Gain Something Through the Pain
What Types of STDs Cause Genital Pain?

Gain Something Through the Pain

A painful sensation is often a sign of concern that many would not even dare brush off or ignore for fear of an underlying disease or damages to your organs that you could not perceive due to its internal nature.

This is not to say that there are no people that shrug it off, thinking that it is just as common as the usual headache, but the point for other people’s panic stands – ignoring a painful sensation is close to the worse thing that you can do in response to such a manifestation. Pain is a defense mechanism of the body that allows you to know whether a particular part of your body is either at risk of being damaged or is currently damaged and being exacerbated by some other factor that affects it in one way or another. Pain is a telltale sign of something wrong – one that you should never take for granted and one that you would surely want to probe into lest that it develops into another condition entirely that could end up being irreversible in the long run. Pain, in essence, is the one symptom that you should never ignore, especially when it comes to relatively sensitive organs of the body.

The genitalia is a sensitive part of the body due to its susceptibility to various conditions on top of being at risk to multi-factorial problems – making it hard to protect the area from all conditions imaginable necessarily. Considering that the genitalia is used for reproductive purposes – a somewhat finicky process that requires utmost safety and accuracy to ensure that everything goes well – any manifestation observed within this area should be examined with depth to verify whether the presentation is, in fact, mundane and benign. Unfortunately, due to the stigma that often surrounds the area of sexual health, most presentations are often ignored or brushed off due to how difficult it is to even open up to someone about particular symptoms that you might be having. It might even be difficult for some to communicate to their physicians about it.

However, one should note that the field of sexual health is slowly developing nowadays – evolving into a more open area where people are now relatively more comfortable in asking for help, especially considering that the management approaches for conditions involving the genitalia are extremely sensitive. As such, if you are experiencing a particular symptom, particularly pain in the genitalia that you may or may not know the history of, perhaps learning how to ascertain the proper tests and initial prophylactic measures for its potential causes would go a long way in supporting the efforts by which the population’s sexual health is managed nowadays.

Common Manifestations of Genitalia Pain

Genitalia pain, similar to how other pain symptoms are, is highly subjective to the patient’s description of their experience, making it hard to create an objective diagnostic criterion that could be used to determine the exact level of pain a patient is experiencing. Sure, there are specific measures by which pain can be assessed, such as using scales or visual representations that the patient can select from, but this would remain subjective due to the symptom being dependent on the patient’s response or how the pain registers in the patient’s consciousness.

Pain in the genitalia often presents as either a standalone symptom or one that is coupled with a few other manifestations that are distinctive of particular conditions such as erythematous discharge, painful urination, blood in the urine, swelling and blistering, and many other presentations that could then be used to provide a differential diagnosis.

The primary associated factor to such a manifestation is often anxiety due to how everyone perceives the worst when it comes to painful genitalia. While sexual health is now slowly being unveiled from its years of being cloaked in stigma, the previous preconceptions would be relatively hard to budge – resulting in a relatively normal negative response to learning that your most sensitive part is experiencing some level of damage at that point.

What does Pain in the Genitalia Mean?

Pain in the genitalia is not necessarily always fatal and crucial, but this is akin to being involved in a car crash. It is not necessarily life-threatening at all times, but being careful and wary of all the telltale signs of impending damage would go a long way in ensuring that you are not put at risk in the first place of getting injured. This is essentially the importance of immediately assessing any signs of pain within this susceptible region.

Pain in the genitalia could be caused by various factors – ranging from internal damage to an external infection. Conditions involving the genitalia are already multi-factorial, but the pain is even more prone to multiple predisposing factors and causative mechanisms.

Potential Causes of Genital Pain

Considering that various conditions could cause pain in the genitalia that one might not even consider checking some of them, the following conditions are just some of the non-sexually transmitted infections that might be causing the pain you are experiencing. There are certainly more conditions that might contribute to the presentation of this symptom, but the diseases are the most common among the rest to cause such a manifestation, particularly one that is specific to the genital area, to begin with.

Epididymitis

Epididymitis is a condition that is commonly characterized by the inflammation of the epididymis or the coiled tube located at the back portion of the testicle. This is evident in males of any age, and its primary cause is often a bacterial infection that may or may not be sexually transmitted. A few examples of STDs that often cause epididymitis as one of its complications or regular presentations are chlamydia and gonorrhea.

Epididymitis is often associated with inflammatory and painful symptoms such as having a swollen and red scrotum, pain and tenderness in the testicular area, painful urination, urinary frequency, discharge from the genitalia, pain within the lower abdominal or pelvic area, blood in the semen, and at times, an accompanying fever along with the symptoms mentioned above.

The following conditions are often the non-STD cause of epididymitis development in males of all ages:

  • Trauma: experiencing some level of trauma within the groin area may cause damages to the structures of the genitalia – resulting in a potential case of epididymitis.
  • Tuberculosis: this is a variation of tuberculosis known as genitourinary tuberculosis wherein there is either a painless or slightly painful mass within the scrotum akin to those observed in cases such as those with epididymal-orchitis.

Kidney Stones

Kidney stones are generally defined as a solid crystallized mass mainly composed of salt and minerals within the kidney – leading to the formation of blockages either within the organ itself or within the various tubules and tracts that involve the release of urine. In most cases, the body would attempt to compensate for the presence of these foreign materials by trying to excrete them through the ureter – a relatively narrow tract that is then damaged due to its extreme sensitivity and friction with the passing stones.

While this pathophysiology would often raise the question of why it is related to genital pain, kidney stones can cause pain throughout the genital area and sometimes even along the lower back portion of your body. Due to the constant friction that the stones exert upon passing through the ureter, it may likewise present with a few other accompanying symptoms such as blood in the urine, nausea, and urinary frequency.

Testicular Torsion

Testicular torsion is essentially an instance wherein the testicles rotate up to a certain angle – causing a restriction in the blood flow of the spermatic cord, a vessel that delivers oxygenated blood supply towards the scrotum. Upon testing, an individual may often experience acute testicular pain wherein the genitalia would often be tender and extremely painful, the swelling would be observed along the scrotum, nausea would be experienced, and the testicle would be unusually positioned upon physical examination of the area.

Due to the extreme pressure that the twisting or torsion is applying on your spermatic cord, severe testicular pain can be experienced even when simply walking, standing, exercising, or even sitting. In addition to that, due to the restriction of blood flow towards the area, you must have your condition immediately examined by a physician right away to restore oxygenation of the site.

Medication Side Effects

Considering that the mechanism of action of medications is often hard to understand for many, the only thing you have to note is that certain medicines would lead to an onset of testicular/genital pain. Your physicians are often responsible for explaining the potential side effects of your medications to you upon the provision of prescription, but in case it was not, if you have observed that you started experiencing pain within the genital area after taking the medication, i.e., antibiotics, immediately contact your doctor to know more about the medicine you were prescribed with. While contacting your doctor will not necessarily directly resolve the issues you are experiencing, having the possibility of a medication side effect ruled out will go a long way in pinpointing the condition that is behind your current problem.

Prostatitis

Prostatitis is essentially defined as the inflammation of the prostate gland in males – resulting in symptoms that may include chills, fever, flushing, tenderness and pain along the lower abdominal area, and body pain. Apart from these, the urinary symptoms often present may include blood in the urine, pyuria and dysuria, failure to urinate, foul-smelling urine, or a weak urine stream. Painful sensations are likewise familiar for prostatitis, mainly prevalent along the lower abdominal area, in the lower back, in the testicles, and the area between the anus and genitalia. Pain during ejaculation and defecation may likewise be observed in certain instances.

Henoch-Schonlein Purpura

Henoch-Schonlein Purpura, otherwise known as IgA vasculitis, is a condition wherein the small blood vessels in your skin, joints, intestines, and kidneys present inflammation and eventually bleed – resulting in the characteristic purplish rash along the affected areas, particularly within the lower legs and the buttocks.

The four main characteristics of the condition would include rashes or reddish-purple spots that may be worse in areas of pressure, swollen and sore joints akin to arthritis, mainly in the knees and ankles, digestive tract issues such as pain, nausea, vomiting, and bloody stools, and kidney damage characterized by the presence of protein or blood in the urine.

Mumps

Mumps is a well-known contagious viral infection that can be spread through direct contact with saliva or respiratory droplets from an infected patient. The droplets can be distributed in multiple ways, including coughing, sneezing, talking, sharing items that come into contact with the saliva, and participating in close-contact activities with others.

It is known for the characteristic puffy-cheeks and tender, swollen jaws due to the inflammation of the salivary glands on both sides (parotitis). The inflammation may likewise be accompanied by other symptoms such as fever, headache, muscle pain, tiredness, and loss of appetite.

As the disease progresses, it may cause certain complications that may involve the manifestation of pain along the genital area in both men and women. Mumps may cause inflammation of the testicles and ovaries – leading to the observed genital pain upon the progression of the disease into its later and more severe stages.

Hydrocele

The inflammation of the scrotum characterizes hydrocele due to the collection of fluid within the thin sheath that usually surrounds the testicle. It is relatively common in newborns, but it is immediately resolved even without treatment by the time the patient turns 1. It is not as common in older men, but it can still be developed due to inflammation or injury within the scrotal area.

Hydrocele’s manifestations are often described as not painful in the sense that it pulses every time it is disrupted, but it does cause some level of discomfort due to the heaviness that the swollen testicular area exerts upon the entire genitalia. However, while it is relatively painless for the most part, pain may also be observed, especially when the inflammation continues to progress without the necessary intervention being applied.

Inguinal Hernia

As many people would probably know, an inguinal hernia is a condition wherein a tissue such as a particular part of the intestine protrudes into a specific cavity within the weak abdominal muscles – causing a painful bulge that is often exacerbated with coughing, bending over, or lifting heavy objects.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease or PID is an unfortunate complication of certain infections – mainly characterized by the spread of the illness towards other parts of the reproductive organ such as the uterus, ovaries, fallopian tubes, and cervix. It is more prevalent in cases with untreated STIs due to the extreme proliferation of pathogens within the genital area, and it commonly affects around 5% of the women in the United States. There are several risk factors in women that could cause the development of PID, but one striking factor is the use of excessive douching – a process by which the stream pushes the bacteria into the reproductive organs and thus, causing PID.

Sexually Transmitted Infections that Precipitate Genital Pain

If you are a sexually active individual or are at high risk for contracting sexually transmitted conditions, perhaps it might be efficient to examine the potential presentations of various STDs to determine whether an STD causes your experience genital pain or not.

Chlamydia

Manifestations and Presentations

Chlamydia is a widely common STD transmitted by the microorganism Chlamydia trachomatis – a pathogen that has been found to cause cervicitis, urethritis, and proctitis among infected individuals. It is infamous for its various complications, such as the development of ectopic pregnancy, PID, tubal factor infertility, and chronic pelvic pain. The pathogen has also been found to cause lymphogranuloma venereum - an STD that causes wide proctitis outbreaks, particularly in men who partake in men-to-men sexual intercourse.

Chlamydia is also coined as the “silent infection” due to how widely asymptomatic the condition is among various infected individuals. However, it can also precipitate symptoms such as discharge, bleeding, dysuria, and pain around the genital area.

Diagnostic Process

Several diagnostic tools can be used in the determination of the presence of C. trachomatis within the system. However, it has been found that a nucleic acid amplification test or NAAT is the most sensitive option and the test that requires the least invasive sample collection process – making it favorable for both the patient and physician. Do note, however, that cell culture tests may likewise be administered depending on the discretion of the attending physician.

Management Strategy

The following regimen is the standard treatment plans that are administered for patients with Chlamydia:

  • A 7-day course of antibiotics that the bacteria is currently susceptible to
  • Single-dose antibiotic treatment that the bacteria is presently vulnerable to

The therapies, as mentioned earlier, are also supplemented with abstinence to avoid the transmission of the bacteria while the pathogen is still viable and easily transmissible. Prophylactic treatment may likewise be indicated for the partners of infected patients.

Gonorrhea

Manifestations and Presentations

Gonorrhea is infamous for its ability to penetrate mucous membranes and precipitate manifestations around these areas – making it extremely easy to transmit its causative microorganism known as N. gonorrhoeae. Due to its tendency to target the mucosal membranes of the genitalia, it can penetrate deeper into the reproductive organ, causing infections even in the cervix, uterus, and fallopian tubes.

While widely asymptomatic in most cases, gonorrhea could precipitate symptoms such as discharge, dysuria, vaginal bleeding between periods, and in the case of men with severe complications such as epididymitis, testicular and scrotal pain that manifests when the condition is not imperatively addressed in its early stages.

Diagnostic Process

A nucleic acid amplification test or NAAT is commonly used to diagnose N. gonorrhoeae presence in the patient’s system, but gonorrheal cultures through endocervical and urethral swab specimens can also be used depending on the clinician’s judgment.

Management Strategy

The following process/therapies serve as the primary intervention measures in the management of gonorrheal infections:

  • Single dose 500 mg IM Ceftriaxone
  • Alternative regimens for the treatment of urogenital and rectal gonorrhea (depending on resources and availability of medications)
  • Test-of-cure 7-14 days following the administration of the treatment regimen to ensure that the pathogen has been eradicated

However, please note that while the medication can resolve the infection, it cannot repair any damages that the condition has previously caused. To address this problem, ensure consistent testing, especially when you are sexually active, to detect the presence of the bacteria as soon as you are infected.

Genital Herpes

Manifestations and Presentations

Herpes is a disease caused by two different variants of single viral species – herpes simplex virus types 1 and 2, or HSV-1 and HSV-2, respectively. Herpes is considered standard in the United States, with an estimated 572,000 new cases per annum.

Herpes, particularly genital herpes, is known to be widely asymptomatic among infected individuals. This leads to most cases being disregarded due to how difficult it is to determine whether you have the condition if no symptoms are apparent at all.

In symptomatic cases, herpes precipitates blisters that break and form painful ulcers on or around the genitalia along with other systemic manifestations such as fever, body pain, swollen lymph nodes, and headache.

Diagnostic Process

There are currently two types of tests used to diagnose herpes – both varying depending on when they are used and for what kinds of herpes they are utilized for.

  • Nucleic Acid Amplification Test (NAAT): highly sensitive but not usually used for recurrent or healing lesions due to the drop in viral load.
  • Type-Specific Virologic Tests: used for patients with recurrent or healing lesions, even without a confirmatory NAAT
  • Culture Test: used in situations where the other tests are unavailable

Management Strategy

There is currently no approved medication for the treatment of herpes, but it can be managed with the consistent administration of suppressive antiviral medication therapy to prevent its further transmission.

Potential Testing Laboratories for STD-Induced Pain

Suppose, upon the initial examination of your symptoms, it appears that an STD causes the genital pain you have experienced. In that case, the following testing laboratories are open to providing you with the necessary tests to determine once and for all whether an STD is behind your symptoms.

Laboratory

Chlamydia

Genital Herpes

Gonorrhea

Package Prices

What it Offers

STD Check Labs

Yes

Yes

Yes

Custom Kit at $145.00

  • Obtain result within 1 to 2 days
  • Sample is collected in the laboratory
  • Kit is fully customizable

myLAB Box

Yes

Yes

Yes

8-Panel At-Home STD Kit at $269.00

  • Obtain results in as early as 2 days
  • Private collection of samples
  • Comprehensive at-home testing kit
  • Complete anonymity

HealthLabs

Yes

Yes

Yes

Comprehensive Test at $278.00

  • Obtain results in as early as 3 days
  • Orders performed by phone or online
  • Minimal interaction with other people

GetTested (CDC)

Yes

Yes

Yes

Free to use

  • Free-to-use search tool for potential laboratories with the appropriate tests for your needs

Frequently Asked Questions (FAQs)

How long is the contagious period of mumps?

For most cases, patients may stay contagious for 5 days following the onset of salivary gland swelling.

Is it possible to lead a normal life with herpes?

Yes. Despite its lifetime prevalence, it can be maintained at safe and suppressed levels to avoid its progression.

Is genital herpes contagious for as long as the pathogen is present?

No. Consistent medications would suppress the transmission of the virus and allow the patient to lead a normal life.

How long does chlamydia persist if left untreated?

As long as chlamydia is left untreated, it could persist for several years, causing complications and damages along the way.

Can you contract gonorrhea from toilet seats?

No. Gonorrhea is only contracted through sexual activity.

Additional Reading

Centers for Disease Control and Prevention

National Institute of Health

World Health Organization

References

Mark Riegel, MD

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