Vaginal itching and discharge: Expert advice on dealing with these unwanted issues

 Why your “lady parts” are mad at you and what you can do about it

 

Vaginal itching

There is nothing worse than needing to itch “down there” at the most embarrassing times.  It can be very frustrating to figure out why your lady parts are giving you trouble, so here is a guide to help you do some detective work and figure it out. 

In a perfect world our vagina stays acidic which suppresses the growth of yeast and bacteria.  Many things can affect this PH balance and cause irritation and itching.  Some of these things are beyond our control such as fluctuations in hormones throughout the month, your period, and changes in vaginal discharge with your menstrual cycle.  

It is normal to have some vaginal discharge.  Vaginal discharge is actually your body’s way of cleaning and moisturizing your vagina.  A healthy vagina will secrete fluids made by glands inside the vagina and cervix to carry away dead cells and bacteria.  It is normal for the amount, color and consistency of your discharge to vary throughout the month depending on where you are at in your menstrual cycle.  

Normal vaginal discharge can be clear, white, cloudy, yellowish or even contain mucous.  These can all be normal variations and there is no need to worry if you have no other symptoms.

 Even though the discharge may be normal, much like a baby can get a “diaper rash” you may experience itching/irritation simply due to the wetness of discharge or your period.  Many will describe it as mild itching, burning or a “raw” feel. There are many different causes of vaginal itching, some of the most common ones are discussed below.

 

 

Vulvar dermatitis

 

One of the most common causes of vaginal itching is contact dermatitis.  When this happens in the vaginal area it is often referred to as “vulvar” dermatitis.  The mucous membrane that lines your vagina is more vulnerable to irritation than normal skin.  Our skin is our best protective barrier, but the vaginal mucous tissue is much more sensitive to harsh chemicals.  In addition to all the cleansing products we use, urine, sweat, and friction caused by sexual activity can also cause irritation.  In general dermatitis is usually divided into two types, irritant contact dermatitis, and allergic contact dermatitis. 

 

·         Irritant contact dermatitis-

This refers to an irritant substance that if applied in a high enough concentration would produce irritation/inflammation in anyone.

Sensitivity of individuals skin can vary, but generally speaking this product or substance will directly damage the skin/mucous membrane  if used often enough and high enough concentrations.

The skin may appear mildly red and even inflamed.    

Scratching the area can do further damage to this fragile tissue.  We call this the “itch/scratch” cycle.  The more we itch, the more we scratch, which irritates the nerve endings and causes more itching.  Many of these products are sold over the counter and marketed to women.  This can be terribly frustrating! 

 

·         Allergic contact dermatitis-

This refers to a true “immune response” causing localized allergic reaction and is person specific. 

The product or substance causes our body to trigger an immune mediated response or “allergic reaction” as it is commonly called. 

This causes localized redness, swelling, and itching. 

Since it’s person specific, this means not everyone will react to the same thing. 

Sometimes it is easy to figure out the cause, and other times it can be something you wouldn’t suspect.

Chronic exposure to ANY substance or product can result in contact dermatitis.  This means, just because you have been using it for years does not mean it is not the problem!

 

Sometimes it’s obvious what is causing the trouble, but more often it takes some detective work. Some things that cause these symptoms are caused by external things including feminine hygiene products, soaps, shaving products, laundry detergents, lubricants, and feminine washes marketed to women.  Our grandmothers NEVER had this many “feminine” products to choose from.  Many of these products contain fragrances and chemicals that irritate the sensitive vaginal mucosa.  Once it is irritated and “angry”, it can seem that every little thing makes it worse.  Simple friction of your clothing, urine, and sweat can all further irritate the already inflamed tissue and cause more burning and itching or even a “raw” feeling. Here are some helpful tips to stop the itch/burn.

 

It won’t stop itching. …What do I do?

 

First, you want to make sure and remove all possible irritants.  This means ANY products that come in contact with your vaginal area should be unscented and gentle/hypoallergenic.  Sometimes you may need to be a detective and go through your daily routine and think of everything that can come into contact with your vagina.  Some of the common culprits are….

  • Soaps/body washes- Avoid ANY scented soaps, body washes, or feminine washes that have fragrances.  If it smells “NICE,” it has fragrance.  Even some of the “feminine” washes marketed for women contain fragrances and can cause irritation and can disrupt the natural PH of your vaginal. This includes the soap you wash your body with because it runs downhill
  • Antibacterial soaps- Antibacterial soaps are the worst for that area, because they change the PH and can destroy some of the normal protective flora of the vagina. 
  • ·         Shampoo/hair products- this also includes shampoo if you are washing your hair in the shower.  Shampoo is great at removing oils or hair products, but can be harsh to the genital area and a possible irritant.  If you are washing your hair in the shower, make sure you lean back so it does not run down to “that area”.
  •   ·     Laundry detergents- Many laundry detergents and fabric softeners contain fragrances and chemicals that can cause this area to become irritated and itchy. It is best to use scent free/dye free laundry detergent for any garments that will come in contact with your genitals.  Another time saving option is to use scent free detergent for all your clothes and just add scented fabric softener to things that will not come in contact with your genitals.
  •   ·     Tampons, pads, and toilet paper- For some reason manufacturers have decided that our “tampons/pads” should smell nice and have added fragrances and chemicals that can irritate our vaginal area. Always choose unscented feminine products and toilet paper to avoid possible irritation.
  • ·         Lubricant- If you use lubricant for sexual intercourse choose a product that is unscented and preferably hypoallergenic as these products can cause irritation and disrupt normal vaginal flora.

 

Now that my vagina is “mad” at me…. How to calm the “itch”?

 

·         First and foremost is to remove the “offending” product. 

 ·       At this point you want to “protect” it from further irritation by keeping all possible irritating products away from the vaginal area.

·         Many are really good about washing “that area” with gentle soap, but continue to wash the rest of their body with fragranced body washes/soaps that simply run down your body into the vaginal area.

 ·       You should be washing your entire body with a gentle, fragrance free, hypoallergenic soap or body wash.  Some examples are Dove sensitive skin unscented body bar, Cetaphil body wash (generic is fine), or any other gentle unscented, hypoallergenic product.

·         You can rinse the area after urinating w/ cool water to remove the urine and pat dry. Sitting in a lukewarm bath called a “sitz bath” can also be soothing. If you are irritated then it is best to not use soap in the bath, but just soak in warm water. 

·         It is important to “pat” dry and not rub or scratch the area.

·         After patting dry apply a hypoallergenic protective barrier ointment such as Aquaphor ointment to the entire area.  This is to be applied liberally to the external vaginal mucosa to protect it from further irritation from urine, sweat, and more discharge.  Just like you can apply lip balm to protect irritated/chapped lips you are protecting the skin from further irritation. Ointments can be kept in the refrigerator as it often soothes the burning sensation if it is cold.  Think of it as a “diaper rash”

·         If the itching is bothersome you can take an antihistamine such as Claritin, Zyrtec, or allegra during the day.  If it keeps you up at night you can try a Benadryl that may cause sleepiness to reduce the itching during the night. 

 ·       In a few days, when the irritant has been removed and you have protected it from further irritation, it should start to improve. 

·         If it is not improving, you should see your doctor. Your doctor can help you figure out the cause of itching and you may need prescription medication to treat it.

 

Sexual intercourse

 The friction of sex alone can cause some irritation, especially if you experience vaginal dryness. Things that can help are:

 

  •  Avoid petroleum based lubricants (Vaseline).
  • Use hypoallergenic scent free lubricant - an example is Astroglide but there are many good options out there including some found in your grocery store such as coconut oil.  It is important to avoid some of the “fancy” lubricants out there than contain fragrances, flavors, and “heat” causing as these can cause irritation and even local allergic reactions. 
  •  Rinse your vulva with cool water after sexual intercourse and pat dry.
  •  Always urinate after intercourse.
  • Avoid spermicide creams, gels, or foams that can cause irritation.
  • Condoms are a good way to help prevent sexually transmitted diseases, but often can cause irritation.  If you notice irritation AFTER sexual activity with condoms then you may want to switch to a hypo allergenic or latex free condom. 
  • Stay hydrated- just like your mouth gets dry, your vagina can also be dry if you are not well hydrated.