Vaginal Itching & Irritation
Vaginal Itching & Irritation - Itching for relief
If you have vaginal itching and irritation, you are not alone. These symptoms happen to women of all ages. Many things can cause itching and irritation of the vulva and vagina. Hormonal changes, chemical sensitivity, and infections are all common culprits.
Maintaining general vaginal health may help prevent vaginal itching and irritation. Practicing good hygiene, eating a balanced diet, avoiding chemical irritants, and protecting yourself against sexually transmitted diseases can all reduce your chances of developing bothersome vaginal irritation.
While vaginal itching and irritation can be quite unpleasant, it is rarely the sign of a serious condition. And fortunately you can relieve most cases of vaginal discomfort with a variety of over-the-counter products and self-care remedies. If a bacterial infection is causing the irritation, antibiotics can clear up the problem.
Synonyms
- Vaginitis
- Vulvovaginitis
- Vulvar itching
- Pruritus vulvae
Detailed Description
Since the tissues of the vagina and vulva (the genital area into which the vagina opens) are so delicate, the region is very sensitive to irritants, such as hormonal changes, chemical sensitivity, and infection. Menopausal and postmenopausal women, whose vaginal and vulvar skin has thinned due to decreased levels of estrogen, often have vaginal itching and dryness. Chemical irritants such as those in laundry detergents and bath soap are another common cause. A variety of infections can also contribute to vaginal itching and irritation, as can a number of sexually transmitted diseases. Sex, too, can produce these symptoms.
Since so many factors can cause vaginal itching and irritation, your doctor will consider your age, course of symptoms over time, aggravating factors, relieving factors, and possible laboratory test results in order to make a diagnosis. While vaginal itching and irritation can be uncomfortable, it rarely indicates a serious underlying problem. A variety of over-the-counter products and self-care remedies can help relieve symptoms of itchiness and irritation. If the discomfort is due to a bacterial infection, your doctor may prescribe a course of antibiotics, usually administered topically, to clear up the underlying problem. Furthermore, there are many preventative measures that you can take to maintain vaginal health and protect against many of the contributors to itching and irritation.
How Common is Vaginal Itching?
Vaginal itching, irritation, and vaginal discharge are the common symptoms among adolescent and adult women, regardless of age. The discharge of clear mucus at mid-cycle in reproductive age women (15-45 years) is a sign of normal reproductive health.
Possible Underlying Causes
- Hormonal changes that accompany menopause
- A variety of vaginal infections, which disturb the normal hormone and pH balance of the vagina, such as:
- Vaginal yeast infection (vulvovaginal candidiasis)
- Thinning of vaginal tissue due to a drop in estrogen levels around menopause (atrophic vaginitis)
- Sexually transmitted diseases like trichomoniasis and gonorrhea
- Nonspecific vaginal infection (bacterial vaginosis), previously known as Gardnerella-associated vaginitis
- Heavily scented or colored products
- Chemical vulvitis -- irritation due to exposure to certain chemical ingredients in personal care products, such as:
- Bath soaps
- Bubble baths
- Laundry detergents
- Toilet paper
- Contraceptive gels or foams
- Douches
- Vaginal deodorants (feminine sprays)
- Ointments or creams
- Tampons and menstrual pads
- Pinworms
- Diabetes mellitus
Many other conditions may include vaginal or vulvar itching, including recurring herpes infection, genital warts (human papilloma virus or HPV), vulvar cancer, psoriasis, and lichen planus.
Diagnostic Procedures
To make a diagnosis, your doctor will need information about several aspects of your personal history, including sexual activity and menstrual history. He or she will probably question you in detail about your symptoms and any aggravating or relieving factors you may have noticed. Your doctor may perform a physical exam to look for signs of infection, skin changes, and unusual discharge. If your doctor suspects an infectious agent, he or she will culture a sample of your vaginal discharge and examine it under the microscope. Your doctor may also perform blood and urine tests and do a Pap smear.
Goals of Treatment
The goals of treatment include alleviating discomfort and identifying and treating the underlying cause of the symptoms.
Treatment Options
Drugs most commonly used
The medications your doctor may recommend for you depend on the specific underlying condition.
Vaginitis (vaginal yeast fungal infection):
- Nonprescription antifungal creams or suppositories like miconazole nitrate (Monistat), clotrimazole (Gyne-Lotrimin), and butoconazole (Femstat)
- Prescription antifungal creams or suppositories such as nystatin (Mycostatin) or fluconazole (Diflucan)
Atrophic vaginitis due to menopause
- Hormone replacement therapy
Trichomoniasis (protozoan infection):
- Metronidazole (Flagyl)
For trichomonal infections, it is important that both partners be treated. Uncircumcised men carry these and other organisms more than circumcised men. Using condoms may prevent vaginal infections. You should avoid metronidazole (Flagyl) therapy during at least the first trimester of pregnancy. If you think you might be pregnant, tell your physician.
Bacterial vaginosis (anaerobic bacterial infection)
- Metronidazole (Flagyl)
- Clindamycin phosphate
You should avoid metronidazole (Flagyl) therapy during at least the first trimester of pregnancy. If you think you might be pregnant, tell your physician.
Dietary modifications
If you frequently suffer vaginal irritation due to vaginitis (vaginal yeast infections), eating yogurt with live acidophilus cultures may help. Acidophilus can help to maintain a healthy balance of vaginal yeast. Acidophilus is also available in capsule form. It is also recommended that you limit your intake of sweets and alcohol if you experience recurrent yeast infections.
Supplements
- L. acidophilus: a friendly bacteria found in live-culture yogurt that helps combat yeast. [1] If you'd rather not eat yogurt, take L. acidophilus supplements, available in capsules.
Herbs
- Echinacea: German researchers gave 203 women with recurrent yeast infections either an antifungal drug or the antifungal plus echinacea (one dropperful, three times a day). After six months, the group taking the herb reported significantly fewer infections. [2]
- Goldenseal: contains berberine, the potent natural antibiotic that helps treat both fungal and bacterial infections. Most herbalists and naturopaths recommend one to two teaspoons of tincture three times a day.
- Garlic: another natural antibiotic. The most potent dose is a dozen raw, chopped cloves two or three times a day. If this is not possible or palatable for you, simply use more garlic when cooking, chopped or minced and as lightly cooked as possible.
Sources
1Shalev, E. et al. "Ingestion of Yogurt Containing L. Acidophilus Compared with Pasteurized Yogurt as Prophylaxis for Recurrent Candidal Vaginitis and Bacterial Vaginosis," Archives of Family Medicine (1996) 5:593.
2Duke, J. The Green Pharmacy. Emmaus, PA: Rodale Press, 1997.
Preventing Vaginal Irritation
- Avoid douching. The vagina is a self-cleansing organ. To promote cleanliness, simply wash your genitals while bathing. Douching can irritate the vagina, and it also increases risk of ectopic (tubal) pregnancy and pelvic inflammatory disease, both of which are medical emergencies.
- Avoid synthetic products. Steer clear of feminine hygiene sprays, bath oils, bubble baths, spermicides, hot tubs, dyed underwear, chlorinated swimming pools, and perfumed soaps and toilet paper. Any of these can cause or aggravate vaginal irritation.
- Stick to wearing white cotton panties. They contain no potentially irritating dyes, and cotton fabric breathes and helps maintain a healthy vaginal environment. Synthetics trap heat and moisture, which might contribute to vaginal itching and irritation.
- Eliminate yeast. Presoaking your panties in water with a dash of chlorine bleach before washing them helps kill yeast.
- Stay dry. Don't sit around in wet bathing suits or sweaty exercise clothing -- a moist environment encourages bacterial and yeast growth.
- Abstain from sex until you're back to normal. Then ask your doctor about using condoms for a while. It's possible your partner might have a subclinical yeast infection and keep reinfecting you.
- Wipe from front to back (from vaginal area toward anus) after urination and bowel movements.
- Use a lubricant during sexual intercourse.
- Consider hormone replacement therapy or use a personal lubricant for dryness and irritation due to menopause.
- Use latex condoms to protect against sexually transmitted diseases.
- Urinate before and after sex. This helps wash bacteria out of the vaginal area.
- Avoid certain medicines. Birth control pills and spermicides can both contribute to yeast infections. If recurrent yeast infections are a problem while using either of these, consider another method.
- Eat live-culture yogurt. Its friendly bacteria help keep yeast in check. Israeli researchers gave a cup a day of yogurt made with L. acidophilus bacterial culture to 46 women who had recurrent vaginal infections. While eating the yogurt, the women had significantly fewer yeast infections.
When to Call the Doctor
Contact your health provider if your symptoms persist longer than a week, or if irritation is accompanied by skin changes, unusual discharge, bleeding, odor, or swelling, or if there is pain with intercourse.
Websites & Organizations
American College of Obstetricians & Gynecologists
409 12th Street, SW
Washington, DC 20024-2188
Phone: 800-762-ACOG (2264)
The Centers for Disease Control National STD Hotline
800-227-9822 (Monday-Friday, 8 a.m.-11 p.m. ET)
3M National Vaginitis Association
P.O. Box 2038, Murray Hill Station
New York, NY 10156
Phone: 800-4BV-NEWS (800-428-6397)
Email: info@vaginalinfections.com
National Women's Health Network
514 10th Street NW, Suite 400
Washington DC 20037
Phone: 202-293-6045
North American Menopause Society (NAMS)
Post Office Box 94527
Cleveland, OH 44101 USA
Phone: 216-844-8748
Fax: 216-844-8708
Email: info@menopause.org
The Yeast Infection Home Page
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Duke, J. The Green Pharmacy. Emmaus, PA: Rodale Press, 1997.
Fauci, Anthony J. et. al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.
Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw Hill, 1996.
Hurst, J. Willis. Medicine for the Practicing Physician eds. Stamford, CT: Appleton & Lange 1996.
Murray, Michael T. Encyclopedia of Natural Medicine. Prima, 1998.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Rakel, Robert E. Conn's Current Therapy eds. Philadelphia: W.B. Saunders, 1998.
Taylor, Robert B. Family Medicine: Principles and Practice. New York: Springer-Verlag, 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.
Articles
Fischer, GO. "The Commonest Causes of Symptomatic Vulvar Disease: A Dermatologist's Perspective." Australas J Dermatol. 37(1):12-8. Feb 1996.
Kehoe, S, Luesley, D. "Pathology and Management of Vulval Pain and Pruritus." Curr Opin Obstet Gynecol. 7(1):16-9. Feb 1995.
Klufio, CA, Amoa, AB, Delamare, O, Hombhanje, M, Kariwiga, G, Igo, J. "Prevalence of Vaginal Infections with Bacterial Vaginosis, Trichomonas Vaginalis and Candida Albicans Among Pregnant Women at the Port Moresby General Hospital Antenatal Clinic." P N G Med J. 38(3):163-71. Sep 1995.
Koumantakis, EE, Hassan, EA, Deligeoroglou, EK, Creatsas, GK. "Vulvovaginitis During Childhood and Adolescence." J Pediatr Adolesc Gynecol. 10(1):39-43. Feb 1997.
Lewis, FM, Harrington, CI, Gawkrodger, DJ. "Contact Sensitivity in Pruritus Vulvae: A Common and Manageable Problem." Contact Dermatitis. 31(4):264-5. Oct 1994.
McKay, M. "Vulvitis and Vulvovaginitis: Cutaneous Considerations." Am J Obstet Gynecol. 165(4 Pt 2):1176-82. Oct 1991.
Peer, AK, Hoosen, AA, Seedat, MA, van den Ende, J, Omar, MA. "Vaginal Yeast Infections in Diabetic Women." S Afr Med J. 83(10):727-9. Oct 1993.
Pincus, SH. "Vulvar Dermatoses and Pruritus Vulvae." Dermatol Clin. 10(2):297-308. Apr 1992.
Sener, AB, Kuscu, E, Seckin, NC, Gokmen, O, Taner, D, Cobanoglu, O, Zorlu, G. "Postmenopausal Vulvar Pruritus--Colposcopic Diagnosis and Treatment." JPMA J Pak Med Assoc. 45(12):315-7. Dec 1995.
Shalev, E. et al. "Ingestion of Yogurt Containing L. Acidophilus Compared with Pasteurized Yogurt as Prophylaxis for Recurrent Candidal Vaginitis and Bacterial Vaginosis," Archives of Family Med. (1996) 5:593.