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Vaginal itching

  • By Dr. Ananya Mandal

Vaginal itching is not a disease in itself. It is a symptom of an underlying disease or infection.

There are several diseases and infections that may give rise to an itchy vagina. The cause of vaginal itching also varies between individuals and in different age groups.

Causes of vaginal itching:

  1. Infections: This is one of the commonest causes of vaginal itching. Infections may be caused by fungi leading to vaginal thrush, with worms such as threadworm infections, with parasites such as scabies, and some sexually transmitted diseases (STDs).
    Skin diseases such as eczema, psoriasis, etc.
    Allergic reaction of the skin of the vulva to soaps, deodorants, perfumes, sweat, condoms, sanitary wear, dyes, detergents, fabric conditioners, etc.
  2. During menopause, the levels of female hormones such as estrogen reduce. This makes the vulval skin thinner and drier and makes it itch.
  3. Generalized diseases such as blood disorders, thyroid problems, or kidney or liver diseases lead to whole body itching and may affect the vagina and vulva as well.
  4. Diabetes can lead to increased propensity for vaginal infections and itching.
  5. Some of the rare causes of vaginal itching are lichen planus, lichen sclerosus, cancers of the vagina, incontinence of urine or feces (where the patient is unable to control the flow of urine or stool), etc.

How is the underlying cause of vaginal itching diagnosed?

In most cases the doctor is able to find the cause of vaginal itching by talking to the patient and by examining them. Examination may involve closer observation of the skin in and around the genital region and also an internal (vaginal) examination. Swabs may be taken from the vagina and tested in laboratories for infections. Blood tests may be ordered to look for diabetes, thyroid, kidney, or liver problems, etc. Skin patch testing may be suggested in some cases to determine if there is something that may be sensitising and causing irritation of the vulval skin. In rare cases where cancer is suspected, a small bit of vulval tissue is taken for biopsy examination under a microscope.

Treating vaginal itching:

Treatment involves two approaches – treating the symptoms and treating the underlying cause.

Treating the underlying cause:

  1. The treatment varies depending on the cause. For example, in case of infections, antibiotic creams or pills may be advised. In case or thrush or fungal infections, antifungal cream is advised. Steroid creams are advised for various skin conditions such as psoriasis, lichen, etc. Using hormone replacement therapy (HRT) creams may help patients whose itch is related to menopause.
  2. Some moisturisers such as aqueous cream or emulsifying ointments are prescribed to ease the itch. These can be used in addition to other treatments.
  3. Antihistamine drugs may be prescribed to relieve the itch and also to help in sleep.
  4. Scratching the affected area only worsens the condition by making the itching more intense and also allowing finger nail injury to the soft vulval skin leading to further infections. Women with vaginal itching are advised not to scratch the area. Nails should be kept short, and cotton gloves may be worn at night to prevent scratching.
  5. Prevention of infection should be taught to young girls. They should wipe gently from front to back and to wash and rinse well.
  6. Vulva should be washed gently once a day. It should be kept as dry as possible.
  7. Women are advised to wear loose 100% cotton underwear. Avoid nylon or synthetic underwear material that leads to more sweating.
  8. Underwear should be changed daily.
  9. Tight-fitting clothes such as cycling shorts or leggings should be avoided.
  10. Sometimes soaps, perfumes, deodorants, dyes, etc., can irritate the delicate vulval skin. These should be chosen with care.