| Trauma |
| Sexual intercourse |
| Sexual abuse |
| Foreign bodies (including intrauterine device) |
| Pelvic trauma (eg, motor vehicle accident) |
| Straddle injuries |
| Cesarean scar defect (prior cesarean delivery) |
| Drugs |
| Contraception: |
| Hormonal contraceptives |
| Intrauterine devices |
| Postmenopausal hormone therapy |
| Anticoagulants |
| Tamoxifen |
| Corticosteroids |
| Chemotherapy |
| Phenytoin |
| Antipsychotic drugs |
| Antibiotics (eg, due to toxic epidermal necrolysis or Stevens-Johnson syndrome) |
| Systemic disease |
| Diseases involving the vulva: |
| Crohn disease |
| Behçet syndrome |
| Pemphigoid |
| Pemphigus |
| Erosive lichen planus |
| Lymphoma |
| Bleeding disorders: |
| von Willebrand disease |
| Thrombocytopenia or platelet dysfunction |
| Acute leukemia |
| Some coagulation factor deficiencies |
| Advanced liver disease |
| Thyroid disease |
| Polycystic ovary syndrome |
| Cushing syndrome |
| Hormone-secreting adrenal and ovarian tumors |
| Renal disease |
| Emotional or physical stress |
| Smoking |
| Excessive exercise |
| Diseases not affecting the genital tract |
| Urethritis |
| Bladder cancer |
| Urinary tract infection |
| Colorectal cancer |
| Inflammatory bowel disease |
| Hemorrhoids |
| Other |
| Endometriosis |
