Vaginal itching is a quite common symptom that affects women. Unfortunately, the variety of causes that trigger this condition makes it challenging to pinpoint its etiology.
The vast majority of cases are benign, triggered by hormonal changes and irritating substances. However, it could also be a sign of a sexually transmitted infection (STI) or vulvar cancer.
Causes of vaginal itching
The following sections will cover the various potential causes of vaginal itching:
Irritants
Chemical irritants can trigger vaginal itching when they come in contact with your private parts. We refer to this as contact dermatitis. Symptoms of contact dermatitis in the vaginal area include itchiness, redness, and soreness.
Examples of household products that may contain chemical irritants include:
- Soaps, shower gels, and bubble baths
- Feminine sprays
- Douches
- Topical contraceptives (e.g., spermicide, phexxi)
- Creams, lotions, and ointments
- Detergents
- Fabric softeners
- Scented toilet paper
- Scented pads and liners
Skin conditions
Aside from contact dermatitis, other skin conditions can also trigger vaginal itching. Examples are:
Eczema – This is also known as atopic dermatitis, which causes a red rash and itchiness in the vagina. You may notice a scaly texture as well.
Psoriasis – Psoriasis precipitates red patches, itchiness, and a scaly texture in the joints and scalp. During times of flare-ups, this presentation may develop in the vulva as well.
Yeast infection
The vagina has a collection of bacteria and fungi that we refer to as flora. These microbes have a symbiotic relationship with the vagina. However, they can sometimes grow uncontrollably, leading to a vaginal yeast infection. There are many quality yeast infection treatments available.
Common signs and symptoms of a vaginal yeast infection include:
- Itching
- A burning sensation
- Whiteish discharges
- Malodorous discharge
The most common cause of microbiome disruption is the intake of antibiotics. You see, these medications target the bad and the good bacteria. Because the good bacteria keeps yeast species in check, any disruption to the former leads to the overgrowth of the latter.
Bacterial vaginosis
Bacterial vaginosis (BV) is a bacterial infection that causes vaginal itching. Similar to yeast infections, BV results from flora imbalance.
While not all patients with BV are symptomatic, you could develop vaginal itching and a thin, gray discharge. Note that the discharges have a fish-like smell. There are many good BV treatments available to help with this.
STIs
A more serious cause of vaginal itching is a sexually transmitted infection. Some germs that cause STIs include:
- Chlamydia
- Genital warts
- Gonorrhea
- Genital herpes
- Trichomoniasis
You may also develop symptoms, such as dysuria (i.e., pain during urination), sores, and vaginal discharge. Pubic lice are another cause of vaginal itching. These insects are passed during sexual intercourse but can also be transmitted through towels and bedding. The symptoms are usually worse during the night and start 5 days after the infestation. Note that pubic lice are not an STI.
Menopause
Menopause is characterized by a dramatic decline in estrogen levels. This increases the risk of itching due to the thinning of the vaginal tissues. The vagina also becomes dry, which is a leading cause of irritation.
Stress
Stress is notoriously known for weakening the immune system, increasing the chance of infections. Animal studies found that high levels of cortisol augment the risk of vaginal infections.
Vulvar cancer
This is the most serious cause of vaginal itching. While vulvar cancer is rare, it can lead to itching that does not improve with medical treatment. You may also notice areas of depigmentation, which is when the skin changes color. Bleeding, discharges, and lumps can also be present. Unfortunately, some patients with vulvar cancer do not present any symptoms, leading to a delayed diagnosis and a poor outcome.
When to see your doctor about vaginal itching
Visiting a primary care physician or a gynecologist about vaginal itching might be necessary if your symptoms do not improve after a week or so. Moreover, when the symptoms are severe enough to disrupt your sleep or daily lifestyle, it is time to see a professional.
If you have the following symptoms, along with vaginal itching, it is time to consult a doctor:
- Ulcers or blisters on the vulva
- Pain in the genital area
- Genital redness or swelling
- Dysuria (i.e., painful urination)
- An unusual vaginal discharge
- Dyspareunia (i.e., pain during sexual intercourse)
What to expect during your appointment
After taking your medical and sexual history, your doctor will assess the severity of your symptoms and other characteristics (e.g., duration, triggers, relieving factors).
Your doctor may also perform a pelvic exam, where the vulva is inspected with the help of a speculum. This involves inserting a gloved finger into the vagina and pressing down on the abdomen to check other organs.
Finally, a sample of your discharge may be ordered to look for any microbes. If your symptoms are severe, you may also need some blood or urine tests.
Medical treatment for vaginal itching
After identifying the cause of your itching, a number of treatments may be recommended. However, it all comes down to the specific cause.
Here are the specific treatments for some causes of vaginal itching:
Vaginal yeast infections
Doctors prescribe antifungal medications to treat vaginal yeast infections. These drugs come in cream, ointment, and pill forms. You can also get them from your local drug store as over-the-counter medications.
Bacterial vaginosis
Like other bacterial infections, we treat BV using antibiotics. The drugs are usually taken orally or applied topically.
We recommend completing your course of treatment, even if you notice that your symptoms are improving.
STIs
Because STIs can be the result of bacteria, viruses, or parasites, the treatment varies. While getting treated, you should avoid having sex to prevent the spread of the disease.
Menopause
If vaginal itching is the result of menopause, you may benefit from hormone replacement therapy (HRT). However, your doctor will only recommend this treatment if other severe symptoms are present.
Instead, you could get estrogen cream or a vaginal ring.
Other causes
The treatment of other types of vaginal itching is not always clear. Generally speaking, the symptoms will self-resolve within a few days.
You may help yourself by applying steroid creams to dampen the inflammation and ease up the discomfort. Ask your healthcare provider about the best practices of using topical steroids.
Home remedies for vaginal itching
It can be helpful to try some home remedies for vaginal itching. The following practices can help restore balance to your vaginal flora and relieve your symptoms:
- Wash your genital area with a gentle cleanser and warm water
- Do not use scented products when you are symptomatic (e.g., soaps, lotions, bubble baths)
- Vaginal sprays and douches can make things worse – Avoid them
- Rapidly change your wet clothing after swimming
- Change your underwear daily and only wear cotton-made ones
- Use barrier methods during sexual intercourse
- Test yourself for STIs and ask your partner(s) to do the same
- When in the bathroom, wipe front to back to avoid moving the bacteria to the vaginal area
Takeaway message
Vaginal itching is a very common symptom that can be quite uncomfortable. Fortunately, it is rarely serious. Most patients recover without seeking medical attention. Focus on lifestyle modifications to avoid triggers.
If you feel concerned about vaginal itching, it wouldn’t hurt to consult with a healthcare professional for tailored medical advice.
