TMI, But Why Is My Vagina Swollen? A Guide To This Down-There Discomfort

Are you feeling a little uncomfortable down there? Do you sort of feel like it's on fire? If you've dealt with a swollen vagina or vulva, you know how irritating — and a little scary — it can be. You're probably wondering what's happening, why it's happening, and if you should worry. Or, to the last point, you're probably already worrying but wonder if you should really panic.

There are several reasons that sensitive area of your body might be swollen. Fortunately, they aren't all that serious, and some can resolve quickly — you'll just be super uncomfortable for a few days. To learn more, Scary Mommy asked Dr. Meg Galaske, co-founder and CMO of Trace Femcare, Inc., to explain why your vagina or vulva might be swollen and when to call a doctor.

What are the reasons a vulva or vagina may be swollen?

According to Galaske, there are four main reasons you may experience swelling of the vulva/vagina (also called vulvovaginitis):

1. Infection

"When the vulva and/or vagina swell due to infection, it is due to the insult (bacteria, yeast, etc.) being recognized and fought by the body," Galaske says. "The body is super smart and knows exactly how to try to rid infection; therefore, it sends an inflammatory cascade of signals through the bloodstream to the affected tissue."

Though it's the same process as when you get an infection in other parts of the body, more minor insults may cause more irritation in the vagina or vulva because these areas are more sensitive. Points out Galaske, these areas come "with more nerve endings and larger capillary beds that become engorged with blood (remember, the body is trying to get those signals there!)."

Also, a special mucosa lines the vagina that can be "more sensitive to certain insults, as well as a specific microflora that is usually balanced to keep you happy and healthy and does not like to be disturbed by foreign bacteria, viruses, or yeast," she says.

Different infections cause all different types of inflammation, from general swelling to redness, dryness, discharge, or even lesions. "STIs such as gonorrhea, chlamydia, herpes, and HPV, as well as typical vulvovaginal infections such as yeast (candida albicans) and bacteria (usually gardnerella vaginalis), and skin infections such as staph and strep can cause vulvovaginal irritation, swelling, itching, and even pain," Galaske says.

Even if it's something that you think could be minor or you would like to try treating at home, Galaske warns not treating some of these infections can have long-term consequences. "Untreated, something milder, such as a yeast infection, may be irritating and annoying over the long term, and something more serious, such as gonorrhea, can cause permanent scarring of the uterus," she says. "HSV left untreated can cause painful lesions, recurring over a lifetime. And, of course, HPV can lead to cervical cancer. Each of these presentations is unique and requires both a good history and physical exam, as well as usually some lab testing, to determine the cause and the best course of treatment. Sometimes, it may be able to be treated at home, as mentioned above, and sometimes it requires an antibiotic, antiviral, or antifungal medication."

2. Irritation

"This can occur both on the skin and intravaginally, usually caused by sensitivities to clothing, period products, or topicals used on the area," Galaske says. "This can be a long list — from fibers or finishing chemicals used in underwear and period products to lubes and washes."

Swelling due to irritation is usually called contact dermatitis, which is in the eczema family, explains Galaske, "so think really itchy, red, bothersome swelling. This is a similar process to infection, with the body sending messages to the tissue through the blood; however, it is through a different cascade of chemicals with different receptors in the tissue. In this case, cells called mast cells come into contact with an allergen, which makes them release histamine. This is the chemical that makes itchiness and swelling occur."

This type of vulvovaginitis usually responds well to removing the trigger, says Galaske, although that can sometimes be difficult to nail down. If severe, you can treat the swelling due to irritation with mild topical natural lotion (externally only). Still, she warns you should avoid steroids in the genital area ("So don't use your hydrocortisone hand cream for itchiness down there!"). A cooling pack may be applied, "but never hold it on long enough for the skin to get numb — you can cause nerve/skin damage."

3. Minor Trauma

Repeated mild trauma to the area can cause swelling, as well, cautions Galaske. "This might be from biking, horseback riding, or more fun activities, like sexual intercourse."

4. Arousal

Lastly, it should be noted that the vulva and vagina swell in response to sexual stimuli. "Blood flows to the area, making the tissue swell and feel warm and even tingly," Galaske points out. She adds that this type of physiological swelling is "normal and will resolve with removal of the stimulus."

How can I treat a swollen vagina/vulva at home?

According to Galaske, you might see improvement without doing anything, such as trauma from riding a bike resolving if you take a few days off. But some other reasons require extra love and care. "The biggest thing you can do to help your vulvovaginitis is to leave it alone," she says. "All those extra 'pH-balanced' washes, lotions, and creams are actually harmful to the special microflora that keeps your tender skin/intravaginal mucosa happy and healthy. Your vagina is begging you to go back to just mild unscented soap on the outside, nothing on the inside, or better yet, just water everywhere!"

Galaske notes it may take a few weeks to feel better, "but your body is hella smart and will figure it out! If you don't see improvement, see if your underwear, clothing, sexual wellness, or period products are the culprit." She suggests taking a break or switching products and seeing what happens.

The last thing she advises is to stop trying "wild" OTC treatments for your vagina. "For example, boric acid may help in some situations, but overuse can be horrendous!" she stresses. "Just because you saw it worked for someone else on TikTok doesn't mean it needs to be anywhere near your most sensitive area."

When should I see a doctor?

"If you have prolonged irritation, vaginal discharge that has a strong odor or different consistency than you're used to, visible vulvovaginal lesions, irregular bleeding, or other symptoms, you should consult your healthcare provider, as this could mean infection or sensitivity that needs treatment," Galaske says.