Itching in the vagina occurs as a result of irritation or dryness of the mucous membrane against the background of external influences, changes in the microflora, infectious and inflammatory processes, hypoestrogenism of various origins, endocrine and somatic diseases. Accompanied by a feeling of discomfort, tingling, burning. The cause of the symptom is established based on the data of the survey, physical examination, gynecological examination, and the results of additional studies. Treatment includes antimicrobial agents, hormones, local procedures, measures to restore microflora.
Why does itching occur in the vagina
In healthy women, itching of the vagina and vulva is most often caused by chemical or mechanical irritation. May be caused by the following circumstances:
- unsuitable cosmetics;
- washing powders and rinses with aggressive chemical components;
- synthetic tight underwear, thick waterproof clothing;
- non-observance of hygiene rules;
- changes in the pH of the vagina during the period of taking antibiotics;
- increase in pH and active reproduction of pathogenic microbes during menstruation.
Pubic pediculosis (phthiriasis) and parasitosis (pinworms, scabies mites) often cause itching of the vulva. For some women, discomfort extends to the vagina. Sometimes vaginal itching develops against the background of hypothermia.
This condition can be physiological or pathological. In the absence of diseases, it is observed under the following circumstances:
- the use of tampons in the presence of scant discharge in the last days of menstruation;
- prolonged exposure to chlorinated water (during training or swimming in the pool);
- contact of the mucosa with a latex condom, the use of some lubricants;
- protection by the introduction of spermicides with benzalkonium chloride: vaginal creams, suppositories, tablets;
- lack of sufficient pre-stimulation during sexual contact.
Against the background of hormonal changes, physiological dryness and itching of the vagina are often observed during pregnancy and lactation. Sometimes briefly occur before menstruation. In some women, they are detected when taking oral contraceptives.
Vaginal dryness in various pathological processes is also due to hormonal changes with the development of hypoestrogenism. The most common cause is atrophic colpitis that occurs during menopause. Patients complain of a feeling of tightness, which increases during sexual intercourse. Itching may be similar to sexual arousal, but the attempt at intercourse ends in pain, not relaxation. When an infection is attached, itching intensifies, abundant white or yellowish discharge, dysuria appear.
Post-castration syndrome in women of reproductive age is formed after the removal of the ovaries with or without a uterus. Sometimes it develops as a result of radiation therapy. Itching in the vagina is combined with autonomic disorders, osteoporosis, periodontal disease. Endocrine and metabolic disorders, persistent recurrent cystitis, vulvar kraurosis, leukoplakia are possible.
Non-inflammatory disease, accompanied by a change in the microflora of the vagina. The predominant symptom of bacterial vaginosis is a foul-smelling, thin, greyish or white discharge that may become greenish or yellowish, thick, and sticky over time. Some women are concerned about vaginal itching, dyspareunia, urination disorders, pain during sexual intercourse.
The most common variant of the pathology is gardnerellosis. The disease is manifested by homogeneous pasty grayish leucorrhoea with the smell of stale fish. Burning, itching in the vagina appear mainly during sexual intercourse. Unsharply pronounced dysuric disorders, complications from the internal genital organs are possible.
Itching in the vagina
Manifested by itching, bursting, a feeling of pressure and irritation of the affected area. There is an increase in the amount and change in the nature of the discharge, dysuric disorders, pain during sexual intercourse. Light contact bleeding is possible. The acute process is characterized by pronounced symptoms. In the chronic course of pain, as a rule, there are no, the discharge is scanty, itching is periodic.
With vaginitis, only the vagina is involved in the process, with vulvovaginitis, inflammation covers the vagina and external genitalia. Depending on the nature of the pathogen, the following options are distinguished:
- Candidiasis. Caused by yeast-like fungi, more common in women of childbearing age. Acute inflammation is accompanied by severe itching and burning, aggravated after exercise and water procedures, sharp pain during sexual intercourse, thick, abundant, cheesy, grayish-white discharge. In a chronic process, whites may be absent, atrophy develops.
- Bacterial vaginitis. In the acute phase, leucorrhoea is abundant, often yellowish-white. Itching is intense, almost constant, supplemented by edema, local hyperemia and hyperthermia of the vagina and vulva. When the process is chronic, the amount of discharge decreases, the symptoms smooth out. Exacerbations are provoked by hypothermia, common infections, alcohol consumption.
- Viral colpitis. In adults, it is more commonly caused by HPV, cytomegalovirus, and herpes simplex virus, usually sexually transmitted, but other infection options are possible. Children develop against the background of influenza, SARS, measles. Itching is supplemented by the appearance of serous or serous-purulent discharge, the formation of foci of edema and hyperemia, sometimes erosions, vesicles, condylomas and papillomas.
As a rule, specific vaginitis is caused by STI pathogens. Rare cases of tuberculous colpitis are considered an exception. Among the infections that are sexually transmitted and cause itching in the vagina, the following diseases are distinguished:
- Gonorrhea. Half of the cases are asymptomatic. Most often, women develop gonorrheal cervicitis. Abundant white or yellowish leucorrhoea, itching of the vagina, perineum and external genitalia, nagging pains in the lower abdomen and in the sacrum, dyspareunia are characteristic. Perhaps the accession of urethritis, bartholinitis.
- Mycoplasmosis and ureaplasmosis. Allocations are transparent, not abundant. Itching in the vagina is moderate, complemented by pain during sexual intercourse, burning during urination. It is possible to damage the overlying sections of the urinary and reproductive systems with pulling pains in the lower back and lower abdomen, hyperthermia, severe dysuria.
- Chlamydia. Leucorrhea scanty, yellowish, mucous in nature, with an unpleasant odor. Itching and discomfort in the vagina, urination disorders, pulling pains above the pubis are noted. Sometimes subfebrile condition is detected.
- Trichomoniasis. Itching, pain and cramps in the vagina and urethra are combined with profuse white-green or yellowish fetid frothy discharge mixed with blood. There is a deterioration in well-being, a slight increase in body temperature, sometimes pain in the lower abdomen.
The cause of itching in the vagina is often organic pathology and mental disorders. In the first case, the appearance of a symptom is due to an increase in the level of certain metabolites, in the second - psychological trauma, exhaustion of the nervous system, "obsession" with one's feelings and, possibly, increased sensory sensitivity. Itching may accompany the following conditions:
- Somatic diseases: chronic hepatitis, cirrhosis, renal failure of various origins.
- Endocrine disorders: diabetes mellitus, thyroid lesions.
- Rheumatic diseases: Sjögren's syndrome, gout.
- Oncological processes: lymphogranulomatosis, leukemia.
- Psychiatric disorders: depression, neurosis, hysteria, intense or prolonged stress, history of sexual trauma.
The nature of the pathology is determined by the obstetrician-gynecologist. In the course of the survey, the specialist establishes the moment of the onset of the symptom, its changes over time, the presence of other manifestations. According to the physical examination, signs of somatic and endocrine diseases are revealed. During a gynecological examination, the condition of the vagina and vulva is assessed, signs of inflammation or atrophy are found. The diagnostic program may include the following procedures:
- visualization techniques. The vagina is examined by colposcopy. With inflammation, edema and hyperemia are determined, with dryness - hemorrhages, thinning of the mucosa. Additionally, a Schiller test is performed. To exclude pathologies of the uterus and ovaries, an ultrasound of the small pelvis, a tomographic examination are performed. If indicated, hysteroscopy is performed, less often - diagnostic laparoscopy.
- Smear microscopy. The presence of bacterial vaginosis is preliminarily confirmed by a KOH test. The material is studied under a microscope to detect fungi, protozoa and bacteria, which caused the development of the inflammatory process.
- Microbiological research. When carrying out sowing on nutrient media, the type of pathogen is determined, the sensitivity of pathogens to antibiotics and antifungal drugs is established.
- Serological reactions. Allows you to quickly and accurately diagnose STIs. As a material for the study, vaginal smears are used, which are separated from the vagina. The technique makes it possible to detect any infections, including viral ones, to carry out typing of the pathogen.
- Other laboratory tests. To confirm hypoestrogenemia, an estrogen test is prescribed. If a concomitant lesion of the urinary tract is suspected, urinalysis is performed. To assess the state of the body, to identify somatic diseases, a general and biochemical blood test is performed.
With itching caused by physiological causes, special treatment is not required, it is enough to eliminate provoking factors. With the development of pathologies, the following methods are used:
- Antimicrobial agents. They occupy a leading place in the treatment of colpitis. Depending on the type of pathogen, antibiotics, antiprotozoal and antifungal drugs are used. In the treatment of some STIs, special regimens are required that involve a combination of two drugs.
- Replacement hormone therapy. It is indicated for atrophic colpitis and other conditions accompanied by hypoestrogenism. Treatment is carried out by prescribing estrogens or combined estrogen-progestin drugs. Oral administration, use in the form of ointments, rings and suppositories is possible.
- Local anti-inflammatory therapy. Recommended for both inflammatory and atrophic processes. May include douching, baths, suppositories, creams, ointments, etc. Means are selected individually, taking into account the nature and phase of the pathological process.
- Restoration of microflora. It is necessary for atrophy, bacterial vaginosis, after antibiotic treatment. Preparations with lactic acid bacteria are injected into the vagina to inhibit the growth of opportunistic microorganisms.
Patients with pruritus due to mental disorders require psychotherapy. According to indications, antidepressants, medications with sedative and hypnotic effects are prescribed. Psychotherapeutic techniques and psychotropic drugs are also effective in post-castration syndrome, some diseases accompanied by vaginal dryness.
Surgical techniques in the absence of extragenital complications and the spread of the pathological process to the overlying parts of the reproductive system are used very rarely. With the formation of condylomas, their removal is recommended by laser vaporization, radiofrequency ablation or cryodestruction. Cervical warts in combination with severe dysplasia are considered as an indication for cone excision.