Ditch the Itch: Deciphering Vaginal Itching

Vaginal itching and irritation affects most women at one time or another. Although you may be tempted to assume it's a yeast infection and run off to the pharmacy, many different sources can cause vaginal itching.

Sometimes the simplest explanation applies -- vaginal itching can be caused by irritation, often from soaps or perfumes. Other possible causes of irritation include reactions to tampons, sanitary napkins, spermicides or even condoms. In addition, certain skin conditions including precancerous or cancerous changes may all produce itching and burning in the vaginal and vulval areas.

Estrogen depletion can also cause vaginal irritation. While this occurs commonly with menopause, there are uncommon circumstances in which a premenopausal woman could be deficient in estrogen.

When irritation or skin reactions are not involved, infections are the most common cause of vaginal itching. Infections may be bacteria, fungus or parasites, with various methods of transmission. Bacterial vaginosis is usually caused by the bacterium Gardnerella vaginalis. While this syndrome occurs most commonly in sexually active women, it has been described in women who are not.

Trichomoniasis is a parasitic infection that causes a vaginal discharge and intense itching. While trichomoniasis is usually sexually transmitted, it can also be spread in hot tubs or on contaminated towels.

Candida vaginitis, or a vaginal yeast infection, has little relationship with sexual activity. In this infection, the woman has itching and sometimes a white, cottage-cheese-like discharge. Yeast infections often occur after taking a course of antibiotics for another illness. Although yeast infection treatments are now available over the counter, you should see your doctor if you have never had a yeast infection to be sure of your diagnosis. Many women misdiagnose and treat themselves for a yeast infection they do not have.

Yeast infections can be a particular problem in women with diabetes and HIV infection. These medical problems increase the risk of recurrent and often hard-to-treat yeast infections. If one course of an over-the-counter medication does not help, or if the symptoms keep coming back, it is time to see the doctor.

Regular Ob-Gyn visits are a wonderful opportunity to practice health maintenance -- making sure everything is okay and keeping it that way. It is much easier and more effective to prevent a problem than it is to deal with it once it has happened.

Reviewed by Marc Kaufman, M.D., ACOG

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