Vaginal discomfort and itching are amongst the most common reasons for gynaecological advice. These symptoms may be caused by a condition that only affects the vagina, but they can sometimes be a sign of a more general medical problem or other skin disease.
It is therefore important to visit your doctor to identify the cause & counsel you on management options.
Most common causes of vaginal itching include the following:
Chemical irritants
Vaginal tissues are sensitive to chemicals such as soaps, scents, ointments and creams.
The chemical substances may irritate the skin or disturb the natural pH balance causing itching and occasionally triggering urinary tract infection (UTI).
We therefore advise to refrain from the use of chemicals and choose natural products or switch to plain water for hygiene purposes.
Prefer cotton underwear and avoid tight clothes for the duration of your symptoms.
Usually after 2-3 days the symptoms subside and the vaginal pH normalises.
Vaginal yeast infection
Vaginal Yeast Infection (Candida aka thrush) is very common affecting 75% of women once in their lifetime. A small amount of yeast naturally occurs in the vaginal wall.
Occasionally due to an imbalance between good and bad bacteria (often due to recent use of antibiotics) the yeast population overgrows triggering irritation and soreness of the vulva, sometimes also the discharge that most women are aware of when it affects the vagina.
Yeast infections are usually managed with antifungal remedies.
On some occasions, candida can be passed to a sexual partner so it is important that they are checked and treated if necessary, if your symptoms don’t improve.
Bacterial vaginosis
This infection is a result of overgrowth of ''bad'' bacteria (usually anaerobes). It causes intense vaginal itching, thin watery discharge with foul, fish-like smell. Occasionally it also causes burning sensation as one passes urine.
The management is simple and often involves a course of antibiotics after vaginal swabs are collected by your gynaecologist to target treatment.
If your symptoms arise while you are pregnant you should consult your ObGyn doctor as soon as possible since an untreated vaginal infection is a risk for premature delivery and low birth weight for your baby.
Hormonal changes
The female hormone oestrogen helps maintain thick, elastic and well lubricated vaginal walls. However, with age and hormone fluctuations (such as after childbirth), the vaginal walls thin down and become dry. This triggers unwanted itching, bad hygiene and occasionally urinary leakage.
You can discuss with your doctor the opportunity of oestrogen hormone replacement (HRT) or laser vaginal rejuvenation.
Vaginal eczema
Eczema or atopic dermatitis can affect an part of the skin and outer mucosal areas. It is usually a consequence of a weak immune system, genetics, stress, or environmental factors. Once triggered, it can cause intense itching, redness and rashes.
The usual course of action is a prolonged course of topical corticosteroid creams applied twice daily for 2-3 weeks. Antihistamines or immunotherapy can also be utilised.
Cold packs and pain killers are also effective in the management of symptoms.
Sexual intercourse should also be avoided until clinical improvement is underway.
Sexually Transmitted Diseases (STDs)
Multiple organisms have been involved with diseases that can be passed on through unprotected sex with someone who already has them (and may be asymptomatic), such as chlamydia, gonorrhea, trichomonas, genital warts and genital herpes.
Following careful consultation and examination the management involves antibiotics or antiviral medications. The recovery can day from 7-14 days to a couple of months and contact tracing is undertaken in a sensitive and anonymous manner to treat previous partners.
Other conditions
Other entities that may be associated with vaginal itching include vulval psoriasis, lichen sclerosus/planus (immuno-inflammatory conditions), vulval intraepithelial neoplasia (a precancerous condition) as well as systemic conditions such as diabetes mellitus.
Following clinical examination additional procedures (biopsy) or blood tests may be carried out.
It is therefore important to always consult your doctor and identify the cause before proceeding to empirical treatment.
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