Cyclic vulvovaginitis

Cyclic vulvovaginitis is a condition, typically caused by a recurrent yeast infection, that flares up at the same stage of each menstrual cycle. Cyclic vulvovaginitis can occur in any woman that is still getting periods. It can lead to vulvodynia, which is a chronic vulvar pain condition.

     Symptoms of cyclic vulvovaginitis

  • Burning
  • Itching
  • Stinging
  • Irritation
  • No symptoms between cycles
  • Before or during bleeding
  • Aggravated by sex
  • Worse the day after sex

     Diagnosis of cyclic vulvovaginitis

Getting a swab at the right time is really important, since a swab at the time may not yield a positive swab. This means you must get a swab taken during an asymptomatic time of your cycle. A strain of candida will likely be identified and an antifungal prescribed.

If a strain of yeast is not found, the hypersensitivity may be associated with oestrogen, if the problem arises before your period starts. Once your period has begun, oestrogen is low, and thus this cannot be the problem.

The issue could also be a type of dermatitis or allergic reaction, possibly to tampons or pads.

      Treating cyclic vulvovaginitis

Treatment is usually antifungals, either topical and/or oral. Boric acid can also work very well, and should potentially be tried before antifungal treatment to avoid resistance. Another effective non-drug treatment of yeast infections is gentian violet. If yeast is not identified, antifungal treatment should be avoided.

If candida is not cultured, all antifungal agents should be discontinued. To reduce contact with irritants, it may be helpful to use pads instead of tampons during menstruation, and to take baking soda sitz baths. Non-soap cleanser should be used for washing.

Dermatitis will be treated with hydrocortisone cream, but caution should be advised and long-term use is not recommended.