Anonymous on September 26, 2011

I often see two “paper cut” looking slits on either end of my I have an STD?

I have had recurring vaginal problems for a couple of years. Almost every time after having sex, I become extremely irritated and have severe itching for up to a week. These symptoms are accompanied by two "paper cut" looking slits on either side at the end of my vagina. They’re not deep, but they’re about an inch long and they sting like wouldn't even notice them unless they were pointed out because they literally are on the first layer of skin. Also occurring sometimes is a tiny cut, like a small gash, in the same spot each time in the middle of my clitoris. It's like it just splits or tears down the middle. Is this an STD?

answered by Ruthann M. Cunningham, MD on September 26, 2011

I understand your concerns, and I’ll do my best to help.

A chronic yeast infection is certainly a possibility...but so are STDs. Given the symptoms you describe, getting tested for common STDs is a good idea. It’s also smart to use a latex condom or a dental dam every time you have vaginal, anal or oral sex. 

According to the Centers for Disease Control and Prevention (CDC), complications from untreated STDs can include everything from infertility and upper genital tract infections to heart disease, certain cancers, HIV and other diseases and conditions. So again, please get tested so that you can get treated if you have an STD and avoid these complications.

Instead of a yeast infection or STD, it's possible you could be experiencing vaginal dryness. If you’re peri- or postmenopausal, you may have vaginal dryness caused by decreasing levels of estrogen and anti-estrogen medications. Typical symptoms of vaginal dryness include pain with sex, burning vaginal discomfort or itching, or abnormal vaginal discharge. Two of the most common treatment options for women with vaginal dryness are moisturizers and lubricants, and vaginal estrogen. Your doctor can help you identify the best treatment for you.

Regarding sexual activity...if you do have vaginal dryness, it’s fine to continue having sex. In fact, sex can help keep the vaginal tissues healthy! According to UpToDate - an authoritative medical database widely used by doctors - sexual activity (including masturbation) keeps vaginal tissues soft and pliable, and prevents the tissues from shrinking. Still, you may want to consider using lubrication during sex, especially vigorous sex.

Thank you for taking the time to share your great questions with us. I encourage you to visit your doctor for an exam to identify the cause of your skin irritation. Good luck and I wish you great health. 

Related info:

Ruthann M. Cunningham, MD

Dr. Cunningham is a member of the Analyte Physicans Group. She's also a member of the American College of Emergency Physicians, practicing at both Northwestern Lake Forest Hospital in Illinois and at Wheaton Franciscan All Saints Medical Center in Wisconsin. An ER physician since 2000, she regularly treats patients with STDs. Dr. Cunningham was educated at Wayne State University School of Medicine and completed her Emergency Medicine residency at Cook County Hospital in Chicago, IL.

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