Vaginal Discharge and 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.

Although vaginal itching is the hallmark of yeast infections and other vaginal infections including sexually transmitted diseases (STDs), itching in the vagina and vulva areas has multiple causes. Vaginal itching can also arise due to chemical irritants that may be found in detergents or soaps, douches and vaginal creams, toilet paper, bath products, feminine hygiene products, and vaginal contraceptive products.

Women in the menopausal transition may experience vaginal itching due to fluctuations in estrogen levels. As estrogen levels decline in the perimenopause, the vaginal wall becomes thinner and drier, and itching may result.

Some studies have shown a link between psychological stress and vaginal yeast infections. This is likely due to the fact that stress is known to have a negative effect on the immune system and could possibly increase the likelihood of getting a yeast infection.

The usual mistake with vulva itching is to assume that you have thrush, and keep on applying anti-thrush creams that you have bought from a pharmacy. This may actually worsen the condition, because you can become allergic to some of the ingredients. If an anti-thrush cream does not deal with the problem within a few days, or if the itching comes back, see your doctor. If you have a skin condition, and not thrush, you need the appropriate treatment.

Common causes of vaginal itching and vaginal discharge include:

	Chemical irritants - such as detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies;
	Perimenopause and Menopause - the drop in estrogen causes thinning of the vaginal wall and less lubrication;
	Stress - may increase vaginal itching and make you more susceptible to infections;
	Vaginal yeast infection - often includes a discharge that is white and curd-like. Vaginal yeast infections can be brought on by antibiotics, birth control pills, pregnancy, menstruation, condom use, sexual intercourse, diabetes, and a weakened immune system;
	Vaginitis - inflammation, itching, discharge, and odor caused by other infections including sexually transmitted diseases - Bacterial Vaginosis, Chlamydia, Genital Herpes, Genital Warts (HPV), Trichomonas vaginalis and Gonorrhea;
	Vaginitis in girls before puberty is also common

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

	Psoriasis or other skin conditions;
	Lichen sclerosus;
	Certain skin conditions affecting the vulva skin, some of which may be precancerous;
	Pinworms (a parasitic infection mainly affecting children).

Thrush (yeast infection)

is a fungal infection caused by Candida albicans. About 1 woman in 5 has Candida in her vagina without it causing any symptoms. Hormones in the vaginal secretions and the “friendly” vaginal bacteria keep it at bay. But problems can arise when this natural balance becomes upset, and the Candida multiplies.
The main symptom of thrush is itching or soreness, and this gets worse in the week before a period. If there is a discharge, it is usually only slight, does not smell and looks like cottage cheese.

Bacterial vaginosis

If your vulva smells fishy sometimes combined with itching, it is almost certain that you have bacterial vaginosis (also known as ‘anaerobic vaginosis’). This is an imbalance in the bacteria in the vagina. All women have harmless bacteria in their vaginal passage. In bacterial vaginosis, some of the bacteria multiply so that more are present than is normal (it is usually the Gardnerella and Mobiluncus bacteria that are the culprits). In other words, bacterial vaginosis is not an infection caught from your partner; it is due to bacteria that are normally present in the vagina.

Trichomoniasis

is an infection of the genitals that is caused by the bacterium trichomonas vaginalis (TV). The condition often has no symptoms, but symptoms may include a yellow or green discharge from the vagina with soreness, itching in or near the vagina and discomfort with urination. Infection with Trichomonas vaginalis can be itchy.

Psoriasis

is a skin condition that can be extremely itchy when the genitals are involved. The skin usually becomes bright red, often with painful cracks. The affected area may extend to the groin and to around the back passage (the anus) and between the buttocks. Psoriasis on other parts of the body is scaly (check your scalp, knees and elbows), but in the vulva area it tends to be smooth. You can have psoriasis on the vulva without having it anywhere else on your body.

Lichen sclerosus

is another extremely itchy skin condition affecting the vulva. The itching is often so bad that it can affect a sufferer’s sleep. It is most common around the menopause and in girls just before puberty, though it can occur at any age. Its cause is a mystery. The skin looks thin and pale, and the area around the anus may also be affected. If it is not treated, the lips of the vulva eventually shrink, the vaginal opening narrows and sex becomes painful. Treatment of this condition is simple, and your doctor can prescribe a special steroid cream.

Allergies and sensitivities

can cause redness and itching. The vulva area seems to be very sensitive to chemicals, probably because the vulva is moist and warm – conditions that favour the absorption of chemicals by the skin. It is possible to develop an allergy to almost any chemical substance that comes into contact with the vulva, such as may be present in: skin creams, perfumes in soaps, bubble baths, shower gels and shampoos, disinfectants,
washing powders and fabric softeners, deodorants (including ‘intimate’ ones).

Excessive washing

can irritate the vulva area. Older women who may find it difficult to get into a bath may worry about personal hygiene, with the result that they wash the area too much. There is no need to wash several times a day – once is sufficient.

STRESS or anxiety

Stress can cause itching. When you are stressed or anxious, your nervous system is on alert, and small sensations can become amplified into unpleasant itching or even pain. So it is not imaginary, it is real.

How to avoid vaginal discharge and 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 acidophilus tablets 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;
	Avoid overexertion, heat, and excessive sweating;
	Avoid scratching, which will only aggravate the problem;
	Delay sexual activity until your symptoms get better, or use a lubricant during intercourse;
	Use condoms to avoid catching or spreading sexually transmitted diseases;
	If you know that you have a yeast infection because your symptoms are exactly the same as those you've had in the past, try over-the-counter creams or vaginal suppositories;
	Yeast infections are not considered sexually transmitted. However, sometimes men also develop itching and redness following sexual contact. If this is the case, or you get recurrent infections for unclear reasons, both you and your partner may require treatment. Talk to your doctor;
	For itching related to menopause, your doctor may consider estrogen cream or tablets to insert vaginally;
	If itching is disturbing your sleep, antihistamine medication at bedtime may help. Ask your pharmacist for a ‘sedating’ antihistamine.