Vaginal itching is an uncomfortable and sometimes painful symptom that often happens due to irritating substances, infections, or menopause. Other times it can also occur as a result of certain skin disorders or sexually transmitted diseases (STDs). In rare cases, vaginal itching might develop due to stress or vulvar cancer.
Most vaginal itching may not be a cause for concern. However, women should contact their doctor or gynecologist if the itching is severe or if an underlying condition is suspected.
The doctor can determine the cause of the vaginal itching through examinations and testing. They will also be able to recommend appropriate treatments for the uncomfortable symptom. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Estrogen levels if reduced after menopause and some skin disorders can also cause vaginitis.
Vaginal discharge refers to secretions from the vagina. The discharge may be:
- Either odorless or have a bad odor
- Thick or thin, even pasty
- Clear, cloudy, bloody, white, yellow, or green
The itching of the skin of the vagina and the surrounding area (vulva) may be present along with discharge from the vagina. The itching can also occur on its own.
The most common types of vaginitis are:
Bacterial vaginosis - This results from a change of the normal bacteria found in the vagina to overgrowth of other organisms.
Yeast infection -Which is usually caused by a naturally occurring fungus called Candida albicans.
Trichomoniasis - Which is caused by a parasite and is ordinarily transmitted by sexual intercourse.
Treatment depends on the type of vaginitis.
What Upsets the Normal Vaginal Eco-system
Normally, a healthy vagina already contains bacteria and sometimes yeast that does not necessarily give any infection. However, certain things can change the environment in the vagina that will enable bacterial or yeast overgrowth and cause symptoms.
- Sexual (vaginal) Intercourse
- Rinsing the vagina with water or other liquid (Douching)
- Changes in female hormone levels
- Pregnancy and breastfeeding
It is a fact that not all of the above can be avoided, however douching is absolutely unnecessary and potentially harmful.
TYPES OF VAGINAL INFECTIONS
There are three very common types of vaginal infections,
- Yeast infections,
- Bacterial vaginosis, and
- Trichomoniasis, a sexually transmitted infection.
This remains the most common type of vaginitis. A yeast infection is caused by one of the many types of fungus known as candida. According to medical studies, there are many species of yeast, or candida. However, candida albicans is the most common of them.
Candida normally lives harmlessly in the body in small numbers, including inside the vagina. Under certain conditions however, an overgrowth of candida occurs, and causes vaginal infection.
The above mentioned conditions might include hormone level changes due to pregnancy, the use of birth control pills, or menstruation. Other conditions can raise the risk of vaginal yeast infections, they include having frequent or chronic high blood sugar and a lowered immunity due to medical conditions such as HIV or AIDS.
Symptoms of a vaginal yeast infection include a thick, white discharge. Yeast infections also can cause vaginal itching and redness of the lips of the external female genital area (the vulva) and vagina.
Besides yeast, some 'friendly' bacteria called lactobacilli also live in the vagina. When the number of lactobacilli gets too low, it triggers a condition called bacterial vaginosis (BV).
The changes in levels of bacteria has not been explained yet, but the normal lactobacilli can be replaced by other bacteria, that causes infection-causing.
The bacteria most often associated with bacterial vaginosis is Gardnerella. With bacterial vaginosis, a woman may see a thick or whitish discharge or one that is slippery and clear. It is not likely to itch or burn. During intercourse, a fishy odor may be noticeable.
'Of the three most common vaginal infections, Trichomonas vaginitis, also called Trichomoniasis, is the only one that is a sexually transmitted infection. Commonly called 'trich,' it is caused by a single-celled parasite called Trichomonas vaginalis, and is passed from partner to partner during intercourse.
Symptoms of Trichomoniasis are similar to other vaginal infections: burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. In some women, pain during urination may also be experienced.
CAUSES OF VAGINAL ITCHING
The following are possible causes for itching of the vagina and the surrounding area.
Exposure of the vagina to irritating chemicals causes vaginal itching. These irritants may trigger allergic reactions that creates an itchy rash over various areas of the body, including the vagina.
Common chemical irritants include:
- Bubble baths
- Feminine sprays
- Topical contraceptives
- Fabric softeners
- Scented toilet paper
If an individual has diabetes or urinary incontinence, the urine may also cause vaginal irritation and itching.
Skin diseases, such as eczema and psoriasis, can cause redness and itching in the genital area. Also known as atopic dermatitis, eczema is a rash that primarily occurs in people with asthma or allergies. It may spread to the vagina in some women with eczema. Psoriasis is a skin condition that causes the skin to scale, itch, form red patches along the scalp and joints. In some cases, these symptoms occur on the vagina as well.
Yeast is a fungus that's normally present in the vagina, and which occurs naturally. It usually does not cause problems, until its growth goes unchecked, then an uncomfortable infection can result. This is known as a vaginal yeast infection. It often occurs after taking a course of antibiotics, as these types of medications can destroy good bacteria along with the bad bacteria. The good bacteria is needed to keep yeast growth in check. The overgrowth of yeast in the vagina can result in uncomfortable symptoms, including itching, burning, and lumpy discharge.
Another reason for vaginal itching is Bacterial vaginosis (BV). Just like a vaginal yeast infection, BV is triggered by an imbalance between naturally occurring good and bad bacteria in the vagina. The condition does not always cause symptoms but when symptoms appear, they typically include vaginal itching and an abnormal, foul-smelling discharge. The discharge may be thin and dull gray or white.
Sexually transmitted diseases:-
Many STDs can be transmitted during unprotected sexual intercourse, symptoms of which can cause itching in the vagina. These include:
- Genital warts
- Genital herpes
These 5 listed conditions can also cause additional symptoms, (e.g. abnormal growths, green or yellow vaginal discharge, and pain while urinating).
Menopause - Due to the reduction of estrogen levels that occur during menopause, which leads to vaginal atrophy, women who are going through menopause or who have already done so are more at risk for vaginal itching. This is because the thinning of the mucosa leads to excessive dryness. Dryness commonly causes itching and irritation if not treated.
Stress - Although it is not very common, physical and emotional stress can cause vaginal itching and irritation. This might occur when stress weakens the immune system, leaving the body more prone to the infections that cause itching.
Vulvar cancer - Vaginal itching may be a symptom of vulvar cancer in very rare cases. This is a type of cancer that develops in the external part of the female's genitals (the vulva). It includes the inner and outer lips of the vagina, the clitoris, and the opening of the vagina. For most times, vulvar cancer does not always cause symptoms. However, when symptoms do appear, they may include itching, abnormal bleeding, or even pain in the vulvar area.
If the doctor diagnoses it in the early stages, vulvar cancer can be treated successfully. This is another reason why annual gynecologist checkups are essential.
SIGNS & SYMPTOMS
Itching in the vagina and vulvar areas has multiple causes, although it is the hallmark of yeast infections and other vaginal infections (including STDs). Vaginal itching can also arise due to chemical irritants that may be found in detergents or soaps, douches and vaginal creams, toilet paper, bath products, feminine hygiene products, and vaginal contraceptive products.
It has been established that women in the menopausal transition may experience vaginal itching due to fluctuations in estrogen levels. Estrogen levels drop in the perimenopause, the vaginal wall becomes thinner and drier, itching may result.
Related Symptoms & Signs
Vaginal Discharge - Often a normal and regular occurrence. However, there are certain types of discharge that can indicate an infection. Abnormal discharge may be yellow or green, chunky in consistency, or foul smelling.
Vaginal Odor - The most common explanation for an unpleasant vaginal odor is an infection called bacterial vaginosis (BV), which produces a fishy smell.
Vaginal Dryness - One may have vaginal dryness if she feel sore or itchy in and around the vagina, feel pain or discomfort during sex.
WHEN TO SEE A DOCTOR
Women should see their doctor if they develop unusual vaginal discomfort, especially if:
- They have a particularly unpleasant vaginal odor, discharge or itching.
- They have never had a vaginal infection (a doctor can establish the cause and help identify the signs and symptoms).
- They have had vaginal infections before.
- They have had multiple sex partners or a recent new partner. One could have a sexually transmitted infection. Some sexually transmitted infections have signs and symptoms similar to those of a yeast infection or bacterial vaginosis.
- They have completed a course of over-the-counter anti-yeast medication and symptoms persist.
- They have a fever, chills or pelvic pain.
One probably may need to see the doctor every time there is vaginal irritation and discharge, particularly if:
She's previously had a diagnosis of vaginal yeast infection and the signs and symptoms are the same as before.
She knows the signs and symptoms of a yeast infection, and is confident that the symptoms are the same.
Factors that increase a woman's risk of developing vaginitis include:
- Sexual activity
- Uncontrolled diabetes
- Wearing damp or tightfitting clothing
- Use of spermicides for birth control
- Hormonal changes (e.g. as associated with pregnancy, birth control pills or menopause)
- Having a sexually transmitted infection
- Medications, such as antibiotics and steroids
- Use of hygiene products such as bubble bath, vaginal spray or vaginal deodorant
- Using an intrauterine device (IUD) for birth control
Because of the inflammation caused by disorders, women with Trichomoniasis or bacterial vaginosis are at a greater risk of acquiring sexually transmitted infections.
To diagnose vaginitis, the doctor is likely to:
- Review the patient's medical history - This includes history of vaginal or sexually transmitted infections.
- Perform a pelvic exam - The doctor may use an instrument (speculum) to look inside the vagina for inflammation and abnormal discharge.
- Collect a sample for lab testing - The doctor might collect a sample of cervical or vaginal discharge for lab testing to confirm the type of vaginitis.
How is vaginal discharge diagnosed?
Women should see their doctor if the vaginal discharge increases, changes color or odor, or is suddenly itchy or irritated. It could be a yeast infection, bacterial vaginosis, or Trichomoniasis. The doctor will need to conduct an examination to make a diagnosis. The exam will include questions about symptoms.
The doctor might test the vaginal acidity (pH) by applying a pH test stick or pH paper to the wall of the vagina. An elevated pH can indicate either bacteria vaginosis or Trichomoniasis. However, pH testing alone is not a reliable diagnostic test.
A variety of organisms and conditions can cause vaginitis, so treatment usually targets the specific cause:
- Yeast infections:-
Usually, yeast infections are treated with antifungal creams or suppositories (e.g. miconazole), clotrimazole, butoconazole or tioconazole) bought over-the-counter. Yeast infections may also be treated with oral antifungal medication, such as fluconazole (Diflucan). Over-the-counter treatment offer convenience, cost and not having to wait to see the doctor. The reality however is that the individual might have something other than a yeast infection. The dangers that can arise from using the wrong medicine and the delay of an accurate diagnosis and proper treatment cannot be over emphasized.
The doctor may prescribe Flagyl (metronidazole) or Tindamax (tinidazole) tablets.
- Bacterial vaginosis:-
The doctor may prescribe Flagyl (metronidazole) for this type of vaginitis. This could be tablets that is taken orally or Metro Gel (metronidazole gel) or Cleocin cream that is applied to the vagina.
- Non-infectious vaginitis:-
To treat this type of vaginitis, the source of the irritation must be clearly identified and avoided. Possible sources include new soap, laundry detergent, sanitary napkins or tampons.
- Genitourinary syndrome of menopause (vaginal atrophy):-
This condition can be effectively treated with estrogen in the form of vaginal creams, tablets or rings and is available by prescription from the doctor.
LIFESTYLE AND HOME REMEDIES
For Trichomoniasis, bacterial vaginosis and vaginal atrophy, prescribed medication will be needed for treatment.
If a woman has a yeast infection, the following steps can be taken:
An over-the-counter medication specifically for yeast infections can be taken. There are several options, (one-day, three-day or seven-day courses), of cream or vaginal suppositories. Some of the products come with an external cream to apply to the labia and opening of the vagina. Package directions must be followed and entire courses of treatment completed even if one feels better right away.
There is actually no need to prevent normal vaginal discharge. However, abnormal vaginal discharge may be prevented by following these tips.
- Do not douche, it is totally unnecessary.
- Avoid hot tubs.
- To help prevent bacteria from the rectal area into the vagina, always wipe from front to back after using the toilet.
- It is advisable to wear cotton underpants during the day. Cotton allows air to the genital area. Do not wear underpants at night.
- Wearing of tight pants must be avoided, same for panty hoses, swimming suits, biking shorts for long periods.
- Pay attention to laundry detergents or fabric softeners, should any of them irritate the genital area, have it changed.
- Bathe or shower daily and pat the genital area dry.
- Avoid feminine hygiene sprays, colored or perfumed toilet paper, deodorant pads or tampons, and bubble bath.
It is common for most women to have vaginitis at least once in their life, and it is usually not dangerous.
Prescription courses must be adhered to. Completing a course of antibiotics prescribed by a doctor will typically remove any infections and ease the related inflammation.
Abstaining from sex and avoiding vaginal products that contains potential irritants for few days after diagnosis may also speed up recovery.