Vaginal Swelling: Symptoms, Causes, and Treatments

There are a number of reasons why someone might experience vaginal swelling. The swelling of the vagina may be a natural response to sexual arousal or pregnancy. Or, it may be the result of irritation, allergy, trauma. or an infection (including a sexually transmitted infection).

It can sometimes be difficult to pinpoint the underlying cause of a swollen vagina (or the swelling of external genitalia like a swollen labia or clitoris). And it may be possible that more than one cause is involved. This is why it is important to see a healthcare provider if vaginal swelling is sudden and unexplained or if the symptoms are severe, persistent, or recurrent.

This article describes eight different causes of vaginal swelling and what can be done to treat them

Allergy

Certain substances that come into contact with the vagina can cause an allergic reaction, referred to as allergic contact dermatitis.

An allergy is an abnormal immune reaction in which the body releases an antibody, called immunoglobulin E (IgE), in response to an otherwise harmless trigger, known as an allergen. This sets off a chain reaction that instigates the release of a chemical called histamine which directly causes allergy symptoms such as rash, swelling, redness, and itching.

Allergens that can trigger vaginal swelling include:

• Soaps (particularly fragranced soaps)
• Vaginal douches and washes
• Tampons and sanitary pads
• Skin creams and lotions
• Spermicides and personal lubricants
• Latex condoms
• Vaginal contraceptives
• Laundry detergent

Mild cases are treated with OTC antihistamines like Claritin (loratadine) and Zyrtec (cetirizine) that block the action of histamine. A mild topical steroid cream, like hydrocortisone, may be prescribed to ease inflammation and rash.

Irritants

The swelling of vaginal tissues can also occur when they are exposed to certain irritants. The condition, known as irritant contact dermatitis, is also caused by an abnormal immune response. But, unlike allergic contact dermatitis, IgE is not involved.

Even so, many of the triggers and symptoms of irritant contact dermatitis are the same as those of allergic contact dermatitis. The main difference is that symptoms tend to develop quickly, sometimes almost immediately, and may involve burning, stinging, and tiny blisters. The symptoms also tend to revolve faster.

Irritant contacted dermatitis may also be less responsive to antihistamines. In their place, a mild hydrocortisone cream or an NSAID vaginal cream like Ginenorm (ibuprofen) can be prescribed to help ease symptoms.

Vaginal Trauma

Vaginal tissues are delicate and can easily become inflamed if treated roughly. This includes having rough or prolonged intercourse, intercourse without ample lubrication, or forced intercourse. The use of larger vaginal toys can also cause trauma, especially if vaginal numbing creams, alcohol, or illicit drugs are used to block pain signals.

Using proper lubrication during sex can help reduce the risk of vaginal trauma. The avoidance of alcohol and drugs should also be considered.

If you are being sexually abused or have been sexually assaulted, help is available. Talk to a trained healthcare professional or reach out to your local rape crisis center for support.

Yeast Infection

A yeast infection, also known as vaginal candidiasis, is caused by the overgrowth of a fungus found normally in the vagina called Candida albicans. The infection occurs when the immune system is suppressed, allowing the fungus to grow excessively.

Symptoms of vaginal candidiasis include vaginal swelling and redness, pain with urination, vaginal itching, and a cottage cheese-like discharge with a foul odor.

Hormonal changes can affect the immune response and lead to candidiasis, such as can occur with pregnancy, menstruation, and the use of hormonal contraceptives. Antibiotics can disrupt the natural balance of the vaginal floral, leading to fungal overgrowth. Diabetes is also a risk factor.

The treatment of uncomplicated yeast infections involves OTC topical antifungal creams like Lotrimin (clotrimazole) or Monistat (miconazole). Prescription antifungals (including topical, oral, and vaginal suppository formulations) may be used for more severe cases.

Sexually Transmitted Infections

Many sexually transmitted infections (STIs) can cause vaginal inflammation and swelling. Others cause rashes, blisters, or lesions that may be seen or unseen, causing pain, pain with urination, pain with sex, abnormal vaginal discharge, and swollen lymph nodes in the groin.

STIs that commonly cause vaginal swelling include:

• Chlamydia
• Genital herpes
• Gonorrhea
• Mycoplasma genitalium
• Syphilis
• Trichomoniasis

Bacterial STIs like chlamydia, gonorrhea, mycoplasma genitalium, and syphilis can be treated and cured with the appropriate antibiotic. Trichomoniasis is a parasitic infection that can be cured with the antibiotic drug metronidazole.

Genital herpes caused by the herpes simplex virus (HSV) is not curable but can be effectively managed with antiviral drugs.

Pregnancy

Vaginal swelling is common during pregnancy, in part because of the increased flow of blood to the uterus (womb) to support the growing fetus. As the fetus grows, increasing pressure within the womb can impede the flow of blood (through blood vessels) and lymph (through lymphatic vessels), triggering inflammation and swelling of the vagina.

Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) can be used for the occasional relief of inflammation and pain. A cold compress may also help.

Bacterial Vaginosis

Bacterial vaginosis (BV) is similar to a yeast infection in that is caused by an imbalance of the natural vaginal flora, in this case with bacteria. BV causes vaginal redness and swelling, pain with urination, pain with sex, and a grayish or yellowish discharge with a "fishy" smell.

BV occurs when the level of "good" bacteria in the vagina drops, allowing "bad" bacteria like Gardnerella vaginalis to grow excessively. It can also occur when harmful bacteria are introduced into the vagina during sexual intercourse.

The standard treatment for BV is a short course of antibiotic drugs. The preferred, first-line options are Flagyl (metronidazole) and Cleocin (clindamycin).

Cysts and Abscesses

Cysts are generally harmless pockets of fluids that can affect many different tissues of the body, including those in the genitals. They generally only cause problems when they are large and press on vulnerable tissues or become infected.

There are two types of cysts that can affect the vagina and cause vaginal swelling:

• Gartner’s duct cysts form in remnants of ducts that usually disappear during fetal development. While they tend to be harmless, the cysts can become problematic when they grow and can even emerge outside of the vagina. Problematic cysts are usually removed surgically.
• Bartholin cysts occur in moisture-secreting glands, called Bartholin glands, situated on each side of the vaginal opening. A cyst is usually not noticed until it becomes infected, causing a painful, pus-filled abscess. Severe cases may require antibiotics and surgical drainage.

When to See a Healthcare Provider

Vaginal swelling may be something you can readily treat at home, such as with an uncomplicated yeast infection. But, if you are not sure what is causing vaginal swelling and it either persists or recurs, it's in your best interest to see your gynecologist.

See a healthcare provider as soon as possible if the following occurs:

• Vaginal swelling and pain do not improve with at-home treatments
• You have blisters, growths, or lesions on the vagina or vulva
• The swelling is accompanied by high fever or other flu-like symptoms
• You have profuse, foul-smelling vaginal discharge
• There is severe pelvic pain with urinary symptoms
• There is pain during sex with bleeding
• There are visible tears in vaginal tissues

Summary

Vaginal swelling can occur for many reasons, including pregnancy, allergy, irritants, trauma, yeast infections, bacterial vaginosis, sexually transmitted infections, and vaginal cysts and abscesses. The treatment for each varies, so it is important to see a healthcare provider to get the correct diagnosis and receive the correct treatment.