What is vaginal itching and burning?
Vaginal itching and burning are very common complaints in girls and women of all ages, from pre-adolescents to postmenopausal women.
Vaginal itching can occur on any part of the vulva and vagina, including the outside vulvar area (the labia majora), the clitoris, the vaginal opening, or deeper inside the vagina.
It’s important to treat vaginal itching that doesn’t go away or seems severe. You should see a doctor if you also have pain or discharge that looks and smells different from normal vaginal discharge.
What vaginal itch or burning feels like
Vaginal itching is an uncomfortable sensation that can be so intense that you can’t resist scratching the area. If you scratch a lot, it can cause a burning sensation, which can lead to more inflammation and irritation.
Vaginal burning can feel tight, warm, and painful. Sometimes it’s described as sore, stinging, rawness, and throbbing.
Depending on the cause, the symptoms may be worse at night. Iching and burning may also worsen during and after sex because of friction.
You may also have other symptoms
- Abnormal vaginal discharge
- Redness or skin discoloration
- Vaginal bleeding
When I see a patient in my office for vaginal itching/burning, the first thing I do is look at their age. Are they an adolescent and not yet sexually active or are they in menopause? Other important details for me to understand is if they are sexually active, if this is a new problem or if it keeps occurring, if this recently started or they have been dealing with it for a while, and have they tried any treatments. I then want them to get as specific about their problem as possible. —Dr. Jessica Katz
Vaginal itch after sex
Some women have vaginal itching and burning after sex. There are a number of possible causes:
- A latex allergy (if a certain type of condom or lubricant was used)
- Having dry and sensitive skin
- Lack of lubrication around the genital area
- Sexually transmitted diseases (STDs) like chlamydia, gonorrhea, or trichomoniasis
- Sex can cause an imbalance of vaginal pH that may lead to bacterial vaginosis or a yeast infection.
- Vaginal dryness can make sex uncomfortable and cause itching or burning.
If sexual intercourse triggers vaginal itching, there are many preventative and treatment options.
- Try latex-free condoms and lubricants if you’re allergic to latex.
- Use over-the-counter (OTC) lubricants.
- If you tend to get bacterial or fungal infections after intercourse, your doctor may recommend using a boric acid suppository twice a week to help keep the vaginal pH in balance.
- Women who are menopausal and have itching and discomfort after intercourse can try lubricants. Or they may need to see an ob-gyn who will check for vaginal atrophy, which can be treated with an estrogen cream or tablet.
- If you notice vaginal dryness after you start taking birth control or an antidepressant, ask about switching to a different type.
Two questions to ask your doctor: Is there anything I could do to prevent this from happening to me again? Once treated, how long will it take for my symptoms to resolve? —Dr. Katz
Causes of itching and burning with discharge
1. Yeast infection
A yeast infection is caused by the fungus Candida. Certain factors, like other medical conditions, antibiotic use, or sexual intercourse, can make you more likely to get yeast infections. But sometimes there isn’t an obvious trigger.
Common: Up to 75% of women have a vaginal yeast infection at least once in their life.
Symptoms you may have:
- Vaginal discharge
- Burning or soreness
- Pain and burning when you urinate
- Pain during or after intercourse
Treatment and urgency: If you have vaginal itching and other symptoms like abnormal vaginal discharge, see a doctor to confirm that you have a yeast infection. Self-diagnosis is often inaccurate and can delay getting the best treatment. Treatment includes an antifungal oral medication or vaginal cream.
What causes a vaginal yeast infection?
Candida is a fungus that causes vaginal yeast infections. It is usually found in the gastrointestinal tract and vagina. When candida starts overgrowing, because of medication, stress, injury, intercourse, or other causes, it can cause an infection.
What are the first signs of a yeast infection?
The first signs of a yeast infection include itching or irritation of the vaginal opening, pain when urinating, and vaginal discharge that may look thick, clumpy, and white. These symptoms are similar to many other conditions including bacterial infections and dermatitis. So it’s important to get a diagnosis to be sure that you have a yeast infection before starting treatment.
When will my symptoms resolve?
Most yeast infections resolve within a few days of starting topical (on the skin) or oral (by mouth) treatment. But you may still have itchiness and irritation even after the infection goes away. If your symptoms aren’t improving, it’s possible that you didn’t have a yeast infection. You may actually have bacterial vaginosis instead, so call your doctor.
A yeast infection is not the only cause of vaginal itching. There are so many other reasons why you could be experiencing vaginal itching or burning. See your physician instead of just assuming it is a yeast infection and self-treating with an over-the-counter medication. —Dr. Katz
2. Bacterial vaginosis
Bacterial vaginosis (BV) develops when there’s too much of a certain bacteria in the vagina. While some women may not have any symptoms, it can cause strong symptoms in others. BV can lead to an increased risk of preterm delivery (if you’re pregnant) and STDs (including HIV).
Common: BV affects 29% of women between 14 and 49 years old. BV is more common among Black women (51%) and Mexican-American women (32%) [Source: CDC].
Symptoms you may have:
- A fishy odor
- Pain during or after intercourse
Treatment and urgency: See a doctor as soon as you can. If you have BV, they will prescribe an oral antibiotic or a vaginal antibiotic cream.
Some sexually transmitted diseases, like trichomoniasis, gonorrhea and chlamydia, may cause vaginal itching and discharge.
Very common: STDs are extremely common and spread through sexual activity.
Symptoms you may have:
- Vaginal discharge
- Vaginal itching
- Burning with urination
- Frequent urination
- Abnormal vaginal bleeding
- If an STD leads to a pelvic inflammatory disorder, it may cause fever, chills, and pelvic pain.
Treatment and urgency: It’s important to see a doctor right away to get diagnosed and treated. STDs are treated with different medications, depending on the type. Treatment can help prevent the infection from spreading to other parts of your body, and from getting complications like infertility. It also reduces the risk of passing on the STD to your partners.
Causes of itching and burning without discharge
Many substances can irritate vaginal tissue and cause itching or burning. These include:
- Contraceptive foams or rings
- Laundry detergents
- Tampons or pads
- Scented toilet paper
- Fabric softener
Treatment and urgency: Try to identify what’s causing this new irritation. It may be from a product you just recently tried, such as a different laundry detergent.
Avoid using any products to clean your vagina or vulva—the vagina is constantly cleaning itself. This includes vaginal douches, which can flush out the good vaginal bacteria. It’s okay to skip soap and just cleanse the vaginal area with warm water.
You can try a barrier cream (to help keep skin from getting irritated) like Aquaphor, Vaseline, or coconut oil without additives, but don’t apply any scented creams or lotions in the area.
5. Dermatologic issues
Many skin conditions can occur on the vulva or vagina. They should be diagnosed by a gynecologist (ideally with a biopsy) to confirm the diagnosis.
- Eczema can develop on various parts of the body. The affected patches of skin become rough and inflamed, which can lead to itching and sometimes bleeding.
- Lichen planus affects the mucous membranes—the vulva, vagina, and other areas like the mouth. Lichen planus looks like lacy white patches that may burn or feel itchy or sore. Sometimes the lesions are purple and include small areas of raised skin.
- Lichen sclerosus causes thin, white areas of skin on the vulva that can lead to discomfort, itching, and pain. In rare cases, it can lead to vulvar cancer.
- Lichen simplex chronicus develops from constant scratching or rubbing of itchy vulvar skin and causes areas of thickened skin.
- Psoriasis is an autoimmune condition that can occur on all areas of the body. When psoriasis affects the vulva, the plaques may look red (or purple, gray, or dark brown) with silvery white buildup of dead skin cells.
- Vulvar cancer is very rare, but vaginal itching or burning can be the first signs. Other symptoms include skin changes (thickening and changes in color) and a lump, wart-like bump, or ulcer.
Treating dermatological issues
Topical steroids applied to the skin are often used for vulvar and vaginal dermatologic issues.
6. Herpes simplex virus
Herpes simplex virus is an STD that causes recurrent outbreaks of sores in the genital area. A first outbreak of genital herpes is usually very painful and you’ll have flu-like symptoms, like fever and chills.
Following outbreaks usually start with symptoms such as itching and tingling in the genital area or low back. These last for anywhere from 30 minutes to 2 days before the outbreak starts. You may also feel itching and tingling as the lesions heal.
Common: Genital herpes affects an estimated 12% of people ages 14 to 49 in the U.S. [source: CDC].
Symptoms you may have during outbreaks:
- Itching and tingling in genital area or low back
- Painful, clear fluid-filled bumps in the genitals
Treatment and urgency: See a doctor right away if you notice any new vaginal lesions or ulcers, especially if this is the first time you’ve them. If you have severe pain while urinating, go to an urgent care center for treatment.
You will be prescribed antiviral medication (acyclovir or valacyclovir/valtrex) to take during outbreaks to help speed up the healing time. If you have frequent outbreaks, you might be prescribed antiviral medication to take daily to help prevent infections and protect sexual partners.
Women in menopause develop thinner, drier vaginal skin because of low levels of estrogen.
Symptoms you may have:
- Vaginal itching and burning
- Painful intercourse
- More frequent vaginal infections
- Painful urination
- More frequent urinary tract infections
Treatment and urgency: Treatment includes barrier creams, moisturizers, and lubricants. Your doctor can prescribe estrogen creams or vaginal estrogen (a cream or tablet inserted into the vagina). Estrogen produces thicker and more lubricated tissue, decreases inflammation, and promotes a vaginal pH and bacteria that decreases vaginal infections.
Vaginal itch cream
There are over-the-counter (OTC) and prescription medications that can soothe itching and treat any underlying causes.
If itching is mild and you have no other symptoms like pain or heavy discharge, you may want to try an OTC cream before seeing your doctor. These include:
- Barrier creams such as Desitin, Vaseline, and Aquaphor
- Monistat Care Instant Itch Relief cream
- Vagisil, which contains the local anesthetics benzocaine and resorcinol
- Lotrimin (clotrimazole), an antifungal that treats yeast infections and reduces vaginal burning, itching, and discharge
- Monistat (miconazole), an OTC antifungal cream to treat a yeast infection
- Hydrocortisone, a mild, low-strength corticosteroid cream that can be applied to the vulva area but not inside the vagina
Prescription creams your doctor may recommend:
- Medium- to high-potency corticosteroids (clobetasol propionate or betamethasone dipropionate). These are for skin conditions such as eczema, psoriasis, lichen simplex chronicus, lichen planus, and lichen sclerosus. They can also be used for irritants that are causing extreme itching and pain.
- Estrogen cream will be prescribed if you have vaginal atrophy (can be used as both a suppository and for applying on the outside of the vulva).
- Lidocaine cream for vaginal pain and burning (applied externally)
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