All hail the vagina and its fantastically self-sufficient ways! However, beyond STIs and over-enthusiastic douching, we may be sabotaging our vaginas’ health in a way we may never have considered: with our thoughts.

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We are beginning to wake up to the effects of mental health on your physical health (ie that persistent cold could be due to the stress you’re experiencing at work). And yes, anxiety, depression and chronic stress might be making your vagina unhappy. So what is an unhappy vagina? Symptoms such as abnormal discharge, recurring yeast infections, pelvic pain and painful sex are some ways your vagina could be trying to tell you that it’s time to address your mental health.

1. Anxiety

Psychologist Micah Abraham explains that the main issue with anxiety is the stress it causes: ‘Anxiety causes stress to be placed on the body, and that stress has a way of altering your body’s internal chemistry – including hormones, healthy bacteria and more.’

Vaginal discomfort

The above-mentioned imbalance of hormones and healthy bacteria can lead to vaginal discomfort in the form of infections (due to a lowered immune system), increased or abnormal vaginal discharge as well as cramping and pain in the pelvic region (due to the constant tensing of muscles associated with chronic stress). Additionally, Micah states that ‘high amounts of stress can cause itching, burning and dryness within the vaginal wall’. This can be down to ‘the way that anxiety affects hormonal regulation within the body’.

Discomfort awareness

The above can be worsened by ‘discomfort awareness’ which means that symptoms of discomfort are felt more intensely by someone experiencing anxiety as ‘the anxious mind has a tendency to become over-sensitive to this discomfort and focus on it to such a degree that it amplifies the discomfort’. The above combined with the negative impact anxiety has on sexual arousal, is a double whammy.

This Calm Clinic anxiety test might be a useful tool to assess how much anxiety (and therefore stress) your mind and body are currently under.

2. Depression

The ‘sad vagina’

Sex and the City brought the term ‘sad vagina’ into public awareness, but did you know that the term actually refers to a real vaginal condition called vulvodynia (aka ‘Burning Vulva Syndrome’)? The reality of which is no laughing matter. The condition is experienced for minimum three months to years, as chronic pain, throbbing, soreness and burning in the vulva (vaginal opening) that can cause painful intercourse. The exact cause is still unknown due to lack of funding in research for benign gynecological disorders.

Vulvodynia is hard to diagnose as it doesn’t always show physically during an examination. An NIH-funded Harvard study reported that 60% of women consult three or more doctors before receiving a diagnosis. Something Dr Ross Pagano, director of the Vulva Disorders Unit at the Royal Women’s Hospital in Melbourne, sums up well, saying that often vulvodynia is simply written off. ‘Women have gone to the doctor with symptoms, the doctor has found the vulva looks quite normal, and women have been labelled as psychologically disturbed.’

While vulvodynia isn’t always caused by depression, a study found that depressive disorders ‘may constitute a risk factor for vulvodynia and occur as a secondary condition to pain’.

Low libido and dryness

Depression can affect the body and libido in similar ways to anxiety, when the causal factors are similar. Depression (especially when treated with anti-depressant medication) has been linked to a low libido and vaginal dryness, says Naomi Wolf, author of Vagina: A New Biography.

A check-in with your gynae is the only way to narrow down the causes of vaginal discomfort. When talking to a doctor about your physical symptoms, we recommend including information on your mental health and possible excessive strain you may be experiencing. This will enable them to make a more accurate diagnosis. Prioritising your mental health is not just about the benefits of a happy sex life and a happy vagina, it means a happier you, too.

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MORE: all the reasons why sex might be painful for you