In postmenopausal women, a marked decrease in estrogen causes vaginal thinning (atrophic vaginitis), increasing vulnerability to infection and inflammation. Vaginal discharge is not always present in yeast infections, but when occurring it is typically odorless, thick, white, and clumpy. Cancer of the vulva, cervix, vagina, uterus, or fallopian tubes, Skin conditions, such as desquamative vaginitis and. A bimanual examination is done to identify cervical motion tenderness and adnexal or uterine tenderness (indicating PID). Colonization by these bacteria keeps vaginal pH in the normal range (3.8 to 4.2), thereby preventing overgrowth of pathogenic bacteria. However, some STDs, a broken skin on labia lips and even rough waxing can cause vaginal itching. Soak in a warm but not hot bath may help your symptoms. This is very common among women of childbearing age. While this form of cancer is rare, vaginal itching is a common symptom. Schrager SB, Paladine HL, Cadwallader K. Gynecology. Any specific cause of the itching or discharge is treated. A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). Noninfectious vulvitis accounts for up to 30% of vulvovaginitis cases. This is called bacterial vaginosis (BV). Menopause and low estrogen levels. If you have diabetes, keep your blood sugar levels in good control. Davidson's Principles and Practice of Medicine. Nonspecific vulvovaginitis is a diagnosis of exclusion. If no foreign body is present and children have trichomonal vaginitis, sexual abuse is likely. Wearing loose-fitting clothes and not wearing panty hose. Another common response of women faced with a vaginal discharge or itch is to wash the vulvar skin vigorously, on the assumption that this will disinfect the area or remove irritants. Bacterial vaginosis produces a thin, gray discharge with a fishy odor. Check if your vaginal discharge is normal. These secretions may turn white or yellow when exposed to the air. A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. Besides itching, other symptoms that come with bacterial vaginosis are inflammation, burning, discharge, and a fishy-smelling odor. The amount of mucus produced varies during the menstrual cycle. is among the first to achieve this important distinction for online health information and services. It may result from hypersensitivity or irritant reactions to various agents, including hygiene sprays or perfumes, menstrual pads, laundry soaps, bleaches, fabric softeners, and sometimes spermicides, vaginal creams or lubricants, latex condoms, vaginal contraceptive rings, and diaphragms. Other causes of vaginal discharge and itching may be: Keep your genital area clean and dry when you have vaginitis. This infection inflames the vaginal and vulvar tissues causing soreness, burning and itchiness. Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Vaginal itching is the most common symptom of candida vulvovaginitis. An etiology can be obtained in most cases with careful external inspection and, if necessary, blind vaginal cultures. Vaginal discharge refers to secretions from the vagina. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. In women of reproductive age, discharge due to vaginitis must be distinguished from normal discharge: Normal vaginal discharge is commonly milky white or mucoid, odorless, and nonirritating; it can result in vaginal wetness that dampens underwear. Symptoms of vaginitis are one of the most common gynecologic complaints. Estrogen levels are high in the following situations: During the first 2 weeks of life (because maternal estrogens are transferred before birth), During the few months before menarche and during pregnancy (when estrogen production increases), With use of drugs that contain estrogen or that increase estrogen production (eg, some fertility drugs). Vaginal itching can occur for a number of reasons and usually isn't cause for concern. If your vulva feels irritated, however, it is important to seek advice from your doctor as to what might be causing the irritation. This may lead to vaginal dryness and other symptoms (. These include bacterial vaginosis, yeast infections, and allergies. Forgotten tampon or foreign body. In atrophic vaginitis, discharge is scant and may be watery and thin or thick and yellowish. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. If they have unexplained vaginal discharge, cervicitis, which may be due to a sexually transmitted disease, should be considered. An itchy vagina or vulva itch is commonly caused by yeast infections. U.S. Department of Health and Human Services, Clear, cloudy, bloody, white, yellow, or green. Differential Diagnosis of Common Complaints. Here are 10 reasons your vagina is itchy and how to stop vaginal itching. Normal bacteria that live in the vagina overgrow and cause a gray discharge and fishy odor. Wash thoroughly before and after using the bathroom. In postmenopausal women, atrophic vaginitis is a common cause. Fistulas are usually obstetric in origin (due to vaginal birth trauma or a complication of episiotomy infection) but are sometimes due to inflammatory bowel disease or pelvic tumors or occur as a complication of pelvic surgery (eg, hysterectomy, anal surgery). At any age, conditions that predispose to vaginal or vulvar infection include, Fistulas between the intestine and genital tract (which allow intestinal flora to seed the genital tract), Pelvic radiation or tumors (which break down tissue and thus compromise normal host defenses). Spotting may occur due to scratching the vulva or from vaginal bleeding in the case of a severe infection. For menopause-related itching, replacing the depleted hormones with creams or tablets may take care of the problem or lessen it. If vaginal discharge is present, patients should be asked about the color and odor of the discharge and any exacerbating and remitting factors (particularly those related to menses and intercourse). Alternative names: Pruritus vulvae; Itching – vaginal area; Vulvar itching; Yeast infection – child Definition: Itching, redness, and swelling of the skin of the vagina and the surrounding area is a common problem in girls before the age of puberty.Vaginal discharge may also be present. Vaginitis develops when the vaginal flora has been altered by introduction of a pathogen or by changes in the vaginal environment that allow pathogens to proliferate. You have burning with urination or other urinary symptoms. If chronic vulvar inflammation is due to being bedbound or incontinent, better vulvar hygiene may help. This may irritate the vagina or the skin around the vagina. Contact irritant or allergic reactions cause significant irritation and inflammation with comparatively minimal discharge. Learn more about A.D.A.M. Review of systems should seek symptoms suggesting possible causes, including the following: Fever or chills and abdominal or suprapubic pain: Pelvic inflammatory disease (PID) or cystitis, Polyuria and polydipsia: New-onset diabetes. Ovulation (the release of an egg from your ovary in the middle of menstrual cycle). Odorless or have a bad odor. Redness and swelling on the vulva and labia (lips of the vagina) Blisters on the vulva. verify here. Small cracks on the skin of the vulva. 's editorial policy editorial process and privacy policy. Use pads and not tampons while you have an infection. Clear stretchy discharge is a sign of ovulation, while clear watery vaginal discharge occurs between periods, sexual arousal, or pregnancy. Itching often affects the vulva. Philadelphia, PA: Elsevier; 2017:chap 23. Make sure to seek help from health care provider for the best treatment. There may be a whitish vaginal discharge and a burning sensation. It may also occur as a … Call 911 for all medical emergencies. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. The symptoms are a vaginal discharge with a foul or fishy odor Itchingfishy odor. Vaginal itching and discharge - adult and adolescent, URL of this page: //medlineplus.gov/ency/article/003158.htm. Abnormal discharge means abnormal color (brown, green), and odor. Physical examination focuses on the pelvic examination. The sensation of itch in this site in the absence of a known skin condition is referred to as pruritus vulvae. Clear, cloudy, bloody, white, yellow, or green. Dyspareunia is common, and vaginal tissue appears thin and dry. Know how to properly clean their genital area while bathing or showering. Infections spread during sexual contact. The discharge may be: Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. Other symptoms of vulvovaginitis include redness and soreness (74–82%), 3 pruritus (45–58%) 1, 3 and dysuria (19%). Prepubertal girls should be taught good perineal hygiene (eg, wiping front to back after bowel movements and voiding, washing their hands, avoiding fingering the perineum). Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. It is a symptom which is common to many conditions. The cervix is inspected for inflammation (eg, trichomoniasis) and discharge. It can also occur on its own. The colour, smell, and consistency of the discharge can vary, depending on the cause of the problem. Sexually transmitted infections. You have itching, redness, and swelling in the genital area. Vaginal discharge usually isn't anything to worry about if it: doesn't have a strong or unpleasant smell; is clear or white; is thick and sticky; is slippery and wet; You can get vaginal discharge at any age. Dry thoroughly afterward. Rather than using a towel to dry, you may find that gentle use of warm or cold air from a hair dryer may result in less irritation than the use of a towel. The trusted provider of medical information since 1899. For most patients, measure vaginal pH and obtain a sample of secretions for microscopic examination and testing; if needed, do culture for sexually transmitted organisms. Clear vaginal discharge is an often common and normal symptom from the female reproductive system. A.D.A.M. is also a founding member of Hi-Ethics. An underlying cause can usually be identified from the history and examination. The irritation of labia may be accompanied by a white or brown discharge, or no discharge at all. Also, high estrogen levels maintain vaginal thickness, bolstering local defenses. All women have vaginal discharge or secretions which help to keep the vulva and vagina moist and remove bacteria and dead cells. Soaps and unnecessary topical preparations (eg, feminine hygiene sprays) should be avoided. They should also be asked about use of hygiene sprays or perfumes, spermicides, vaginal creams or lubricants, latex condoms, vaginal contraceptive rings, and diaphragms. Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. You have symptoms that get worse or last longer than 1 week despite home care measures. However, irritation, burning, and pruritus are never normal. The evaluation of vaginitis requires a di… The vulva should be kept as clean as possible. Comprehensive Gynecology. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. Others can be treated with steroid creams or lotions. In children, a vaginal discharge suggests a foreign body in the vagina. * If discharge is present, microscopic examination of a saline wet mount and KOH preparation and cultures or PCR for sexually transmitted organisms are done (unless a noninfectious cause such as allergy or a foreign body is obvious). Scaly, thick, whitish patches on the vulva. The discharge may be: Thick, pasty, or thin. Textbook of Family Medicine. In atrophic vaginitis, inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. In postmenopausal women, promptly evaluate any vaginal discharge. A late discharge at the end of your period can look brown instead of red. If sexual abuse of a child is suspected, a structured forensic interview based on the National Institute of Child Health and Human Development (NICHD) Protocol can be used. 33 Vaginal Discharge and Itching Vaginal discharge, which may be accompanied by vulvar itching or burning, is one of the most common problems seen in the physician’s office. URAC's accreditation program is an independent audit to verify that A.D.A.M. The saline wet mount is examined using a microscope as soon as possible to detect motile trichomonads, which can become immotile and more difficult to recognize within minutes after slide preparation. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Brown or bloody discharge is usually normal, especially when it occurs during or right after your menstrual cycle. This site complies with the HONcode standard for trustworthy health information:   A trichomonal infection produces a frothy, yellow-green vaginal discharge and causes vulvovaginal soreness. History of present illness includes nature of symptoms (eg, pruritus, burning, pain, discharge), duration, and intensity. Vaginal yeast infection, caused by a fungus. Biopsy is seldom indicated. The following factors can increase the amount of normal vaginal discharge: Different types of infections may cause itching or an abnormal discharge in the vagina. Vulvar itching that gets worse at night has many possible causes. A.D.A.M. Editorial team. In: Ralston SH, Penman ID, Strachan MWJ, Hobson RP, eds. Poor hygiene (eg, in patients who are incontinent or bedbound) can lead to chronic vulvar inflammation due to chemical irritation by urine or feces. Vaginal itching is an uncomfortable and sometimes painful symptom that often occurs due to irritating substances, infections, or menopause. You have blisters or other sores on your vagina or vulva. Last full review/revision Mar 2020| Content last modified Mar 2020, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Some Causes of Vaginal Pruritus and Discharge, Musculoskeletal and Connective Tissue Disorders, National Institute of Child Health and Human Development (NICHD) Protocol. Besides, people with vaginal itching can experience dry vaginal skin area, vaginal pain, vaginal swelling, vaginal redness, vaginal bleeding and other discomforts, especially at night. Discharge that is watery, bloody, or both may result from vulvar cancer, vaginal cancer, or cervical cancer; cancers can be differentiated from vaginitis by examination and biopsy. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. Vaginal itching is a symptom that may signify something is occurring with your vagina.Signs and symptoms of itching can involve the vagina or the genital area called the vulva. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). The most common causes of vaginal itching and discharge vary by patient age (see table Some Causes of Vaginal Pruritus and Discharge). 1, 3 The discharge can be clear, yellow or green and may be offensive smelling. 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