Vaginal itching: causes and treatment

The vagina is often described as "self-cleaning". This is because it has its own mechanisms to keep it clean and healthy.

It produces mucous to wash away substances like blood, semen or discharge.

It is also slightly acidic with a pH value between 3.8 and 5.0. This stops the overgrowth of bad bacteria or other microorganisms.

The vagina also has its own microbiome known as the "vaginal flora". It contains a delicate balance of microorganisms that also helps prevent infection.

When these mechanisms are disrupted, it can cause itching, irritation and discomfort.

There are a variety of potential causes, some more simple to treat than others.

Below are the most likely causes:

• irritants
• vaginal thrush
• sexually transmitted infections (STIs)
• menopause
• lichen sclerosus

Keep reading to learn more about each cause, the symptoms and what you can do to treat it.

One of the most common causes of vaginal itching is irritants. This type is known as vulvar dermatitis or vulvitis. This occurs when certain products irritate the vulva (the external area of your vagina).

Things that can irritate the vulva include:

• soaps, bubble baths and douches
• condoms, spermicides and lube
• tight and synthetic underwear or clothes
• laundry detergents and fabric softeners
• sanitary products (e.g. pads and tampons)
• wearing wet or sweaty clothes for too long
• waxing, shaving or other hair removal products

These factors can irritate the skin, disrupt pH and the vaginal flora. This can lead to itching and other symptoms, such as:

• vaginal discharge
• cracked or dry patches of skin
• red, painful and inflamed vulva
• vulvar pain during sex or from inserting a tampon

You should not put any harsh chemicals or irritants in or around the vagina. It can irritate but increase the risk of developing other infections like bacterial vaginosis (BV) and thrush.

Thrush, or vaginal candidiasis, is one of the most common vaginal infections women experience.

It is caused by an overgrowth of a fungus or yeast called candida. It usually lives harmlessly in the vagina. However, an imbalance in the flora can cause it to overgrow and cause symptoms.

This can be caused by:

• vaginal irritation from scented products or poor hygiene practices
• antibiotics
• poorly controlled diabetes
• a weakened immune system (e.g. during chemotherapy or from HIV)
• pregnancy

One of the main symptoms of a yeast infection is itching. It also causes an unusually thick, white discharge that looks like cottage cheese and a burning sensation while peeing.

Thrush usually goes away on its own. However, you can speed up recovery by taking an antifungal called Fluconazole. You can also get direct relief from topical antifungals like Clotrimazole.

Another common cause of vaginal itching is sexually transmitted infections.

As the name suggests, STIs are passed on through unprotected anal sex, oral sex or vaginal sex. The bacteria can pass through fluids or skin-to-skin contact.

The STIs that are most likely to cause vaginal itching are:

• chlamydia
• genital herpes
• trichomoniasis
• pubic lice

Some STIs like mycoplasma genitalium or ureaplasma urealyticum rarely cause symptoms in women. However, they may indirectly cause other infections that do cause itching like urethritis.

If you have recently had unprotected sexual activity, you should get an STI test as soon as possible - even if you don’t have any symptoms of an STI.

If you have tested positive for an STI, your doctor will prescribe you a short course of treatment. You can also order discreetly online from certain healthcare providers, such as euroClinix.

Vaginal itching is also a common symptom of the menopause.

The menopause is a natural stage in a woman’s life where their periods stop. This occurs because the ovaries stop producing as much oestrogen. It also occurs in women who have their uterus surgically removed (hysterectomy).

There are over 30 recognised symptoms of menopause. This includes hot flashes, mood swings, night sweats and brain fog. Another one of these is vaginal dryness.

Oestrogen is important for keeping the vagina healthy. It is responsible for maintaining elasticity and lubrication. When oestrogen levels drop during menopause, this causes vaginal dryness which can cause itching.

There are plenty of treatments for menopause symptoms. There are HRT tablets or patches which supplement oestrogen levels.

There is also a HRT treatment for vaginal dryness. It’s an intravaginal cream that provides direct relief.

Lichen sclerosus is a skin condition that can affect the vulva. It can affect all ages but it is more common in women over 50.

It causes patches on the skin that are:

• itchy
• white
• smooth or crinkled
• easily damaged (e.g. easily hurt or bleed when rubbed or scratched)

Over time, this can cause the skin to tighten and scar. It can also cause pain during sex or whilst peeing.

Unfortunately, there is no cure for this condition. Your doctor may prescribe a steroid cream to help relieve symptoms. You might need to use it regularly over a few months to control symptoms.

The best way to prevent this kind of vaginal itching and infections is to keep good hygiene practices and stop using certain products.

As the vagina is "self-cleaning", you do not need to use any specific soaps.

You should use a gentle soap and water to clean the vulva. Then, pat it dry instead of rubbing it with the towel. Do not use any products inside the vagina, only in the external vulva.

Avoid any products marketed for vaginal health such as douches, vaginal deodorants, bubble baths or soaps. They do not clean the vagina or vulva and promote irritation.

You should also remove any sweaty or wet clothes as soon as possible and opt for breathable, cotton underwear where possible. In addition, you should pee as soon as possible after sex to prevent irritation.

Your doctor may also suggest taking probiotics or eating foods high in probiotics (e.g. kimchi, yoghourt or sauerkraut). They contain good bacteria that will help to balance the vaginal flora.

Vaginal itching is a common condition with multiple causes.

It may be as simple as using harsh products. However, it could be a sign of a condition that requires treatment.

If you’re worried about your symptoms, you should go to see your doctor.