Diagnosis is based on symptoms, severity, and duration of itching and irritation. Pelvic examination is one of the most common diagnostic tests for identifying the cause of irritation. In a pelvic examination, vulva and vagina are inspected to evaluate the cause.
The reproductive organs are also checked for any abnormalities. A sample of vaginal skin and discharge is also analyzed to diagnose the cause of the condition. Blood and urine tests are also suggested in some cases, depending on the cause.
Treatment options for vaginal itching are based on the underlying cause of the condition. The course of treatment may also vary according to the cause. Medications are commonly used for yeast and fungal infections.
This may be in the form of creams, ointments or pills. Bacterial vaginosis is treated with antibiotics. STDs are also treated with antibiotics. Estrogen creams, tablets, and vaginal ring are used for the control of itching related to menopause.
Steroid creams and lotions are useful in reducing itching and inflammation in the area. But these medications should be used with caution as overuse may result in chronic irritation.
Good lifestyle and hygiene are very important in preventing vaginal itch. Genital area should be washed with a mild cleanser and warm water. Strong soaps and lotions should be avoided.
Prefer cotton underwear and avoid damp clothes. These home treatments are particularly important in those cases where the underlying cause cannot be definitely determined.
Irritants – many irritant chemicals may result in vaginal itching. This is caused by an allergic reaction that causes itching in various parts of the body including the vagina. Some common irritants are:
Dermatological causes – skin conditions like eczema and psoriasis also cause itching and redness in the genital region. Atopic dermatitis or eczema often affects people with allergies. The itching in eczema may spread to the vagina in some women. Psoriasis cause scaly, red patches and usually affects scalp and joints. Episodes of psoriasis may sometimes affect the genital region.
Yeast infection – yeast infection in vagina occurs when the organism grows abnormally in the genital area. This uncomfortable condition is called as a vaginal yeast infection. It is most commonly seen after a course of antibiotics which tends to destroy the good fauna in the genital region. Abnormal growth of yeast in the vaginal region may result in itching, thick discharge, and burning sensation.
Bacterial vaginosis – This condition is caused by an imbalance between naturally occurring good bacteria and bad bacteria in the vaginal region. Bacterial vaginosis may remain asymptomatic in most of the cases. When present, symptoms include itching and foul-smelling discharge from the vagina. The vaginal discharge may be grayish and foamy.
STDs – unprotected intercourse leads to STDs that have vaginal itching as one of the symptoms. Some STDs that irritate the vaginal region include:
Accompanying vaginal itching is other symptoms like green or yellow colored vaginal discharge, abnormal growths in the genital area, and pain during urination.
Menopause – menopause in women increases the risk of developing a vaginal itch. During menopause the estrogen levels in the body reduce, resulting in atrophy of vagina. Vaginal atrophy is characterized by thinning and drying of mucosa in the region. When left untreated, dryness of vaginal mucosa irritates the vagina, leading to itching.
Stress – stress, whether physical or mental, may lead to vaginal irritation and itching. This usually happens when the immune system is weakened by stress. It increases the susceptibility of infections in the genital area.
Diabetes – uncontrolled diabetes with high levels of sugar increases the frequency of urination. The risk of vaginal itch and irritation is high in this condition.
Pregnancy – pregnancy is associated with vulval engorgement which irritates the vaginal skin. Pregnancy increases the risk of infections and vaginal discharge, both of which may cause itching and irritation.
Breastfeeding – the levels of estrogen remain low during breastfeeding and this increases the risk of vaginal itch.
Vulvar cancer – rarely, itching in the vaginal region may be caused by vulvar cancer, a type of cancer that develops in the vulva. Vulvar cancer, like bacterial vaginosis, may remain asymptomatic in most of the cases. Symptoms when present includes itching, abnormal bleeding, and pain.
Lichen sclerosis – it is a rare condition, characterized by thin, white patches in the vaginal area. It may cause scarring in the vulva. Lichen sclerosis is most commonly seen in postmenopausal women.
In children, pinworm infection may lead to itching and irritation in the vagina. Inadequate cleaning or hygiene of the genital area, particularly in young girls, may make the skin moist in the region. This leads to irritation and itching.
3 Diagnosis and Treatment
Medical history, symptoms and physical examination are the main diagnostic measures in vaginal itch. The doctor will conduct a pelvic examination to evaluate the health of vulva and the internal organs in the genital area.
A speculum is usually used to check the vagina during a pelvic examination. During the examination, the abdomen is pressed down while a gloved finger is inserted into the vagina.
This helps to detect the abnormalities in the reproductive organs. A sample of skin tissue from the vulva and vaginal discharge is analyzed to diagnose the cause of itching. Urine and blood tests are recommended based on the cause.
Blood tests are used to detect conditions like diabetes, kidney disease or liver problems. Patch testing of the skin from the vulval region helps to detect sensitivity to particular chemicals. This will help to identify the irritants of the vaginal skin. In some rare cases, biopsy of vulval skin sample is conducted.
Treatment of vaginal itch depends on the cause of the condition. Many types of vaginal itching resolve on its own without any specific treatment. Steroid creams, lotions, and ointment are usually used to reduce inflammation.
These also help to ease the discomfort due to vaginal irritation. Hydrocortisone creams and lotions are commonly used for alleviating the symptoms of this condition.
The use of these lotions and creams should be done with caution as an abuse of these medications may lead to chronic itch in the genital area. Vaginal moisturizer is used control vaginal dryness and avoid scratching the affected area.
Yeast infections are treated with antifungal medications. This may be in the form of creams, pills or ointments. Some of these medications are available over the counter. But these medications should be taken only after discussion with the physician.
Bacterial vaginosis is treated with antibiotics, either as oral pills or as creams. Antibiotics, whenever prescribed, should be used as per the directions and the course completed.
Sexually transmitted diseases are treated with medications like antivirals or antiparasitics. Antibiotics are recommended when the condition is caused by bacteria.
These medications also should be taken as per the directions for successful treatment of the condition. Sexual intercourse should be avoided during the treatment period.
Estrogen cream and tablets are recommended for treating vaginal itch related to menopause. An insert of vaginal ring is another treatment method for vaginal irritation associated with menopause.
Hygiene and lifestyle habits are good in vaginal itching, some common like:
Use condoms during intercourse
Use mild cleanser to wash the genital area
Avoid strong soaps, lotions and bubble baths
Avoid using damp clothing after activities like swimming or exercising
Wipe from front to back while cleaning
Avoid products like sprays and douches
Avoid scented wiping pads and feminine sprays
Having yogurt with live cultures helps to reduce the chance of getting infections in the genital area. In children, diapers should be changed regularly.
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