Vaginal ulcers causes symptoms and quick treatment methods

Vaginal ulcers are a health concern that causes significant anxiety for many women—not only because they affect daily comfort, but also because they can signal underlying medical issues. In this Daleely Medical article, we'll provide a clear and detailed explanation of the causes, symptoms, and modern, effective treatments for vaginal ulcers. Our goal is to help you better understand the condition and take the right steps toward safe and timely treatment. Whether the ulcers are caused by infections, inflammations, or other factors, you’ll find all the information you need here to protect your health and avoid complications.

What Are Vaginal Ulcers?

Vaginal ulcers are small wounds or open sores that appear on the skin or inner lining of the vagina. They can be shallow or deep and are often accompanied by pain, itching, or a burning sensation. These ulcers can result from various causes, including infections, allergies, or certain skin conditions.

What Are the Most Common Causes of Vaginal Ulcers?

There are several possible causes for vaginal ulcers, including:

Infections: Such as viral infections (like herpes), bacterial infections, or fungal infections.
Allergies and Irritation: Triggered by certain soaps, scented vaginal washes, or perfumed daily pads.
Chronic Skin Conditions: Like lichen sclerosus or lichen planus.
Weakened Immunity: Seen in patients with diabetes or those taking immunosuppressive medications.
Rough Sexual Activity or Unsafe Tools: Can cause physical trauma or abrasions.

Are Vaginal Ulcers Contagious?

Not all of them. Some types are contagious, while others are not:

Contagious: Such as herpes or syphilis ulcers—these are sexually transmitted infections and can spread from one person to another.
Non-contagious: Ulcers caused by irritation or allergies are not contagious.

Can Vaginal Ulcers Affect Fertility?

Usually not, especially if treated early.
However, if the ulcers are caused by severe or chronic infections (like herpes or syphilis) and are left untreated, they may lead to complications affecting the reproductive system and potentially reduce fertility.

Do Vaginal Ulcers Cause Pain During Intercourse?

Yes, vaginal ulcers often cause pain or burning during intercourse. This discomfort can also impact emotional well-being and reduce sexual desire.
That’s why it's important to seek prompt treatment and avoid intercourse until the ulcers are completely healed.

When Should I See a Doctor Immediately?

You should consult a doctor right away if you notice:

New or painful vaginal sores.
Foul-smelling discharge or discharge with blood.
Fever or general fatigue along with the ulcers.
Persistent or frequently recurring ulcers.

Types of Vaginal Ulcers and Their Causes

Vaginal ulcers can be alarming, especially when painful bumps or lesions suddenly appear in the sensitive genital area. Each type of ulcer has its own cause and treatment method. Let’s explore the most common types:

1. Ulcers Caused by Viral Infections

Genital Herpes:
Appears as fluid-filled blisters that eventually burst and form painful sores.
Symptoms: Burning sensation during urination and painful intercourse.
Herpes is a chronic condition that can recur.
Human Papillomavirus (HPV):
Causes genital warts, which can turn into ulcers if irritated or inflamed.

2. Ulcers Caused by Bacterial Infections

Syphilis:
Begins with a painless ulcer that may disappear without treatment, but the infection remains in the body.
Chlamydia and Gonorrhea:
These don’t always cause ulcers directly but can lead to inflammation, resulting in abrasions or skin damage.

3. Ulcers Caused by Fungal Infections

Yeast Infection (Candida):
Causes intense itching, redness, and—if scratching occurs—can lead to ulcers or skin inflammation.

4. Ulcers from Allergies or Irritants

May result from:

Strong or scented vaginal washes.
Tight or synthetic underwear.
Perfumed sanitary pads or panty liners.

5. Ulcers Due to Chronic Skin Conditions

Lichen Sclerosus:
Causes white patches, dryness, and painful cracks in the skin.
Lichen Planus:
May cause persistent ulcers inside the vagina.

6. Ulcers Caused by Sexual Activity

Rough or aggressive intercourse without sufficient lubrication.
Vaginal dryness after menopause can lead to painful cracks and ulcers.

7. Ulcers Linked to Cancer or Precancerous Conditions

Vulvar or Cervical Cancer in early stages may present as non-healing ulcers or post-intercourse bleeding.
Requires thorough medical evaluation and possibly a biopsy.

8. Ulcers Due to Weakened Immunity

Common in people with:

HIV/AIDS
Autoimmune diseases like lupus
Chemotherapy patients

Their bodies are more prone to infections, leading to more frequent and slow-healing ulcers.

9. Ulcers from Physical Injuries

Can result from:

Incorrect use of tampons
Aggressive pelvic exams
Improper hair removal or shaving techniques

These are usually superficial but must be kept clean to prevent infection.

10. Psychological Ulcers (Rare Cases)

In rare cases, women suffering from severe anxiety or obsessive-compulsive disorder may unintentionally cause self-inflicted scratches, which require both psychological and dermatological treatment.

11. Ulcers Caused by Chronic Diseases like Diabetes

Diabetes weakens the immune system and increases the risk of infections, making recurring vaginal infections and ulcers more likely.

12. Ulcers of Unknown Cause

Sometimes ulcers appear without a clear reason. In these cases, doctors may request comprehensive tests to rule out serious conditions.

Who Is More Likely to Develop Vaginal Ulcers?
Vaginal ulcers can cause pain and anxiety for many women, but not all women are at the same risk. Certain factors increase the likelihood of developing these sores. Here's a simple and clear explanation of who is more at risk:

Sexually active women
Especially those with multiple partners or those who don't use protection like condoms. They’re at a higher risk of sexually transmitted infections (STIs) such as herpes or syphilis, which often cause noticeable vaginal ulcers.
Women with STIs
Infections like genital herpes, syphilis, gonorrhea, or chlamydia can lead to ulcers. These diseases not only cause sores but also increase inflammation, itching, and pain.
Women with weakened immune systems
Those with compromised immunity—like HIV-positive women or those on immunosuppressive medications after organ transplants—are more vulnerable to infections, making ulcers more likely.
Women with recurrent vaginal infections
Frequent infections weaken the vaginal wall and make the skin more prone to cracks and ulcerations.
Women with chronic skin conditions
Conditions like lichen sclerosus or psoriasis can affect the skin around the vaginal area, leading to ongoing inflammation and painful sores.
Hormonal changes
During menopause or when estrogen levels drop, the vaginal lining becomes dry and sensitive, increasing the risk of developing ulcers.
Use of harsh chemical products
Perfumed soaps, deodorants, or latex condoms can trigger allergic reactions or irritation in some women, leading to vaginal ulcers.
Poor personal hygiene
Neglecting hygiene can lead to bacterial or fungal build-up, causing infections and sores. On the other hand, excessive washing with strong cleansers can also irritate the skin and lead to ulcers.
Chronic health conditions
Like uncontrolled diabetes, which weakens the immune system and makes the body more prone to infections and ulcers.
Pregnancy
Hormonal changes during pregnancy, along with increased vaginal discharge and pressure from the growing uterus, can raise the risk of irritation and infection, which may lead to ulcers if not properly managed.

Causes of Vaginal Ulcers
Vaginal ulcers are painful and uncomfortable, and they can be a source of anxiety for many women. While many assume they’re always caused by sexually transmitted infections (STIs), there are actually several different causes. Let’s go through them in a clear and simple way:

Sexually transmitted infections (STIs)
One of the most common causes, especially in sexually active women:

Genital herpes: Appears as small blisters that burst and turn into painful sores.
Syphilis: Starts as a painless ulcer but can worsen if untreated.
Chlamydia & gonorrhea: May cause strong inflammation that can lead to ulceration.

Fungal or bacterial infections
Not all ulcers come from STIs. Some regular infections can also lead to sores:

Yeast infections (Candida): Cause intense itching, and scratching may lead to ulceration.
Bacterial vaginosis: Causes irritation and burning that can develop into sores.

Allergic reactions or skin irritation
Certain products or habits can irritate the sensitive skin in that area:

Scented soaps or strong vaginal washes
Scented sanitary pads or tight underwear
Latex condoms or lubricants (if allergic)

Rough intercourse or vaginal dryness

Intense friction or lack of lubrication
Vaginal dryness (especially after age 40 or during breastfeeding) can cause cracks and ulcers.

Chronic skin conditions

Lichen sclerosus or lichen planus: Skin disorders that affect the vulva and lead to ulcers
Psoriasis or eczema: If present in the genital area, they can cause inflammation and ulceration

Weakened immune system
When the body can't fight infections well, ulcers become more likely:

Conditions like HIV, lupus, or medications like corticosteroids or cancer treatments

Physical injuries or trauma

Improper shaving
Inserting objects like tampons too forcefully
Rough pelvic exams

Hormonal changes or puberty

During puberty or just before periods, the vagina can become more sensitive
Excessive washing or scratching mild dryness can lead to ulceration

Cancer or precancerous changes
In rare cases, persistent ulcers may be a warning sign of:

Vulvar cancer or abnormal cell changes that require immediate medical evaluation

Severe psychological stress

Stress, sleep deprivation, and emotional pressure can weaken immunity
This makes it easier for dormant infections like herpes to flare up and cause ulcers

Poor personal hygiene

Over-cleaning: Damages skin and leads to irritation
Poor hygiene: Allows bacteria and fungi to grow
Balance is key ✅

Vitamin and mineral deficiencies

Low levels of B12, zinc, or iron
Can lead to ulcers in the mouth, vagina, and other areas

Certain medications
Some drugs have side effects that affect the vaginal area:

Cancer treatments (chemotherapy)
Some antibiotics
Drugs that weaken immunity or dry out the skin

Urinary tract infections (UTIs)
Sometimes infections spread from the bladder to the vagina, causing burning and sores—especially during urination.
Friction during physical activity

Cycling, running, or tight sportswear can cause friction, leading to irritation and vaginal ulcers.

Symptoms of Vaginal Ulcers: How to Know If You Have Them

Vaginal ulcers aren't just painful—they also come with clear signs that are easy to notice. If you experience any of these symptoms, it’s important to see a gynecologist as soon as possible:

Pain in the genital area
You may feel pain while moving, sitting, or during intercourse. The intensity of the pain depends on the type of ulcer.
Burning sensation when urinating
When urine touches the ulcer, it causes a sharp burning feeling—this is one of the most uncomfortable symptoms for many women.
Small blisters or bumps
Sometimes, ulcers start as fluid-filled blisters (like in herpes), which later burst and leave open sores.
Severe itching
The skin becomes extremely sensitive, and scratching can worsen the ulcer and make it deeper.
Redness or swelling
The area around the ulcers might be red and visibly swollen or inflamed.
Unusual vaginal discharge
The discharge may have an unusual color (yellow or green) or smell, indicating an infection.
Light bleeding
You might notice light spotting, especially after sex or due to friction from clothes.
Swollen lymph nodes
The lymph nodes in the groin area may enlarge and feel tender or painful.
Flu-like symptoms
If the cause is viral or bacterial, you may feel tired, feverish, have a headache, or experience general fatigue.
Tingling or numbness before ulcers appear
With conditions like herpes, you might feel tingling or a prickling sensation in the area before the ulcers appear.
White coating or crusts
If there's a fungal or skin infection, ulcers might have a white coating or develop a crust.
Foul odor
Bacterial infections often come with a strong, unusual smell.
Vaginal dryness
Dryness increases pain and itching and could either cause or result from ulcers.
Pain while walking or sitting
If ulcers are in areas that rub against clothes or get pressure, movement can become very painful.
Fever
With severe infections (like herpes or syphilis), your body temperature may rise, causing exhaustion.
Pus or discharge from the ulcers
If the ulcers are infected, they may release yellow or green pus-like fluid.
Lower abdominal pain
Infections like chlamydia or gonorrhea can cause pain that extends to the lower abdomen or pelvis.
Skin rash elsewhere
Some conditions like syphilis or autoimmune diseases may cause rashes on other parts of the body—not just around the vagina.

How Are Vaginal Ulcers Diagnosed? | Key Tests and Examinations

If you notice sores or ulcers in the genital area, your doctor will not only examine their appearance but also order certain tests to find the exact cause.

Let’s look at the main steps involved in diagnosing vaginal ulcers:

Clinical examination by a gynecologist
The doctor will examine the vaginal area externally and internally using a speculum. She will assess the ulcers’ shape, size, location, and whether there’s any unusual discharge or odor.
Medical history and symptom review
You’ll be asked questions like:

When did the ulcers appear?
Is there pain, itching, or discharge?
Have you had recent sexual activity?
Any previous infections or treatments?
Do you use creams or feminine washes?

These questions help the doctor narrow down the possible causes.

Swab sample from ulcers or discharge
A sample is collected and tested in a lab to check for:

Bacteria
Fungi
Viruses like herpes

Blood tests
Blood tests can help detect:

STDs like syphilis or HIV
Inflammatory markers
Immune system issues

Microscopic examination
The lab examines the sample under a microscope to identify the infection or affected cells.
Urine test
This helps rule out urinary tract infections, which can cause similar symptoms like burning or pain.
Biopsy of the ulcer
If the cause is unclear or if there’s suspicion of a chronic skin condition or tumor, a small tissue sample may be taken for further analysis.
Additional tests if needed
Examples include:

HPV testing if there are unusual changes in the cervix
Immune system tests for recurring ulcers

⚠️ Complications of Vaginal Ulcers | Why You Shouldn't Delay Seeing a Doctor

Vaginal ulcers aren’t just uncomfortable—they can lead to more serious problems if left untreated. Here are some possible complications:

Increased pain and limited movement
The deeper or more widespread the ulcers get, the more painful and difficult it becomes to sit, walk, or have sex.
Infection spreading
If the ulcers are caused by infections like herpes or bacteria, they may spread to other parts of the reproductive system or even enter the bloodstream.
Scarring or dark spots after healing
Some ulcers leave behind marks or discoloration, which may cause emotional discomfort.
Negative effect on sexual relationships
Pain or embarrassment about the area’s appearance can cause stress in intimate relationships and affect mental well-being.
Risk of transmitting infection to partner
If the ulcers are caused by an STD like herpes or syphilis, they can directly transmit the infection during intercourse.
Weakened skin immunity
Affected skin becomes more sensitive and prone to irritation or new infections.
Chronic condition
Some conditions, like herpes or skin disorders, may cause recurring ulcers that require long-term management.
Impact on fertility or pregnancy
Infections like chlamydia or herpes may affect fertility or pose risks during pregnancy.
Pelvic inflammatory disease (PID)
If the infection spreads to the uterus or fallopian tubes, it can cause PID—a serious condition that may lead to infertility if untreated.
Emotional distress or depression
The pain, embarrassment, and recurrence of ulcers can lead to anxiety or depression, affecting everyday life.

Outlook: Is There Hope?

Yes, absolutely! The outcome depends on the cause and how well it’s treated. Here’s what you need to know:

The cause is key
If the ulcers are due to a simple bacterial or fungal infection, treatment is usually quick and effective.
For chronic causes like herpes, symptoms can be managed and outbreaks controlled with proper care.
The right treatment makes a big difference
With accurate diagnosis and appropriate treatment (antibiotics, antifungals, antivirals), most cases improve significantly.
Some conditions may recur
Like herpes or certain skin diseases—but regular follow-up with your doctor helps reduce flare-ups.
Emotional support is essential
You don’t have to suffer in silence. If you feel emotionally affected, talk to your partner, family, or a therapist for support.

5. Prevention Is Always Better Than Cure

Take Care of Your Intimate Area:

Keep the vaginal area clean and dry.
Use protection during intercourse.
Avoid harsh products or strong washes.
See your doctor as soon as you notice any unusual symptoms.

⚠️ Are Vaginal Ulcers Dangerous?

Usually, vaginal ulcers are not dangerous if treated promptly. But ignoring them or using the wrong treatment can lead to complications like:

Pelvic Inflammatory Disease (PID): The infection can spread to the uterus and fallopian tubes.
Fertility Issues: In rare cases, ulcers may affect fertility.

But don’t worry—these are rare scenarios and can easily be avoided with proper treatment and follow-up.

Medical Treatment for Vaginal Ulcers

The treatment depends on the cause. Here are the most common medications:

1. Antibiotics

If the cause is a bacterial infection.
Examples: Amoxicillin, Azithromycin, Cephalosporins.
These help eliminate bacteria and prevent complications.

2. Antifungal Medications

If caused by a fungal infection like candidiasis.
Examples: Miconazole, Clotrimazole, Fluconazole.
Available as creams or oral capsules depending on the severity.

3. Antiviral Drugs

Especially in cases of genital herpes.
Examples: Acyclovir, Famciclovir, Valacyclovir.
They reduce symptoms, speed up healing, and help prevent recurrence.

4. Topical Creams

Used to relieve itching, inflammation, and pain.

Corticosteroid creams: For skin inflammation or autoimmune conditions.
Topical antibiotics or antifungals: Depending on the infection type.

5. Pain Relievers

To ease burning or discomfort.
Examples: Paracetamol (Acetaminophen), Ibuprofen.
These help improve comfort, sleep, and mobility.

6. Supportive Treatments

Antihistamines: If itching is severe.
Preventive meds: To reduce the risk of further infections during ulcer healing.

7. Tailored Treatment

If ulcers are due to chronic skin diseases (like lichen planus or lupus), your doctor may prescribe immunosuppressants or a special treatment plan.

Types of Surgeries Used to Treat Vaginal Ulcers

1. Vaginal Biopsy

A small tissue sample is taken from the ulcer for lab testing.
Essential for diagnosing chronic or suspicious conditions.
Usually done under local anesthesia with minimal pain.

2. Surgical Excision

Complete removal of the ulcer or damaged tissue.
Used when medications don’t work, especially for large or chronic ulcers.
Can be done with a surgical blade or laser.

3. Reconstructive Surgery

Repairs any deformities caused by ulcers or wounds.
Restores the natural look and sexual function of the vagina.
Techniques vary based on the extent of the damage.

4. Electrocautery

Uses heat to destroy damaged tissue.
Less invasive than traditional surgery.
Best for small ulcers or localized lesions.

5. Laser Surgery

High-precision removal of infected tissue using laser beams.
Reduces bleeding and post-op pain.
Ideal for specific types of vaginal ulcers.

6. Tumor or Suspicious Mass Removal

If ulcers are linked to benign or cancerous growths, the affected area is completely removed and sent for thorough lab testing.

How Is Vaginal Ulcer Surgery Performed?

Surgery is done under local anesthesia for small and accessible ulcers, or under general anesthesia for larger or deep-seated ones.
During surgery, the damaged tissue is carefully removed while preserving as much healthy tissue as possible.
After the procedure, the doctor monitors wound healing and may prescribe medications like antibiotics or anti-inflammatory drugs to support recovery.

Risks of Vaginal Ulcer Surgery

Although generally safe, surgery can carry some risks, including:

Bleeding: May occur during or after the operation, but doctors are prepared to manage it.
Infection: There's always a risk of infection post-surgery, which is why hygiene and following your doctor’s instructions are crucial.
Slow Wound Healing: Sometimes, wounds take longer to heal depending on your health and immune response.