Soreness or discomfort in the vaginal and vulvar area during menstruation is a common phenomenon. This discomfort is typically felt as a burning, irritated, or raw sensation around the external genitalia (the vulva), or sometimes as a deep ache referred from the internal reproductive organs. While the uterus is the source of the menstrual bleed, the surrounding tissues are highly responsive to the cyclic changes occurring each month. Understanding the physiological and external factors at play can help clarify why this soreness occurs and how it can be managed.
How Hormonal Changes Cause Discomfort
The deep, aching soreness that radiates to the vaginal area often originates from the uterus, driven by hormone-like substances called prostaglandins. These chemicals are released by the endometrial lining as it breaks down, signaling the uterus to contract strongly to expel the tissue. High levels of prostaglandins cause intense uterine muscle spasms (cramps), and the pain can be referred along nerve pathways to areas like the lower back, thighs, and the pelvic floor.
The significant drop in estrogen and progesterone levels just before and during menstruation also plays a direct role in local tissue sensitivity. Estrogen maintains the thickness, elasticity, and lubrication of the vulvar and vaginal tissues throughout the cycle. As estrogen levels decrease, these tissues become thinner and temporarily drier, leading to increased sensitivity and a raw feeling.
This reduction in natural lubrication makes the vulva and vaginal opening more susceptible to irritation from friction. The hormonal shift also affects the vaginal microbiome, slightly altering the pH balance. This change increases the area’s vulnerability, making it more prone to discomfort during the period.
The Role of External Irritants and Hygiene
Soreness that feels like chafing or surface irritation is frequently caused by external factors related to menstrual product use and physical activity. Menstrual pads, especially, cause friction against the sensitive vulvar skin with every movement. This constant rubbing, combined with moisture from blood, creates an environment ideal for skin irritation and chafing.
Many conventional pads, liners, and tampons contain chemicals, dyes, and fragrances that are known irritants. Contact dermatitis, an allergic reaction, can occur when the skin reacts to these additives, manifesting as burning, stinging, or itchy soreness. Even certain laundry detergents or fabric softeners used on underwear can contribute to this irritation.
Moisture management can also lead to issues, as both excessive wetness and dryness are problematic for the vulvar skin barrier. Wetness can lead to maceration (softening and breakdown of the skin), while over-wiping or using harsh, non-pH-balanced soaps can strip natural protective oils. Wearing clothing that is too tight or non-breathable, such as synthetic fabrics, traps heat and moisture. This further exacerbates the problem by increasing friction and bacterial growth.
When Soreness Indicates Another Health Issue
While mild soreness is common during menstruation, severe or persistent pain that lasts beyond the period may signal an underlying condition exacerbated by the monthly cycle. The hormonal and pH shifts during the period create a less acidic environment, allowing opportunistic infections to thrive. Yeast infections (candidiasis) and bacterial vaginosis (BV) are common examples that can flare up or be intensified by menstrual blood.
These infections cause intense itching, burning, and soreness, often accompanied by an unusual discharge or odor. A condition called vulvodynia involves chronic, unexplained pain in the vulvar area, and symptoms often worsen just before and during menstruation due to increased tissue sensitivity.
Conditions like endometriosis, where tissue similar to the uterine lining grows outside the uterus, can also cause severe pelvic pain that radiates to the vaginal area and intensifies during the period. Any soreness accompanied by a fever, intense burning that makes walking difficult, or pain during urination should prompt a visit to a healthcare provider. These signs suggest an issue requiring professional diagnosis and specific medical treatment.
Managing Discomfort and Finding Relief
Effective management begins with choosing the right products to reduce external irritation and friction. Switching to fragrance-free, dye-free, or 100% organic cotton pads and liners can reduce the risk of contact dermatitis. Alternatives like menstrual cups or discs eliminate the need for external pads, removing surface friction altogether.
For internal pain related to uterine contractions, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are effective because they inhibit the production of prostaglandins. Taking an NSAID at the first sign of bleeding, or slightly before, helps control the chemical process that leads to severe cramping and referred soreness.
Comfort measures can also provide localized relief for vulvar soreness. Applying a cool compress or taking a warm bath can soothe irritated tissues. Gentle hygiene involves rinsing the area with plain water only, avoiding harsh soaps, and always patting the area dry with a soft cloth. Wearing loose-fitting, breathable cotton underwear and avoiding tight clothing minimizes pressure and allows air circulation, which prevents painful chafing.