Vaginal Itching: Causes, Symptoms, and Treatments

Before getting into what causes vaginal and vulvar itching, it’s worth going over some basic terminology.

What is the vulva?

The vulva, is the external genitalia of the female, which includes the mons pubis, labia majora (outer lips), labia minora (inner lips), clitoris, perineum (the tissue between the vagina and anus) and the external openings of the urethra and vagina.

What is a vagina?

The vagina is the muscular canal that connects the cervix (the opening of the womb) to the vaginal opening.

What is the difference between vulvitis and vaginitis?

Both vulvitis and vaginitis refer to the inflammation that affects your reproductive parts, but they target different areas:

• Vulvitis
  • The inflammation affecting your genital area ‘vulva’ (the outer part of your reproductive anatomy)
• Vaginitis
  • The inflammation affecting your vagina mucosa (the inner part of your reproductive anatomy)
• Vulvovaginitis
  • When the inflammation affects both your vulva and your vagina.

What are the symptoms of vulvitis or vaginitis?

Symptoms which are indicative of vulvitis or vaginitis may include:

• Itching
• Burning sensation
• Vaginal discharge
• Cracks over your vulvar skin
• Blisters over the vulva that may burst, ooze and form a crust
• Redness and swelling on your inner labia (lips of your vagina) and your vulva skin
• Thick, whitish patches over vulvar skin
• Painful sexual intercourse

What are the causes of vulvitis and vaginitis?

1) Chemical irritants

• Dyed or perfumed toilet paper
• Scented pads, pantyliners, or tampons
• Bubble baths, soaps, vaginal sprays, and douches
• Laundry detergents and fabric softeners
• Spermicides

2) Environmental factors

• Prolonged wearing of wet bathing suits or sweaty workout clothes
• Chlorinated swimming pools or hot tubs
• Synthetic underwear

3) Foreign bodies

• Forgotten tampons or vaginal pessaries

4) Physical activities

• Cycling or horseback riding

5) Health conditions

• Skin conditions like eczema or dermatitis
• Fungal or bacterial infections (yeast infections, bacterial vaginosis)
• STIs and viral infections (genital herpes)
• Vaginal atrophy during menopause
• Alkaline vaginal pH due to menstrual blood or semen

6) Other factors

• Radiation therapy over the pelvic area

When should I see a doctor?

You should seek advice from your doctor if you experience any of the following:

• Symptoms that do not resolve spontaneously or persist for more than a week
• A change in usual vaginal discharge in colour, especially if the discharge is green/yellow/grey colour
• Frothy or has a cottage cheese-like texture of discharge
• Foul odour of discharge
• Symptoms following sex with a new partner or suspicion of having STIs
• Discomfort during sexual intercourse
• Pain or tenderness in the genital area
• Ulcers or blisters on the vulva
• Genital redness or swelling

What to do when I feel my vulva/vagina is irritated?

1. Stop using irritating products

   • Discontinue any feminine hygiene products, powders, sprays, soap, detergents,that may irritate your vulva.

2. Wear breathable undergarments

   • Wear loose-fitting, breathable white cotton undergarments to air out your vulva and vagina.

3. Take regular sitz bath

   • A shallow, warm bath can help to relieve itching and burning sensation.

4. Avoid scratching

   • Instead of scratching, you can try patting or tapping the itchy area. Scratching over sensitive vaginal tissues may worsen irritation and may lead to infection.

5. Use a cold pack

   • Using a cold pack or a cool bath can help cool down the affected area to reduce sense of itchiness

6. Consider antihistamine

   • You can take an antihistamine that might reduce itching and make you sleepy

7. Use hydrocortisone cream

   • Hydrocortisone cream or ointment can reduce the irritation and itching of the vulva. Make sure that you should not put hydrocortisone cream inside your vagina. It can increase inflammation or cause atrophy (dryness and irritation).

8. Seek medications in cases of infection

   • Antibiotics or antifungal medications if it is caused by vaginal infections.

9. Oestrogen creams or tablets

   • Menopause-related itching may be treated with oestrogen cream or tablets.

FAQ

Who is vulnerable to vulvitis?

Anyone with a vulva can experience vulvitis, but it is more common in females with lower oestrogen levels, as in children and post-menopausal women.

Low oestrogen levels can make the vulvar tissues thinner and drier, thus increasing the risk of injury and inflammation.

How is vulvitis or vaginitis diagnosed?

Vulvitis or vaginitis is diagnosed through a medical history and physical examination. This includes a pelvic exam to check for vaginal discharge and noting its colour and odour.

Is it normal if my vagina itches during my periods?

It isn’t uncommon that some people might experience itchiness over the vaginal area during the menstrual period. It might be caused by irritation that might resolve spontaneously. You can try changing to unscented tampons or pads.

Sometimes, it could be related to hormonal changes during the menstrual period, thus you might feel vaginal irritation too before or after your periods. However, it is advisable to visit a doctor if the irritation doesn’t resolve itself. 

How to prevent vulvitis or vaginitis?

1. Hygiene practices

   • Toilet paper: avoid scented toilet paper.

   • Wiping: always wipe front to back to keep bacteria away from your vulva and vagina

   • Cleaning: use mild, unscented soaps and warm water, or just warm water.

   • Feminine products: avoid douching and scented tampons, pads, and pantyliners.

2. Clothing

   • Post-exercise: change into clean, dry clothes after swimming or exercising.

   • Underwear: wear breathable, loose-fitting cotton underwear.

   • Tight clothing: avoid tight clothing that increases heat in the genital area.

3. Menstrual hygiene

   • Change menstrual pads or tampons every 4-5 hours.

4. Additional tips

   • Shaving/waxing: limit shaving or waxing of the genital area.

   • Diaper changes: regularly change diapers for infant girls.

   • Sexual health: use condoms to prevent STIs.

   • Lubricants: use water-based lubricants for vaginal dryness.

By following these practices, you can reduce the risk of vulvitis and vaginitis.

How long does vulvitis/vaginitis last?

Itching and other symptoms can usually be relieved within a few weeks of your diagnosis, depending on what's causing your vulvitis/vaginitis.