Almost every woman has experienced vaginal discomfort or itchiness or at one time or another in her life. It can be an aggravating situation, particularly if the itching it is severe or recurrent. While medical treatments may help resolve (or at the very least control) the underlying cause, there are severe practical tips that may help reduce your risk of recurrence.
Key to the prevention of recurrent vaginal itchiness is the identification of the underlying cause. There is no point in treating a yeast infection, for example, if the cause is allergic or viral. The American Academy of Family Physicians outlines some of the more common causes of vaginal pruritus (itchiness). The include:
- Bacterial vaginosis (BV), caused by the overgrowth of vaginal bacteria and manifesting with itchiness, burning, swelling, discharge, and a fishy-smelling odor
- Vaginal candidiasis, also known as a yeast infection, which affects three out of every four women at some point in their lives
- Sexually transmitted disease (STDs), including chlamydia, genital herpes, genital warts, trichomoniasis, gonorrhea, and mycoplasma genitalium
- Atopic dermatitis, a form of eczema that causes itching, redness, burning, and pain, mainly of the vulva
- Contact dermatitis, an allergic form of eczema caused by an array of possible irritants, including soaps, antiseptics, lubricants, spermicides, tampons, sanitary pads, preservatives, dyes, perfumes, and synthetic underwear
- Lichen planus, an inflammatory skin condition marked by an itchy, bumpy rash, occasionally affecting the vagina or vulva
- Lichen sclerosus, a cousin of lichen planus which primarily affects the vulva of postmenopausal women, causing pain, itching, and thin white skin patches
- Menopause, characterized by a precipitous drop in estrogen and the drying and thinning of the vaginal walls
- Pregnancy, which can cause atopic eruptions in 50 percent of women, most often during the later weeks of pregnancy or the weeks immediately following delivery
Although there are many possible causes of vaginal pruritus, there are times when the condition may be entirely idiopathic (of no known cause). There are also instances where you may be less able to avoid itchiness, such as during pregnancy and menopause.
Whatever the cause, known or unknown, there are things you can do to better avoid or minimize the itch:
- Practice good personal hygiene. This includes cleaning your genitals with water and plain unscented soap and keeping the pelvic area dry during the day.
- Wipe from front to back. This includes wiping after urinating or a bowel movement to reduce the risk of vaginal infection.
- Avoid dyes and fragrances. As a rule of thumb, avoid any product that comes into contact with the genitals that is either perfumed or colored. This includes scented bath soap, feminine hygiene sprays, sanitary pads, bubble baths, or even colored toilet paper.
- Wear white cotton panties. Cotton is breathable and helps circulate air around the vagina. Synthetic fabrics tend to lock in moisture and are also more likely to cause contact dermatitis.
- Use sexual lubricant. If you’re experiencing vaginal dryness, a water-based lubricant (without parabens or glycerin) can prevent irritation that can lead to itching. If an itch is starting to develop, you may want to temporarily refrain from sex until your condition improves.
- Change out of damp clothes. This includes wet bathing suits or sweaty exercise clothes. If you are prone to pelvic sweatiness, you may also want to bring an extra pair of panties to change into during the day.
- Don’t live in gym wear. Since most exercise clothes are tight and not all that breathable, avoid using them as daywear. Instead, look for loose-fitting yoga gear made of cotton.
- Use cold to reduce inflammation. Conditions like eczema are influenced by hot, humid conditions. If you are prone to dermatitis, take a cool shower if you are overheated or apply a washcloth dipped in ice water to the skin. If there is visible redness or swelling, wrap an ice pack in a towel and place it on the skin for 10 to 20 minutes.
Never apply ice packs directly to the skin or ice tissues for more than 20 minutes. Doing so can lead to frostbite and tissue injury.
Diet and General Health
In addition to self-help interventions, there are dietary and general health tips that can help you minimize the risk of vaginal pruritus:
- Lose weight. Obesity is associated with an increased risk of bacterial infection, in part because of the increased inflammation in adipose (fat-storing) tissues. To reduce your risk, ask your healthcare provider about the appropriate low-fat diet and exercise plan to help shed the extra pounds.
- Use probiotics. Eating yogurt with live probiotic cultures or taking a daily probiotic supplement can help maintain healthy vaginal flora and reduce your risk of vaginal infections. A probiotic supplement can also reduce the risk of a yeast infection if you are taking antibiotics.
- Manage your chronic conditions. A strong immune system translates to a reduction in the risk of vaginal infections. If you have diabetes, you need to keep your blood sugar under control. With thyroid disease, you need to monitor your condition to ensure your drug doses are correct. If you have HIV, you need to take your medication every day without fail.
- Use condoms. Using condoms can help reduce irritation as well as prevent STDs that invariably compromise vaginal health.
- Get an STD screen. Not all STDs are overtly symptomatic. If you have vaginal irritation that cannot be explained, you may want to get an STD screen so that the appropriate can be prescribed. In the United States, chlamydia and gonorrhea screening are recommended for all sexually active women.
- Ask your healthcare provider about estrogen therapy. For itchiness related to menopause, estrogen creams or tablets can often help improve the texture of vaginal tissues while alleviating dryness.
If a condition, such as yeast infection, is recurrent or does not resolve with over-the-counter drugs, see your healthcare provider. In the end, it may be an entirely unrelated condition or one exacerbated by the medications you are using.