An itchy vulva or itchy vagina can be caused by many different issues, so figuring out the nature of your itch – and being examined and tested – are your best weapons to fight it.Most options have a link to more information.
Causes of an itchy vagina (inside)
If your vagina is itching, it is a signal to you that something is wrong. Itching varies considerably in its nature, for example, some of you will get very specific spots that itch or itching that only occurs at certain times of the day (like when you’re in bed).
Itching can be unbearable; you could itch in your sleep drawing blood; itching may come and go mysteriously, or it could stick around all day every day.
Yeast infections/thrush
Yeast can irritate your vaginal walls (and vulva) when it overgrows and can cause sometimes intense itching inside the vagina as well as rawness and soreness.
These unpleasant yeasty symptoms may be accompanied by a thick, cottage-cheese-like discharge – lumpy, white, doesn’t smell bad, itchy.
Bacterial vaginosis (BV)
Some of you will have bacterial vaginosis that itches, which is caused by certain bacteria present in your vagina in higher-than-desirable numbers.
To find out which bacteria are causing your issues, you’ll need to get properly tested and then get a suitable treatment. (See Killing BV for some non-antibiotic suggestions and plenty of fascinating information on why you have BV!)
BV is a microbial imbalance in your vagina that causes foul or fishy odours, watery discharge, and sometimes other symptoms like itching.
Rarely, itching with BV may be caused by emphysematous vaginitis, which is usually accompanied by a popping sensation or noise in the vagina.
Aerobic vaginitis (AV}
Aerobic vaginitis is much more likely to cause itching than bacterial vaginosis. Aerobic vaginitis occurs when aerobic bacteria take over your vaginal ecosystem (like E. coli or E. faecalis), as opposed to anaerobic bacteria. You may have green or yellow discharge, itching, pain and odours.
Lactobacillus overgrowth syndrome (cytolytic vaginosis)
Cytolytic vaginosis is a condition whereby healthy lactobacilli overgrow for some reasons. Cytolytic vaginosis is not a well-understood condition and often happens when a lot of probiotic bacteria are put into the vagina over a period of time (say, to try to treat yeast or BV).
Cytolytic vaginosis mimics a yeast infection in most of its symptoms, including itching and thick, white discharge, but does not respond to antifungals (as it is not caused by a fungus).
Genitourinary symptoms of menopause (GSM)
Your vulva or vagina may itch as you enter or proceed in menopause, which was formerly known as atrophic vaginitis. This degeneration of tissue occurs because the vulva and vagina are rich in oestrogen receptors, and are nourished by this hormone.
When oestrogen drops off at menopause, the vagina and vulvar tissue can become thin, easily damaged, and yes, itchy.
A sexually transmitted infection
Not all STIs cause itching, but a few do, such as trich. If you have an itchy vagina, get a test to rule out an STI.
Vaginal pinworms
The intestinal pinworms that kids typically get and spread around can also be found in the vagina, and their wriggling and writhing can make your vagina very itchy. (They don’t like it either.)
Sjogren’s syndrome
Sjogren’s syndrome is a condition whereby all your moisture-producing glands stop working, resulting in dry skin, eyes, nose, and vagina/vulva.
Neurologically-based itch
Itch is a nerve signal, so if your nerves are getting interrupted or changed in some way as they relate to the vagina or vulva, it can trigger the sensation of an itch even though the tissue is actually perfectly healthy. Itching needs investigation, as it could indicate a more serious problem.
Pregnancy-related vaginal or vulvar itch
It is common for women to experience an itchy vulva or vagina, but that doesn’t mean it’s normal or healthy. The vulva can become swollen and more easily irritated, or the increase in vaginal fluids produced/change in fluid constituents can result in itching.
Itching during pregnancy can be caused by any of the conditions or infections on this page and should be checked out.
Causes of an itchy vulva (outside)
You need to establish why your vulva is itching, since sometimes it’s serious and sometimes it’s not.
This is a partial list of dermatological and infectious causes of an itchy vulva, so investigate these, check out the symptoms of each to see if they match, then you can take your ideas to your dermatologist or gynaecologist appointment. Keep a careful diary of your symptoms.
Sexually transmitted infections
STIs like genital warts (HPV) and pubic lice can cause vulvar itching.
Vulvar eczema
Eczema can affect anywhere on your body, including your vulva, causing itching, dryness or flaking skin. The labia may become red when affected by vulvar eczema.
Contact dermatitis
Contact dermatitis on the vulva can present much like vulvar eczema, but this type of dermatitis will disappear once the irritant causing the dermatitis is removed.
Contact dermatitis causes your skin to dry out, which results in an itchy vulva.
Lichen sclerosus (LS)
Lichen sclerosus is one of a collection of lichenoid skin conditions that causes thickening and itching of vulvar skin. Thickened, dry skin can become quite itchy.
Lichen planus (LP)
Lichen planus is a lichenoid skin condition that causes skin changes and itching. Thickened, dry skin can become quite itchy.
Genital psoriasis
Genital psoriasis is an autoimmune skin condition whereby the skin cells replicate too quickly, causing scaly, itchy skin.
Ringworm or tinea (dermatophyte infection) of the vulva
Ringworm or tinea is commonly found in and around other parts of the human body, with the creases of the vulva providing an ideal home for adventurous fungi.
This fungal infection has a variety of specific microbial causes, but one, in particular, is known as Tinea genitalis.
Paget’s disease of the vulva
Paget’s disease of the vulva causes itching, cracked skin, and bleeding, and is an uncommon precancerous state requiring immediate medical attention.
Vulvar syringomas – sweat gland duct tumours
Syringomas are sweat duct tumours that can be found in the groin and particularly around the eyes and armpits, that can cause itching.
Scleroderma
Scleroderma is an autoimmune skin condition that can cause the vagina and vulva to be very itchy, due to skin thickening and tightening.
Vulvar skin cancers
A squamous cell carcinoma of the vulva is a form of skin cancer and can present with itching.
Vulvovaginal yeast infection
Yeast irritates the mucous membranes of the vagina and vulva, causing sometimes intense vulvovaginal itching. The itching from a vulvovaginal yeast infection can sometimes be severe, resulting in scratching that can draw blood.
It may only be felt on the inner labia but may extend to deep inside the vagina and the anal area.
Group B Strep
Group B Strep is a vulvovaginal infection that often goes mis- or undiagnosed due to a perception that it isn’t prevalent, and that if you are not pregnant then it doesn’t matter.
Group B strep can cause itching and burning in the vulva and vagina and many other unpleasant symptoms. If you have a diagnosis of GBS and symptoms, it’s wise to take the connection seriously and request treatment or a second opinion by a more experienced doctor.
Secondary syphilis
Secondary syphilis is the second phase of syphilis, and appears weeks or months after initial infection and primary syphilis, with lesions.
Pityriasis rosea
Pityriasis rosea is a rash caused by a virus that can affect the vulva and vagina with raised scaly skin.
Lupus
While it is rare, itchy lesions can appear on the vulva of women with discoid lupus erythematosus.
Diabetic genital itching
Diabetes can cause genital itching, especially on the scalp, but also on the vulva, a sign of high blood glucose. The vulvar itching probably occurs because more sugar is passed out through the urine, causing bacterial or yeast overgrowth.
Liver disease or failure
People with liver problems may experience intermittent, mild itching that can be all over, or in a specific place. Specific places often include areas under tight-fitting clothing, including the vulva and crotch. It’s not known why this happens.
Iron-deficiency anaemia
Iron deficiency-related itching is usually generalised, but it could be localised to the perineal or vulvar regions. This itching can occur after a hot shower or bath (aquagenic pruritus) with prickling. This symptom may precede disease by several years.
Hypo- or hyperthyroidism
Endocrine-related itching related to thyroid issues is typically generalised but can be located on the vulva.
References
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