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Dear Aunt Vadge,
I’ve had vaginal itching off and on for years. My bottom also itches sometimes. Please help.
Yours,
Itchy
Age 37, Texas, USA
Dear Itchy,
The clue that actually matters here, and often gets missed, is that it’s itching in both places – vagina and bottom – for years. That pattern points you away from the usual first guesses and towards a much shorter, more useful list, because yeast and BV (the conditions everyone reaches for first) don’t usually cause anal itch.
So if your bottom is in on it too, two front-runners rise to the top.
The first is pinworms, especially if it’s worse at night.
They’re the classic cause of itching in both the anus and vagina, and the tell is that night-time flare, when the worms come out to lay eggs – incredibly common, very treatable, but they need worm medication (plus a second dose two weeks later, and treating the whole household), not a yeast cream, so see your doctor if this rings a bell.
The second is a skin or irritant cause: conditions like eczema, psoriasis or lichen sclerosus happily affect both the vulva and the perianal skin and cause exactly this kind of years-long, on-off itch. And they need a doctor or dermatologist to identify and treat.
And the sneakiest culprit of all is wipes – even ‘flushable’ or ‘sensitive’ ones leave a chemical residue that quietly irritates the skin of the vulva and bottom, so if you use them, stop for a few weeks and see what happens (the only ones I’d put near you are water-only wipes). Soaps, detergents and fabric softeners can do the same via contact dermatitis.
If it’s really mostly vaginal, then yeast or BV are worth ruling out with a comprehensive vaginal microbiome test, and some STIs and haemorrhoids can itch too. But for a years-long, both-areas itch I’d really start with pinworms and the skin-and-wipes angle.
While you investigate, don’t scratch (it worsens everything), wear loose cotton, wash with plain water only (no soaps or douches), and keep the area dry. Years of itching is worth getting to the bottom of properly, so do see a doctor, and mention the both-areas, worse-at-night detail, because it really helps point them the right way.
Lots of love,
Aunt Vadge
This is general information based on our clinical experience, not a substitute for personalised medical advice.
