Vaginal pinworms (Enterobius vermicularis)

Pinworms in the vagina and vulva

Parasitic pinworms normally try to make themselves at home in the digestive tract; however, sometimes these worms can wriggle their way into the vagina, becoming vaginal pinworms.

These worms don’t like living in the vagina much, as it’s not their natural habitat. They aren’t seeking out the vagina specifically; vaginal pinworms end up there by mistake because they are hungry, blind and clumsy.

Pinworms may also be called worms, threadworms, or seatworms (Enterobius vermicularis).

These worms are contagious, with their eggs passed from surface to surface – sheets, towels, toilets, underwear, food, cups, plates, etc. We inadvertently eat the eggs, and then they hatch once inside our small intestine.

Once hatched, the larvae enter the large intestine, where they attach to the walls of the intestine. After a month or two, the females head to the rectum to lay their eggs in a jelly-like substance – this substance is likely the cause of the itching that ensues.

When we scratch the itch, the tiny little eggs get onto fingers or clothing, where they then go on their adventure to a new destination.

Pinworm eggs can survive 2-3 weeks on a surface but do not come from animals. You can usually see pinworms if you or your child are infected because they are about as big as a staple and white. They tend to appear in the toilet or underwear.

Signs and symptoms of digestive tract pinworm infection

  • Itchy anus, particularly at night
  • Restless sleep
  • Digestive tract symptoms, though the itch typically comes first

Signs and symptoms of vaginal pinworm infection

  • Vaginal discharge
  • Vaginal and vulvar itching, especially at night
  • Urethral itching or soreness
  • Urinary tract infection
  • Inflammation of vulvar and vaginal area – vaginitis
  • Worms may migrate to ovaries, fallopian tubes, and uterus causing inflammation and pain
  • Scratching can cause cuts or broken skin, leading to secondary infection

Treating pinworm infections

Treating pinworms in the digestive tract is pretty easy with worming medicine, taken once and then two weeks later, repeated. Other people you live closely with may need to be treated too.

Itching may take some time to resolve after treatment, which can be helped with a cream. Ask your doctor.

Lifestyle modifications

  • Wash hands frequently, including carefully after the toilet
  • Clean under fingernails with a nail brush
  • Avoid biting your nails
  • Shower regularly
  • Don’t share bathwater
  • Wash pyjamas/sleepwear often and in hot water
  • Wash underwear in hot water
  • Wash all bedding in hot water
  • Keep surfaces clean in living areas

Vaginal pinworm treatments

Vaginal treatment tends to be the same as digestive tract treatment, but you will need medicines that are absorbed into the bloodstream. Not all worming medications are well-absorbed, so speak to your healthcare practitioner for specifics.

Since the pinworms are primarily found in the digestive tract, taking medicine that has direct contact with the worms works very well there. This isn’t always so in the vagina; follow-up checks should be arranged to check for eggs and worms microscopically after treatment.

Typical medical treatments for intestinal worms are mebendazole, albendazole, or pyrantel pamoate. Mebendazole is poorly absorbed into the bloodstream, so it should be avoided in vaginal worm infections; however, albendazole is reported to have successfully eradicated vaginal pinworm infestations.

Mebendazole and albendazole block the worms’ ability to absorb glucose, which starves them of their energy source within days.

Piperazine or pyrantel pamoate paralyses the worms, so they are passed through the intestine in faeces, so a combination of treatments, especially in heavy infestations, may be used. 

These medicines do not kill the eggs, just larvae and adult worms, which is why repeat treatment is required. Hygiene will need to be modified for a short time to get rid of the eggs on surfaces and from under fingernails.

Treating vaginal pinworms with natural medicine and home remedies

Any treatment needs to treat worms in the digestive tract as well as the vagina with vaginal pinworms, which can present some tricky treatment pickles.

Being thorough is important since any leftovers will set the system up to repeat itself until all the worms die. This can be extremely tiring because killing the worms is only half the puzzle – cleaning all your bedding and clothing and being diligent about not passing the eggs around is very time-consuming.

Individual treatments will vary, but herbal medicine can effectively eradicate parasitic worms in the digestive tract. You may need to get a special treatment designed for the vagina; however, it will depend on the type of herbal medicine chosen.

It is a bit of a gamble using home remedies for your pinworms, not because they don’t work, but because you need to make sure you are getting the right dose of a known remedy.

There are plenty of home remedies pinworms won’t like, but whether it is enough to kill them and prevent reinfestation is the real question.

Using garlic to get rid of vaginal pinworms

A good example of a common remedy to treat pinworms is raw garlic. Garlic is not going to be appropriate for everyone, but can be effective.

  • Vaginal application – finely chop raw, peeled garlic and stuff into capsules and apply deep vaginally before sleep
  • Use orally before meals, not after – contact and surface area of intestines matter
  • Can cause digestive upset if taken orally, especially in anyone who is FODMAP-sensitive
  • How to use garlic vaginally

References



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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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