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Whenever a small painful wound appears on the vulva all of a sudden, the first thing that comes to mind is: "Is this a STD?" The next thing is panic. Slow down. Take a deep breath and think things through logically.

Think back!

Gather your thoughts and think back. For it to be a STD, you have to have had unprotected sex. The risk is high for those who have had multiple partners, diabetic patients, and patients who are on steroids and drugs that suppress the immune response.

Blood transfusions can transmit STDs present in the blood stream, such as HIV. Think back to how it started. Initial itchiness, constant nagging pain, bleeding, burning and "not feeling well" may accompany genital sores. All these will help your doctor to arrive at a diagnosis. Genital sores are not limited to STDs. Some women use strong fragrances, talc and other local applications on the perineum. Contact dermatitis, i.e. a delayed allergic reaction to the chemicals in these applications may give rise to genital sores.

What are the common causes?

Genital herpes is the most common cause. It is caused by the herpes simplex virus. It commonly presents with small painful genital or oral ulcers which are clustered together.

Genital warts are another common cause. Caused by a virus called the Human Papilloma Virus (HPV), this condition is also linked to cervical cancer.

Chancroid presents as a shallow ulcers on the genitalia. They are sharply demarcated, bleed with trivial trauma and are sometimes accompanied by dysuria. Another common condition is Molluscum contagiosum, which presents as pearly white skin nodules.

Viral vulvovaginitis is common in sexually active women and peri-menopausal women. It may start as a viral infection but a secondary bacterial infection is a common complication.

Allergic reactions to chemicals in various local applications, talc and perfumes are very common in out-patient practice.

How to detect?

Consult your doctor if you are worried. Provide a clear history. Don't try to bluff your way out when the doctor goes in to detail regarding you past sexual history. It is always better to divulge and get STDs excluded than suffer later.

Swabs of sores, blood cultures, blood counts and other ancillary investigations will guide your treatment regimen.

Medications?

The treatment regimen will vary according to the probable causative organism. Antibiotics, antifungal agents and anti-viral drugs are your most likely treatments. Steroids are helpful in case of allergic reactions. Anti-itch creams provide blessed relief in some cases.

What should you do?

It is your responsibility to adhere to the prescription. You may get relief after a few doses, but you should follow the prescription through to the end. Good compliance on your part will contribute to the efficacy of the treatment.

Simple methods like soaking in warm water and sitz baths relieve pain as much as medications do in some conditions.

How to prevent?

Prevention is always better than cure. Always practice safe sex. Be mindful of your overall health as well. Check your blood sugar levels often. Exercise and eat healthy. A bad diet and lack of exercise can lower your defenses so that opportunistic infections can get in at will.

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