The underwear It is a common symptom between women, often associated with infections, hormonal alterations or skin sensitivity. However, recent research suggests that psychological factors such as anxiety, stress and fear of pain can play a significant role in its expression and persistence.
A study conducted in Sweden highlighted that many women with chronic genital pain have high levels of anxiety, catastrophic thoughts on pain and avoidance behaviors (Thomtén & Karlsson, 2014). This suggests that intimate burning is not only a physical question, but can also be influenced by psychological and relational dynamics. The perception of skin sensitivity in the genital area is in fact highly subjective and can vary on the basis of biological, environmental and cultural factors (Farage, 2019).
But how can our emotions and convictions amplify the perception of pain and contribute to the chronicization of physical pain?
The psychological stress has a significant impact on the human body, influencing various physiological systems, including the immune system and thehormonal balance. When the body perceives a threat, both physical or emotional, activates the hypothalamic-pituitary-legal axis (HPA), leading to an increase in the production of cortisolalso known as “stress hormone” (Amabe & Anumba, 2020). Although this response is essential to deal with emergency situations, when the level of stress remains high for a prolonged period, it can have deleterious effects on health, including one ‘alteration of the vaginal microbiota and a greater one susceptibility to infections and inflammation.
The role of stress in the genesis and perception of intimate burning
One of the main effects of the chronic stress It is the suppression of the immune system. Cortisol, in fact, reduces the body’s ability to respond to infections by modulating the production of pro-inflammatory cytokines and altering the number of circulating immune cells (AmabeBe & Anumba, 2020).
This condition can encourage the proliferation of pathogenic agents such as bacteria responsible for bacterial vaginosis or mushrooms of the candid genre, which are often implicated in cases of intimate burning. In addition, cortisol can inhibit the deposition of glycogen in vaginal epithelial cells, thus reducing the availability of essential nutrients for the growth of lactobacilli, beneficial bacteria that contribute to maintaining the acid vaginal pH and preventing infections (AmabeBe & Anumba, 2020).
In addition to the direct effects on the microbiota, stress can influence the perception of pain. A study by Benetton et al. (2010) showed that individuals with high levels of anxiety and stress tend to experience pain in a more intense way than those with low stress levels. This happens because stress activates pain centers in the brain, increasing sensitivity to harmful stimuli and amplifying the emotional response to physical discomfort.
Consequently, a woman who suffers from a pre -existing condition such as candidiasis or vulvodynia could perceive a more intense intimate burning in periods of greater stress.
For this reason it is essential to consider that the link between stress and intimate pain can be read in a bidirectional way: on the one hand, stress contributes to the appearance or intensification of symptoms, on the other, persistent pain generates further stress, creating a vicious circle difficult to interrupt. It is therefore essential to recognize the influence of stress on intimate health and adopt strategies to manage it, as techniques of relaxation, physical activity and psychological support.
Causes and symptoms of intimate burning: contact dermatitis, candidiasis and vulvodynia
Among the More frequent causes of intimate burning there is the Vulvovaginal Candidosis (VVC), a fungal infection that causes itching, redness and dense and whitish vaginal secretions. A study conducted on young sexually active women highlighted that 42% of participants had a positive culture for candida And many of them reported pain during sexual intercourse (Rylander et al., 2004).
In addition to infections, intimate burning can derive from contact dermatitis, hormonal changes (as in menopause or during the menstrual cycle) and chronic pathologies Like Lichen Sclerosus, an inflammatory condition that affects the skin of the vulva (Woelber et al., 2020).
As we have seen, the intimate burning can be present, in some cases, even in the absence of an evident physical condition due to stress. However, before reaching this conclusion, it is necessary to lead a careful differential diagnosis.
When intimate burning becomes persistent and is not associated with infections or other evident pathologies, it could be vulvodynia, a chronic condition characterized by pain and burning vulvar without an apparent cause (Leusink et al., 2018). Vulvodynia affects about 8.3% of women and is often confused with recurring infections, leading to ineffective treatments and a negative impact on the quality of life. The main symptoms include burning, irritation and contact pain, both during sexual intercourse and in everyday life.
Also in this case the psychological aspect is fundamental: many women who suffer from vulvodynia develop anxiety, depression and difficulties in intimate relationships, since the condition is often underestimated or not diagnosed correctly. For this reason, it may be important to contact a specialist for an accurate evaluation and avoid inappropriate treatments, working on a multidisciplinary approach that includes pain therapy, psychological support and stress management techniques (Leusink et al., 2018).
More generally, prevent and treat intimate burning It requires a complete approach that takes into account both medical causes and psychological factors.
One of the fundamental strategies is the correct intimate hygieneconsidering that too aggressive hygiene practices can alter the balance of the vaginal flora and worsen the symptoms. According to Stockdale and Boardman (2018), many vulvar pathologies are exacerbated by irritating detergents, excessive washing or perfumed products, which can compromise the skin barrier and prepare for infections and inflammation. The use of delicate detergents, without perfumes, and breathable cotton linen to reduce irritation is therefore recommended.
Another important preventive measure concerns the care of vulvar skinespecially for those suffering from chronic conditions such as dermatitis or lichen sclerosus. The application of emollients and moisturizing creams Specifications helps to maintain the skin protected and less reactive to external stimuli. In cases where the burning is linked to infections Like candidiasis, it is essential to follow a targeted treatment with antifungal prescribed by a doctor, avoiding the frequent use of antibiotics that can alter the vaginal ecosystem (Stockdale & Boardman, 2018).
An often neglected aspect is the role of muscles of the pelvic floorwhose dysfunction can contribute to vulvar pain. Relaxation and pelvic physiotherapy techniques They can be useful for those suffering from chronic tension in this area, especially in cases of vulvodynia (Fischer, 2004).
Finally, it is important, in cases where the burning is exacerbated and/or exacerbates a condition of stress, seek psychological support. This can represent an effective tool to stop this vicious circle. Through the psychotherapyit is possible to better manage anxiety and unpleasant emotions related to chronic pain, thus reducing muscle tension and hyperactivation of the nervous system. In addition, therapy helps to recognize any dysfunctional schemes of thought that amplify the perception of pain and to replace them with more adaptive strategies.
Even relaxation techniques such as mindfulness and diaphragmatic breathing have proven to be useful in reducing the tension of the pelvic floor and in improving the quality of life of patients with vulvar disorders (Gold, 2005).
By supporting a therapeutic path to the medical management of intimate burning can therefore represent an effective solution for those suffering from recurrent symptoms or chronic pain.
Intimate burning: listen to your body to respect your needs
Dating intimate burning can be frustrating and debilitating, but knowing that there are effective solutions, both medical and psychological, it is an important step towards one’s well -being and the possibility of responding one’s needs.
It is very important to take care of yourself with correct hygiene, targeted treatments and strategies to reduce stress but it is essential, when the symptoms persist, to contact a trusted professional to find the right support and improve the quality of life.
Each person deserves to feel good in his own body and every body deserves to receive the attention and care he deserves.
Cover image: Sora Shimazaki
