-8 hours) or acetaminophen (500mg every 6 hours) to manage discomfort and inflammation.
- Avoid tight clothing, wear cotton underwear, and abstain from sexual activity until symptoms resolve, typically within 2-3 days. If symptoms persist or worsen, it's crucial to consult a healthcare provider to rule out other potential causes, such as sexually transmitted infections or vulvovaginitis, which may require alternative treatments, such as fluconazole 150 mg oral tablet, one tablet in a single dose 1. In cases of severe vulvovaginitis, a longer duration of therapy (7-14 days) with a non-fluconazole azole drug may be recommended as first-line therapy 1. Using a water-based lubricant during future sexual activity can help prevent this issue by reducing friction that damages the delicate vulvar tissue.
From the Research
Possible Causes of Red Painful Vulva after Intercourse
- Trichomoniasis: a sexually transmitted infection that can cause inflammation and irritation of the vulva 2
- Bacterial vaginosis: a bacterial infection that can cause vaginal discharge, odor, and irritation 2
- Candidiasis: a fungal infection that can cause redness, itching, and burning of the vulva 3
Treatment Options
- Metronidazole: an antibiotic that can be used to treat trichomoniasis and bacterial vaginosis 2, 4
- Fluconazole: an antifungal medication that can be used to treat candidiasis 3
- Clotrimazole: an antifungal medication that can be used to treat candidiasis 3
- Combined therapy: using a combination of systemic and topical treatments, such as fluconazole and metronidazole/clotrimazole, to treat recurrent candidiasis 3
Considerations
- Single-dose therapy: can be effective for treating certain sexually transmitted infections, but may have drawbacks such as reduced efficacy or increased toxicity in certain situations 4
- Treatment efficacy: may be affected by factors such as bacterial vaginosis status or the presence of other infections 2
- Adherence: self-reported adherence to treatment regimens can be high, but may vary depending on the specific treatment and patient population 2