A friend complained to me that she was having discharge from her vagina and it was accompanied by itching.
This complaint is a very frequent one that is very preventable when the cause is known.
In this post, I will be writing about vaginal itching and in my next post, I will be writing on discharge from the vagina.
- About half of the women of reproductive age have experienced vaginal discharge in their lifetime.
- Not all vaginal discharge are abnormal vaginal discharge.
- Pregnant women tend to come down with vaginal discharge than the non-pregnant population. I will say reasons why as I write on.
- Most abnormal vaginal discharge is due to a variety of organisms. However, the most implicated organism is Bacterial vaginosis.
- Vagina itching can stem from a lot of things ranging from normal things like menopause to acquired conditions like sexually transmitted infections like vulvovaginal candidiasis.
Pruritus vulvae simply mean itching of the vulva. However, women experience itching once in a while so pruritus vulvae are not just itching of the vulva. Pruritus vulvae are when the itching causes distress and it becomes persistent. The vulva is that part of the body that comprises the labia majora, labia minora, clitoris, mons pubis and perineum. It is not a diagnosis on its own, it is a symptom and can be a pointer to an underlying condition.
Pruritus vulvae can occur in any age group. However, it happens to be more common in the pregnant population.
A study done by Fischer GO showed that the commonest cause of chronic vulvar symptoms was due to dermatitis. Dermatitis accounted for more than half of patients with vulva symptoms. Other causes include lichen sclerosus(13%) chronic vulvovaginal candidiasis (10%), dysaesthetic vulvodynia (9%) and psoriasis (5%).
The causes of pruritus vulvae can be grouped into the following
Infections: Infections like Trichomonas vaginalis, candidiasis, lymphogranuloma venereum(LGV), chancroid and molluscum contagiosum can cause genital itching.
Infestation: Infestation by organisms causing Scabies, pediculosis can cause genital itching. Pinworm infestation can cause pruritus vulvae.
Endocrine conditionslike poorly controlled diabetes mellitus can cause itching.
Contact dermatitis due to exposure to an allergic reaction.
Dermatologic disorders like psoriasis, Lichen planus.
Precancerous conditions like vulva intraepithelial neoplasm(VIN).
Physiologic conditions like menopause, breastfeeding and pregnancy can cause itching.
It could also be idiopathic.
Some causes of genital itching have specific features which can be used to identify them.
Candida vulvovaginitis can be associated with a whitish vaginal discharge. However, candida vulvitis can present with satellite red superficial papules, the papules might have pus in them. There might be subtle fissuring which usually looks like a cut.
Warts are easy to identify, the itching is accompanied by a cluster of visible warts.
Itching due to sudden irritant contact dermatitis may be shiny or waxy and most times there is a history of recently used chemical or agent.
When should you see a doctor?
Itching can be very embarrassing and trust me itching down there is worse but a lot of people experience it. A doctor should be seen when itching becomes distressful and persistent. When medications fail to work, you should see your genitourinary doctor.
It is always better to prevent than curing the disease. Much of the prevention is not beyond our control.
Hygiene plays a pivotal role in preventing most of the causes of itching in the vulva
Good glycemic control in diabetics will help reduce itching in diabetics. Good glycemic control involves exercise, dieting, and proper use of anti-diabetic drugs.
Avoid the use of harsh agents on the genitals.
Safe sex practices as some of the causes are sexually transmissible. Safe sex practices involve the use of condoms and washing up after sexual intercourse
Avoidance of multiple sexual partners.
Genital itching is a common symptom. Inflammation, infections and infestation are some of the causes of genital itching. The mainstay of prevention involves hygiene, safe sex practice and good health-seeking behaviour. Treatment modalities involve the use of antipruritic agent and treatment of the underlying cause.
- Fischer GO. The commonest causes of symptomatic vulvar disease: a dermatologist's perspective. Australas J Dermatol. 1996 Feb;37(1):12-8. doi: 10.1111/j.1440-0960.1996.tb00988.x. PMID: 8936065.
- Mayo clinic
- Web MD
Thank you for reading