Aunt Vadge: cuts of unknown origin

TL;DR

A 19-year-old from the UK shares her distress over recurring vaginal cuts, fearing herpes but suspecting her contraceptive pill’s role in her symptoms. Aunt Vadge advises on the importance of proper diagnosis, the potential impact of hormonal birth control on vaginal health, and the steps to take towards healing, emphasizing the need for a balanced vaginal microflora and exploring non-hormonal birth control options.

Dear Aunt Vadge,

I am age 19, from the UK. I read your article on vaginal fissures and I’m not quite sure which category I’d fit in to.

I am on the contraceptive pill and have been suffering with cuts for a year now. I know it is an issue but I have avoided getting it checked out in fear that it could be herpes. 

My cuts appear on the inner pink bits of my vagina and appear like paper cuts which sting and itch, sometimes multiple cuts at once. These tend to occur every 3-5 weeks but are not as severe as they have been in the past. 

I have had a bit of a history with these issues – around 18 months ago I had around three months worth of terrible water [urinary tract] infections which were painful and often occurred after sex. These water infections cleared up after about three months, but I think I had associated sex with them so I was very panicked whenever me and my boyfriend had sex, which caused a lot of stress for me and a lot of vaginal dryness and pain during sex.

Me and my boyfriend have since used lubrication and can now have sex comfortably, although things are not completely perfect. I can self-lubricate again, but (possibly due to pill) my libido is very low and I still get pain for the first few minutes after penetration, and these cuts sometimes appear – often out of the blue. My boyfriend is very understanding and patient.

My vagina is generally very dry if I touch it when washing and it cuts very easily if I touch it. My cuts are never around the entry area, just on the lips. Something down there does not feel right to me, as I said I feared that it was herpes but after reading I am unsure as these are paper like cuts in a concentrated area and are not blisters or sores. I understand it still could be but I\’m not sure how to tell.

Any advice would be greatly appreciated.

Just also to mention that i get a sting/burn when my boyfriend ejaculates in me.

Thanks
Broken
_______

Hi there Broken,

Thank you for your detailed email – you have give us lots of info to work with. It’s great.

It sounds like you have a greater problem than just a local vaginal one, and it’s possible that your birth control is a problem for you. A dry vagina that cuts easily and often for no particular reason is a problem that needs solving, and if it is herpes, you should really know about it! It doesn’t actually sound like herpes though – you’re right about that.

You went on the pill presumably because you wanted to be able to have sex and not get pregnant, but instead now your libido is low and your vagina has dried up, making sex a debacle, not the fun thing it is meant to be. Sex is painful, you have anxiety associated with it, and your vagina stings and burns. This is probably because your vagina is a bit raw all the time. Frequent infections of your urethra can be caused by a lack of proper vaginal microflora, which in turn results from the hormonal balance being out – lactobacilli love the glycogen that oestrogen causes to be excreted from the vaginal walls – it’s their food source. So if your vagina is dry, your good bacteria have less to eat, and infections can occur more easily since there are just less good bacteria to fight off the bad ones.

You may want to think about changing birth control to a non-hormonal variety for a while, and see if the situation improves. You are doing the right thing using a lot of lube – great start – but the problem has not been solved. Since the problem comes every 3-5 weeks, it seems related to your cycle, which is also between three and five weeks long.

There are a lot of other methods of birth control that you could try, but the first one would be the humble condom with a good-quality water-based lubricant. Speak to your doctor before going off the pill (since you might be on the pill for non-birth-control reasons) and run your symptoms past them, and get an examination, as they might have other ideas about what’s wrong. It’s important to rule out anything serious.

It is also important to be clear about your birth control options. See our contraception page, since there are a lot of options available to you, but not all of them will be suitable. Enjoying sex is of great importance here, since what’s the point if it hurts and causes you anxiety? It is damaging to you and your relationship with your boyfriend.

Your problem is definitely solvable, and it probably isn’t herpes, so go and see your doctor and get yourself a new system for not getting pregnant that works for you, and does not contain hormones (at least for six months). Once you are off the pill, keep close track of your cycles using a period tracker app or calendar, and learn about when you ovulate, and plan your fertility so you can tell what your hormones are up to. There may be something deeper happening and if this doesn’t resolve, this information will be pertinent later.

But you are 19, young, and your body bounces back quickly if you give it everything it needs to thrive – eat well, sleep well, drink plenty of fluids, exercise, and above all else, laugh plenty. Your body constantly strives for a state of balance, so if you don’t have any underlying problems (an infection, a hormonal imbalance), you will be just fine when your body re-regulates itself back to normal without the influence of artificial hormones.

If your problem doesn’t resolve and you need more help, please get in touch anytime. We are always happy to hear from you! Don’t forget to see your doctor or local sexual health clinic – they are a great resource for these problems, since they see them all the time. Don’t be shy.

Warmest regards,
Aunt Vadge  



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