Advertisement

8 Vagina Red Flags to Get Checked Out ASAP

Bleeding, burning, bumps and other reasons to call your gyno immediately.

Medically reviewed in July 2022

Updated on July 14, 2022

woman talking to gynecologist
1 / 9

There's a lot going on in and around your vagina, and most of the time those things are normal. But some below-the-belt issues mean you should see your gynecologist. From abnormal bleeding and discharge to itching, here are signs you might need to book an appointment.

womens razor
2 / 9
You have bumps or masses down there

The vulva is the outer part of the female genitals, including the opening of the vagina. Bumps or lumps around that area can be a sign of something pretty harmless, but could also indicate something serious.  

One common condition is razor burn. “We call this folliculitis, where the hair follicle has become inflamed from shaving,” says OBGYN Elizabeth Newell, MD, of Swedish Medical Center in Littleton, Colorado. To avoid irritation, Newell recommends trimming or waxing. If you do want to shave, use a new and sharp razor, always apply shaving gel, and make sure your skin is wet before you start. “The bumps can actually get infected,” she explains.

If you notice flesh-colored bumps that look similar to cauliflower, you may have genital warts, a common sexually transmitted infection (STI) caused by the human papillomavirus (HPV). Most people won’t notice warts, though they can catch on underwear or clothing when you’re moving around or exercising, says Newell. Your gynecologist can cut, freeze, or burn them off. Other treatments include topical creams like imiquimod (Zyclara, Aldara) and resins such as podophyllin and podofilox (Condylox).

woman going into public restroom
3 / 9
It burns when you urinate

If you’re having trouble urinating, you feel like you have to pee often, or it burns when you go, Newell says it’s best to book a visit with your gyno.

It may be that your skin is irritated from scented products like soaps and perfumes. But, if you have a urinary tract infection (UTI), there's bacteria in your urine, and you’ll need antibiotics. “If UTIs are left untreated, they can cause kidney infections and make you very sick,” says Newell. With proper treatment, UTIs usually clear up within one or two days, but kidney infections last longer and may require a hospital stay.

A yeast infection, or overgrowth of yeast in the vagina, can also cause urination discomfort. “The urine hits against the vulva where the yeast infection is, and causes pain,” explains Newell. 

Yeast infections are simple to treat—a single-dose oral medication or over-the-counter or prescription antifungal medications can clear symptoms in three to seven days. For those that don’t respond to antifungals or return within two months after the first treatment, you may need stronger medications.

panty liner
4 / 9
You’re bleeding heavily after sex

Light vaginal bleeding or spotting is common after sex—especially if you haven’t done it in a while, you didn’t use lubrication, or you’re about to begin or finish your period. But if you’re vomiting, have a fever, or bleed so much you soak a sanitary napkin in an hour, Newell says it's cause for concern. 

Causes of postcoital bleeding include:  

  • Cervical polyps: growths located on the cervix
  • Cervicitis: inflammation of the cervix triggered by STIs like chlamydia or HPV
  • Genital sores: lesions from STIs like herpes or syphilis
  • Vaginal atrophy: thinning, drying, and inflammation of the vaginal walls  
  • Cervical cancer: cancer that begins in the cells lining the cervix

If you’ve hit menopause and experience vaginal bleeding after sex, you should see a healthcare provider (HCP). It could be atrophy but could also indicate endometrial cancer.

Treatment depends on your condition. Your gynecologist will perform a pelvic exam to look for polyps, inflammation, or tears, and tests to look for STIs. Polyps can be removed via a simple procedure, while an STI may require antibiotics or antivirals. Moisturizers, lubricants, and topical estrogen replacement therapy can relieve symptoms of vaginal atrophy.

clean underwear
5 / 9
You have funky discharge

Vaginal discharge is tricky because there are so many types, says Newell. It’s normal to have discharge during sex, ovulation, and pregnancy, as well as after giving birth. But other health conditions can bring about discharge that looks or smells funny:

  • Bacterial vaginosis causes thin white or gray discharge that smells fishy. Antibiotics will usually help clear up the infection.
  • Yeast infections produce thick, white, cottage cheese-like discharge with itching and burning. Oral medications or over-the-counter or prescription antifungal medications are used to treat these.

If you have discharge that is green or yellow and has a strong smell, you should see an HCP. In addition to discharge, itching, pelvic pain, bleeding, and trouble urinating are also causes for concern. These symptoms could be a sign of an STI such as chlamydia, gonorrhea, or trichomoniasis.

gyn, flower
6 / 9
It feels like your vagina is swollen

Vaginal swelling is uncommon, but not unheard of. “Sometimes, adolescents or young women who have just gotten their period for the first time can experience some swelling on both sides of the vaginal lips,” says Newell. This normal process is nothing to worry about.

But if your vagina is swollen or feels full, you may have a Bartholin gland cyst, a small, round, sac-like structure near your vaginal opening. A large cyst can be irritating and cause pain when you're walking. If it becomes infected, it can turn into an abscess—a red, painful bump packed with pus. 

To treat this condition, your gynecologist can perform a needle aspiration, during which they open and drain a cyst. If it recurs, a catheter may be inserted to create an opening, but the catheter is not permanent. Long-term prevention of Bartholin abscess is a surgical opening of the gland. An infected cyst may need antibiotics.

uncomfortable woman
7 / 9
You have itching that just won’t go away

Most of the time, vaginal itching occurs because you use soaps, perfumes, or fabrics that irritate your skin; this is called contact dermatitis. If this is a problem for you, try avoiding scented products. Bathing regularly and applying a thin layer of petroleum jelly can help relieve irritation, too.

If you’re still itchy, it could be something else like desquamative inflammatory vaginitis or a yeast infection. Intense vaginal itching might indicate lichen sclerosus, a condition that causes the skin to thicken. You may notice small white spots that eventually form patches, and sometimes red or purple bruises. 

“Often with lichen sclerosus, you can get into what we call an itch-scratch-cycle where you scratch it, it becomes inflamed and then the inflammation makes you itch more, and the whole cycle repeats,” says Newell. Left untreated, these patches can scar, and while uncommon, Newell says skin patches scarred by lichen sclerosus are more likely to develop into skin cancer.

Strong cortisone creams or ointments can relieve the itch, but often these medications cause other issues like stretch marks, yeast infections, and skin redness. So, other long-term treatments such as oral retinoids, retinoid topical creams, and tacrolimus, an immunosuppressive drug, may be necessary.

birth control, fertility, gyn, women's health
8 / 9
Your menstrual bleeding is out of control

Some women have heavier periods than others, but if you have heavy bleeding that lasts longer than seven days, you soak through a tampon or pad within an hour, or you have blood clots at least the size of a quarter, it’s time to see your gyno. Here are some of the more serious causes of heavy menstrual bleeding:

  • STIs like gonorrhea or chlamydia
  • Irregular ovulation
  • Uterine fibroids and polyps
  • Medications such as blood thinners, aspirin, and intrauterine devices (IUDs)
  • Endometrial, cervical, or ovarian cancer
  • Endometriosis
  • Miscarriage
  • Pelvic inflammatory disease

For diagnosis, your gynecologist will discuss lifestyle factors like your pregnancy history, medications, and menstrual cycle, and then perform a pelvic exam and lab work to test for STIs. Depending on your symptoms and age, you may need an ultrasound, endometrial biopsy, or other surgical management.

Treatment options vary, but for conditions like endometriosis, irregular ovulation, and fibroids, hormonal birth control options can regulate bleeding.

cramps, cramping, gyn, gi, digestive health
9 / 9
It feels like something is falling out of your vagina

If your vaginal region feels heavy, full, or uncomfortable (as if it’s pulling into the pelvis), you may be experiencing pelvic organ prolapse, or a condition that results from the weakening of muscles and connective tissue. When this happens, the uterus, bladder, and rectum can drop down from their normal position and press against the vagina. In more serious cases, they may protrude out through the vaginal opening.

Prolapse is usually a result of stress and pressure on pelvic floor muscles. Vaginal childbirth, genetics, natural aging, and prolonged jarring exercises like jumping and running can contribute.

Having symptoms? You'll be tested for pelvic floor strength and bladder function. 

Once diagnosed, it is wise to seek out a physical therapist who has a specialty in pelvic floor therapy. The first line of treatment is usually Kegel exercises, during which you lift, then relax pelvic floor muscles. If these strengthening moves don’t help, a supportive device called a vaginal pessary may be inserted by your HCP. Surgical options include hysterectomy—removal of the uterus—or colporrhaphy, which tightens the front or back walls of the vagina.

Quick Kegel how-to: Contract your pelvic muscles (as if you were holding in urine) for three seconds then release for three seconds. Repeat 10 times, up to three times a day.

Slideshow sources open slideshow sources

American Academy of Dermatology. How to shave. Accessed June 28, 2022.
Mayo Clinic. Folliculitis. Aug. 18, 2020. Accessed June 28, 2022.
Mayo Clinic. Genital warts. Jan. 14, 2022. Accessed June 28, 2022.
American College of Obstetricians and Gynecologists. Urinary Tract Infections. Last updated November 2020. Accessed June 28, 2022.
Mayo Clinic. Yeast infections (vaginal). March 17, 2021. Accessed June 28, 2022.
Merck Manual. Bartholin Gland Cysts. Last reviewed March 2021. Accessed June 28, 2022.
Merck Manual. Desquamative inflammatory vaginitis. Last updated: Jun 20, 2022. Accessed June 28, 2022.
American College of Obstetricians and Gynecologists.  Heavy menstrual bleeding. Last updated May 2021. Accessed June 28, 2022.
Mayo Clinic. Vaginal bleeding. June 15, 2021. Accessed June 28, 2022.
Cleveland Clinic. Vaginal prolapse. Last reviewed Dec. 30, 2019. Accessed June 28, 2022.
National Health System (UK). What causes a woman to bleed after sex? July 5, 2021. Accessed July 14, 2022.
Tarney CM, Han J. Postcoital bleeding: a review on etiology, diagnosis, and management. Obstetrics and Gynecology International. 2014;2014:192087.
Mayo Clinic. Vaginal bleeding after sex: When to see a doctor. November 25, 2020. Accessed July 14, 2022.
Lisa K. Pappas-Taffer. Lichen Sclerosus Treatment & Management. MedScape. September 25, 2020. Accessed July 14, 2022.
American College of Obstetricians and Gynecologists. Disorders of the Vulva: Common Causes of Vulvar Pain, Burning, and Itching. November 2020. Accessed July 14, 2022.

More On

How Vaginal Changes Affect Sex After Menopause

video

How Vaginal Changes Affect Sex After Menopause
Post-menopausal women may experience pain during sex due to vaginal alterations and decreased levels of estrogen. In this video, Patricia Geraghty, NP...
4 Reasons You Have a Vaginal Yeast Infection—and What to Do About It

article

4 Reasons You Have a Vaginal Yeast Infection—and What to Do About It
If you’re like many women, you’re familiar with yeast infections. About three-quarters of women will develop one at some point in their life, and near...
7 Reasons You Miss Your Period (Without Being Pregnant)

slideshow

7 Reasons You Miss Your Period (Without Being Pregnant)
Skipping a menstrual cycle doesn’t always mean you’re expecting. 
Are There Alternative Treatments for Perimenopause Symptoms?

video

Are There Alternative Treatments for Perimenopause Symptoms?
Women's health nurse practitioner and menopause clinician Marcy Holmes discusses some alternative treatment options for perimenopause symptoms. Watch ...
Can I Have an Orgasm After Menopause?

video

Can I Have an Orgasm After Menopause?
Post-menopausal women may experience alterations to the vagina, resulting in painful sex and difficulty orgasming. In this video, Patricia Geraghty, N...