vaginal itching

Vaginal itching is a tingling or uneasy irritation of the skin of the vagina and the surrounding area (vulva). The itching may cause a desire to scratch the affected area.

Causes

Common causes of vaginal itching include:

• Chemical irritants such as detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies.
• Menopause. A drop in the hormone estrogen causes vaginal dryness.
• Stress may increase vaginal itching and make you more susceptible to infections.
• Vaginal yeast infection
• Vaginitis. Vaginitis in girls before puberty is common. If a young girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed.

Other possible, but less common, causes of vaginal itching include:

• Precancerous skin conditions of the vulva
• Pinworms (a parasite infection mainly affecting children)

Home Care

To prevent and treat vaginal itching:

• Avoid colored or perfumed toilet tissue and bubble bath.
• Avoid feminine hygiene sprays and douches.
• Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible.
• Cleanse the area by wiping or washing from front to back (vagina to anus) after urinating or having a bowel movement.
• Eat yogurt with live cultures or take Lactobacillus acidophilustablets when using antibiotics. Check with your doctor.
• Keep your genital area clean and dry. Use plain, unscented soap.
• Keep your blood sugar under good control if you have diabetes.
• Lose weight if you are overweight.
• Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from synthetic materials. For infants and toddlers, change diapers often.

If you are sure that you have a yeast infection, try over-the-counter creams or vaginal suppositories. See: Vaginal yeast infection

For itching related to menopause, your health care provider may consider estrogen cream or tablets to insert vaginally. See: Vaginal dryness

Teach children to resist and report any attempted sexual contact by another person. Do not try to remove any foreign object from a child's vagina. Take the child to a health care provider right away for removal.

When to Contact a Medical Professional

Call your health care provider right away if:

• You have increased thirst or appetite, unexplained weight loss, frequent urination, or fatigue -- these may be signs of diabetes.
• You have pelvic or lower abdominal pain or fever.

Call your health care provider if:

• You have blisters or ulcers on your vagina or vulva.
• You have burning with urination or other problems urinating.
• You have unusual vaginal bleeding, swelling, or discharge.
• Your partner also has symptoms or you think you may have a sexually transmitted infection.
• Your symptoms get worse, last longer than 1 week, or keep coming back despite self-care.

What to Expect at Your Office Visit

Your doctor will examine you, including doing a pelvic exam, and ask questions to help diagnose the cause of your vaginal itching. These questions may include:

• When did the itching begin?
• Have you had it before?
• Is the itching severe?
• Does it limit your activities?
• Where exactly is the itching? On the inside of the vagina or on the outside (vulva) as well?
• How often do you bathe or shower?
• Do you use scented soap, scented or colored toilet paper, or bubble bath?
• Do you frequently swim or participate in water sports? Do you change your clothes soon after such activities?
• Do you wear cotton panties or synthetic ones?
• Do you wear tight pants or tight pantyhose?
• Do you use douches or feminine hygiene spray?
• Are you sexually active? Do you use contraception? What type?
• Does anything make you feel better?
• Does anything make you feel worse?
• Have you tried any over-the-counter creams? Which ones?
• Do you have any other symptoms, such as vaginal bleeding, swelling, rash, or pain on urination?
• Do you have a personal or family history of diabetes?
• What medications do you take?
• What is your menstrual history? How old were you when your periods began? How often do your periods usually come? How long do they generally last?
• Do you have any allergies?

Diagnostic tests that may be performed include:

• Culture and microscopic exam of vaginal discharge
• Pap smear
• Skin biopsies of the vulvar area
• Urine and blood studies (including hormone levels)

The health care provider may prescribe drugs, such as:

• Antibiotics for bacterial vaginal infections, including sexually transmitted diseases
• Antifungal drugs for yeast infections
• Benzodiazepines or antihistamines for nighttime relief
• Ointments containing hormones
• Steroid creams or lotions to reduce inflammation

References

Biggs WS, Williams RM. Common gynecologic infections. Prim Care. 2009 Mar;36(1):33-51,

Superficial fungal infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 13.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.