What is vaginal itching?

Vaginal itching is an unpleasant sensation experienced by many women. Vaginal itching is one of the most common gynaecological complaints. Some women may experience vaginal itching without any other symptoms, while other women may have abnormal vaginal discharge and other symptoms accompanying their itching.

Although vaginal itching is uncomfortable and occasionally painful, it can usually be prevented or treated.

Causes

There are many different causes of vaginal itching. Some causes are infectious, while others are non-infectious.

A normal and healthy vagina contains the bacteria Lactobacillus acidophilus, which colonises the vagina and plays a vital role in the production of acidic vaginal secretions. Maintaining this acidic environment is important, as it makes it more difficult for microbial growth to become excessive. Any changes to the acidity of the vaginal environment can make it more likely for a vaginal infection to set in.

Infectious causes of vaginal itching

Bacterial infection

Bacteria normally live in a healthy vagina in smaller numbers, but when their growth becomes excessive, it can cause a condition called bacterial vaginosis. Bacterial vaginosis is associated with vaginal itching and irritation around the genital area that may be accompanied by abnormal discharge that has a strong odour. 

Other bacteria that do not normally live in the vagina can be the cause of vaginal itching. Neisseria gonorrhoea and Chlamydia trachomatis are two species of bacteria that can be transmitted sexually and whose infection is associated with symptoms that may include abnormal vaginal discharge, burning, painful urination, pain during sexual intercourse and bleeding between periods. 

Yeast infection / thrush

The most common species of yeast associated with vaginal yeast infections is Candida albicans. A yeast infection, also known as thrush or candidiasis, can cause vaginal itching that is usually accompanied pain or a burning sensation during urination and/or sex and an abnormal vaginal discharge.

Common cause of vaginal itching; yeast infection of vagina.A yeast infection can cause vaginal itching. 

Parasitic infection

Parasites do not normally live in a healthy vagina, but when they grow in the vagina or genital area, they cause a range of symptoms.

Trichomonas vaginalis is the parasite that causes trichomoniasis. Trichomoniasis is an infection that is associated with vaginal itching and may be accompanied by irritation of the genital area, abnormal vaginal discharge and pain during urination.

Scabies is an infection that is caused by Sarcoptes scabiei, which are mites that burrow under the skin, sometimes including in the genital area. Scabies can be associated with severe vaginal itching that is sometimes accompanied by a rash with blisters.

Enterobiasis is an infection of parasitic worms that can be spread from the anus area and is associated with severe vaginal itching that is often worse at night.

Viral infection

Viruses do not normally live in a healthy vagina and some sexually-transmitted infections (STIs) can be caused by viruses.

The herpes simplex virus (HSV) can be sexually transmitted and its infection can result in vaginal itching - and often pain - that is accompanied by blisters around the genital area, redness and flu-like symptoms.

The human papillomavirus is usually sexually transmitted and infection may result in genital warts and vaginal itching. Some cancers are associated with infection by certain strains of human papillomavirus and vaccination is an effective means of its prevention.

Non-infectious causes of vaginal itching

Allergic vaginitis/contact dermatitis

The vagina is delicate and can easily be traumatised by the use of aggressive cleaning agents and methods such as vaginal douching (washing out the inside the vagina). Repeated exposure to certain cleaning gels, soaps, tampons or pads may irritate the vagina and cause allergic vaginitis (contact dermatitis), whereas douching can upset the normal balance of microbes in the vagina and lead to yeast or bacterial overgrowth.

Psoriasis

Psoriasis is an inflammatory skin condition. It can affect different areas of the body, but when psoriasis affects the genital area symptoms can include red scaly patches, itchiness and flaking of the skin. 

Seborrheic dermatitis

Seborrheic dermatitis, or dandruff, in the genital area may be associated with red, greasy skin and vaginal itching.

Vaginal / vulvar dystrophy

Vaginal dystrophy causes changes in the skin or inside the vagina. It presents as white or grey thickened areas of skin. Some causes are conditions such as lichen sclerosus or nutritional deficiencies in iron, folic acid and vitamins B1, B2 and B12.

Antibiotics

Antibiotics are used to eliminate harmful bacterial infections, but they also reduce the number of normal and beneficial bacteria that live in the vagina. Yeast that are normally only found in smaller numbers can overproduce and cause unpleasant symptoms. Yeast infections can lead to symptoms of vaginal itching, abnormal discharge and a burning sensation during urination and/or sex. 

Poor hygiene

Women of menstruating age may develop a bacterial or yeast infection if they use tampons, but fail to change them regularly. Tampons left in the vaginal canal too long can make it easier for an infection to develop.

Stress

Stress can contribute to the development of many health conditions, including vaginal itching.

Wearing tight underwear/clothing

Yeast and bacteria thrive in moist and warm environments. Women who frequently wear overly tight clothing, pantyhose or underwear may be more likely to develop bacterial or yeast vaginal infections. 

Diabetes

Poorly-controlled diabetes is associated with fluctuations in blood glucose levels. Vaginal secretions of diabetic women contain higher levels of glucose. Because yeast cells thrive with excess glucose, they are able to multiply, so women with diabetes are more likely to experience yeast infections.

Antibiotics

Chemical substances that kill or suppress the growth of bacteria.

Anus

The opening at the end of the anal canal, between the buttocks, through which faecal matter and intestinal gas exits the body.

Cancers

A large group of diseases whose common feature is that they are caused by an uncontrolled growth of the body's cells.

Cells

The fundamental unit of life; the simplest living unit that can exist, grow, and reproduce independently. The human body is composed of trillions of cells of many kinds.

Chlamydia trachomatis

A species of bacteria that is responsible for the sexually-transmitted infection chlamydia.

Diabetes

A metabolic disorder that is caused by problems with insulin secretion and regulation and which is characterised by high blood sugar levels. Also known as diabetes mellitus.

Douching

To wash or clean out with water or other solutions.

Enterobiasis

An intestinal infection caused by threadworms (also called pinworms). More common in children than adults, it causes itching but is easily treatable. The most common worm infection in Australia.

Glucose

A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.

Human papillomavirus

A virus with many subtypes that cause warts, including common warts of the hands and feet, and genital warts. Some strains of HPV cause cervical cancer.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Infectious

Can be spread from one person to another.

Lactobacillus acidophilus

A species of bacteria that is thought to be beneficial for health and can be found in the mouth, intestines and vagina.

Mites

A tiny arachnid. Many mites are parasites and they can cause skin irritation and other symptoms in humans.

Neisseria gonorrhoea

A species of bacteria that is responsible for the sexually-transmitted infection gonorrhoea.

Parasites

An organism that lives off another organism.

Stress

The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.

Vaccination

The practice of administering a vaccine, a solution containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.

Viruses

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

Yeast

A single-celled fungus that can causes infections. Candida, the cause of thrush, is an example of a yeast.

Sexually-transmitted infections

A viral or bacterial infection contracted through sexual intercourse or genital contact. Such an infection can lead to development of diseases such as chlamydia, gonorrhoea, genital herpes and AIDS.

Lichen sclerosus

A chronic skin condition in which small white spots appear on the skin, usually in the genital and anal regions. The skin becomes itchy and painful.

Microbes

A microorganism, such as bacteria or fungi, that can cause disease.

Risk factors

Females of any age can potentially experience vaginal itching, but it is a very common and treatable condition.

Some risk factors of developing vaginal itching may include:

Antibiotics

Chemical substances that kill or suppress the growth of bacteria.

Diabetes

A metabolic disorder that is caused by problems with insulin secretion and regulation and which is characterised by high blood sugar levels. Also known as diabetes mellitus.

Immunocompromised

Descriptive of a person whose immune system is weak and ineffective, or something that weakens a person's immune system.

Postmenopausal

The stage in a woman's life where she no longer experiences menstruation. This is usually defined as occuring 12 months after her last period/menses.

Signs and symptoms

Itching may be experienced around the vagina and vulva and may be accompanied by a range of symptoms, depending on the cause. Some common symptoms that may accompany vaginal itching may include:

  • Abnormal vaginal discharge that is atypical in colour, smell, texture or amount;
  • Redness around the affected areas;
  • A burning sensation;
  • Pain during urination and/or sexual activity;
  • Blisters or warts around the genital area, and;
  • Flaky skin around the genital area.

Vulva

External female genitalia.

Methods for diagnosis

The diagnosis of the cause of vaginal itching may involve a physical exam and the doctor taking a detailed medical history and a physical exam. During the examination, a swab may be taken from the vagina. This is used to identify what, if any, microbial growth is present. Depending on the age and sexual history, other testing might be carried out to check for the presence of bacteria that cause gonorrhoea and chlamydia, which are sexually transmitted. Based on the symptoms, history and examination, a Pap test may be performed to check for the presence of atypical cells

Cells

The fundamental unit of life; the simplest living unit that can exist, grow, and reproduce independently. The human body is composed of trillions of cells of many kinds.

Pap test

A test used to check for abnormal changes in the cells of a woman's cervix. It is performed using a speculum to reach the cervical cells with a small brush, through the vagina.

Types of treatment

The types of treatment used for vaginal itching vary, depending on its cause.

Treatment for infectious causes of vaginal itching

For vaginal itching that is caused by an infection, the treatment is as follows:

Yeast infection

Yeast infections are usually treated with antifungal agents that come in the form of a tablet or a vaginal pessary

Bacterial infection

Bacterial infections are usually treated with antibiotics

Parasitic infection

The treatment for a parasitic infection depends on its type. It may include a course of oral medication or a topical cream. 

Treatment for non-infectious causes of vaginal itching

Contact dermatitis and other skin conditions

These are generally treated by avoiding irritants such as soaps, tampons and douching. Topical steroid creams may also be recommended depending on the location and severity.

Diabetes

Following a healthy and balanced diet, getting regular exercise and properly controlling blood glucose levels can reduce the likelihood of getting vaginal yeast infections. 

Antibiotics

Chemical substances that kill or suppress the growth of bacteria.

Antifungal

A medication that kills fungi or inhibits their growth.

Douching

To wash or clean out with water or other solutions.

Glucose

A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Steroid

A class of chemical substances that have a certain complex of carbon particles. The body produces several types of steroids naturally and artificially-produced steroids are used as medications.

Yeast

A single-celled fungus that can causes infections. Candida, the cause of thrush, is an example of a yeast.

Vaginal pessary

A small and soft removable device that is inserted into the vagina to deliver medications and/or provide support to the female genital tract. Also known as a pessary or vaginal ring.

Potential complications

Vaginal itching generally poses no significant complications. However, chlamydia or gonorrhoea infections, if left untreated, may progress to pelvic inflammatory disease, which can lead to other complications including infertility. Rarely, vaginal itching may be associated with a more serious underlying condition such as cancer.

Cancer

A large group of diseases whose common feature is that they are caused by an uncontrolled growth of the body's cells.

Infections

Entry into the body of microorganisms that can reproduce and cause disease.

Infertility

Inability to produce offspring.

Prognosis

The conditions that cause most cases of vaginal itching respond well to treatment. 

Prevention

Once the cause of your vaginal itching has been identified, there are some strategies that may help prevent its recurrence. Some ways of reducing your risk of experiencing vaginal itching may include:

  • Avoiding douching;
  • When going to the bathroom, wiping from front to back to avoid contaminating your vagina with bacteria from faecal matter;
  • Choosing underwear made from natural fibres, as synthetic fibres can promote sweating, and;
  • Practising safe sex to reduce the risk of acquiring sexually-transmitted infections

If you are experiencing vaginal itching it is important to see your doctor to diagnose and treat the cause and to exclude more serious conditions that may be associated with this symptom.

Douching

To wash or clean out with water or other solutions.

Infections

Entry into the body of microorganisms that can reproduce and cause disease.

Sexually-transmitted infections

A viral or bacterial infection contracted through sexual intercourse or genital contact. Such an infection can lead to development of diseases such as chlamydia, gonorrhoea, genital herpes and AIDS.