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. A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. These secretions may turn white or yellow when exposed to the air. Oral antihistamines lessen pruritus and cause drowsiness, helping patients sleep. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Clear, cloudy, bloody, white, yellow, or green. You are concerned that you may have a STI or you are unsure if you have been exposed. If you have diabetes, keep your blood sugar levels in good control. Cancer of the vulva, cervix, vagina, uterus, or fallopian tubes, Skin conditions, such as desquamative vaginitis and. 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). In postmenopausal women, atrophic vaginitis is a common cause. The trusted provider of medical information since 1899. Wipe properly after using the toilet -- always from front to back. In: Seller RH, Symons AB, eds. Symptoms of vaginitis are one of the most common gynecologic complaints. This infection inflames the vaginal and vulvar tissues causing soreness, burning and itchiness. 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). It can also occur on its own. Cotton increases air flow and decreases moisture buildup. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). The sensation of itch in this site in the absence of a known skin condition is referred to as pruritus vulvae. Forgotten tampon or foreign body. Sometimes another infection (eg, gonorrhea, chlamydial infection) causes a discharge. A.D.A.M. You have a sudden change in the amount, color, odor, or consistency of discharge. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. You have fever or pain in your pelvis or belly area. If symptoms are moderate or severe or do not respond to other measures, drugs may be needed. Abdominal pain, cervical motion tenderness, or cervical inflammation suggests PID. After menopause, risk of cancer increases, and a bloody or watery discharge is more likely to be due to cancer; thus, any vaginal discharge in postmenopausal women should be promptly evaluated. Infections spread during sexual contact. If they have unexplained vaginal discharge, cervicitis, which may be due to a sexually transmitted disease, should be considered. Depending on the reason for the irritating vaginal itch, you may also experience burning, swelling, irritation, and an unpleasant vaginal odor with thicker discharge. Flushing the genital area with lukewarm water may also provide relief. The slide is examined using a microscope; KOH dissolves most cellular material except yeast hyphae, making identification easier. U.S. Department of Health and Human Services, Clear, cloudy, bloody, white, yellow, or green. Editorial team. Other causes of discharge include vaginal cancer, cervical cancer, and endometrial cancer and, in women who are incontinent or bedbound, chemical vulvitis. follows rigorous standards of quality and accountability. verify here. Learn more about A.D.A.M. To use the sharing features on this page, please enable JavaScript. The most common signs and symptoms are irritation and soreness of the vulva, external vaginal itching, pain while urinating, pain while having sex, and a red and swollen vagina. Pruritus vulvae; Itching - vaginal area; Vulvar itching. Make sure to seek help from health care provider for the best treatment. In postmenopausal women, promptly evaluate any vaginal discharge. Learn more about our commitment to Global Medical Knowledge. In postmenopausal women, a marked decrease in estrogen causes vaginal thinning (atrophic vaginitis), increasing vulnerability to infection and inflammation. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. In women of all ages, vaginal pruritus and discharge may result from skin disorders (eg, psoriasis, lichen sclerosus, tinea versicolor), which can usually be differentiated by history and skin findings. Most often, symptoms involve irritation or eruption of the vulvar … However, pruritus vulvae means the itch is persistent and causes distress. The vulva is the area of skin just outside the vagina. Persistent vaginal itching that doesn't improve could be a sign of vulvar cancer. It is associated with itching or irritation. The most common symptom is vaginal discharge, which occurs in the majority of girls (62–92%). Scaly, thick, whitish patches on the vulva. Soak in a warm but not hot bath may help your symptoms. Changes that could indicate a problem such as infection include: Treatment depends on the cause of your symptoms. The vulva, or external genitalia of the female, includes the mons pubis, labia majora (outer lips), labia minora (inner lips), clitoris, perineum (the tissue between vagina and anus) and the external openings of the urethra and 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). Clear vaginal discharge is an often common and normal symptom from the female reproductive system. For menopause-related itching, replacing the depleted hormones with creams or tablets may take care of the problem or lessen it. Philadelphia, PA: Elsevier; 2017:chap 23. Spotting may occur due to scratching the vulva or from vaginal bleeding in the case of a severe infection. Colonization by these bacteria keeps vaginal pH in the normal range (3.8 to 4.2), thereby preventing overgrowth of pathogenic bacteria. Symptoms of vaginitis are one of the most common gynecologic complaints. This organism usually causes a thick cottage cheese-like white discharge with vulvar and vaginal itching. Also, high estrogen levels maintain vaginal thickness, bolstering local defenses. 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. Odorless or have a bad odor. Itching often affects the vulva. This health condition is characterized by itching or soreness of the vagina. Allow more air to reach your genital area. Others can be treated with steroid creams or lotions. If no foreign body is present and children have trichomonal vaginitis, sexual abuse is likely. There may be a whitish vaginal discharge and a burning sensation. 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. In children, a common cause is vaginitis, usually due to infection with gastrointestinal (GI) tract flora (nonspecific vulvovaginitis). You have blisters or other sores on your vagina or vulva. Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Ovulation (the release of an egg from your ovary in the middle of menstrual cycle). The cervix is inspected for inflammation (eg, trichomoniasis) and discharge. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. 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). Vaginitis is the most common gynecologic diagnosis in the primary care setting. Some vaginal itching may require steroid creams or specially medicated lotions. Normal bacteria that live in the vagina overgrow and cause a gray discharge and fishy odor. Vulva is the general name given to the external parts of the female genitals. Chemicals in bubble baths or soaps may cause inflammation and pruritus of the vulva, which often recur. Know how to properly clean their genital area while bathing or showering. Thick clear vaginal discharge can indicate something more serious like a yeast infection, bacterial vaginosis, or menopause. A common contributing factor in girls aged 2 to 6 years is poor perineal hygiene (eg, wiping from back to front after bowel movements, not washing their hands after bowel movements). All women have vaginal discharge or secretions which help to keep the vulva and vagina moist and remove bacteria and dead cells. Vaginal discharge. Factors that predispose to overgrowth of bacterial vaginal pathogens include, Use of antibiotics (which may decrease lactobacilli), Alkaline vaginal pH due to menstrual blood, semen, or a decrease in lactobacilli, An intravaginal foreign body (eg, a forgotten tampon or vaginal pessary). Call 911 for all medical emergencies. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). Candidal vaginitis produces a white discharge that resembles cottage cheese, often increasing the week before menses; symptoms worsen after sexual intercourse. This site complies with the HONcode standard for trustworthy health information: These include: Dermatological conditions. 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. This is very common among women of childbearing age. An itchy vagina or vulva itch is commonly caused by yeast infections. The following findings are of particular concern: Trichomonal vaginitis in children (suggesting sexual abuse), Fecal discharge (suggesting a fistula, even if not seen). 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. You have burning with urination or other urinary symptoms. This may mean that you have a urinary tract infection. KOH = potassium hydroxide; PCR = polymerase chain reaction. Vaginal itching and discharge - adult and adolescent, URL of this page: //medlineplus.gov/ency/article/003158.htm. In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. Abnormal discharge means abnormal color (brown, green), and odor. 9th ed. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. The amount of discharge varies. Contact irritant or allergic reactions cause significant irritation and inflammation with comparatively minimal discharge. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. Dyspareunia is common, and vaginal tissue appears thin and dry. The most common causes of vaginal itching and discharge vary by patient age (see table Some Causes of Vaginal Pruritus and Discharge). It helps the child report information about the experienced event and improves the quality of information obtained. Foreign bodies may cause nonspecific vaginitis, often with a scant bloody discharge. Symptoms of vulvar itching (or pruritus vulvae) include itching, stinging, or … † 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. A late discharge at the end of your period can look brown instead of red. Vaginal itching is the most common symptom of candida vulvovaginitis. 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. In: Rakel RE, Rakel DP, eds. These infections often also cause pelvic inflammatory disease. The most common types are, Trichomonal vaginitis (usually sexually transmitted). This happens due to the change in hormone levels in the body. Learn about more these and … Causes of vaginal pruritus and itching vary depending on the patient’s age. However, some STDs, a broken skin on labia lips and even rough waxing can cause vaginal itching. Nonspecific vulvovaginitis is a diagnosis of exclusion. Vaginitis may also result from foreign bodies (eg, a forgotten tampon). Any specific cause of the itching or discharge is treated. Bacterial vaginosis produces a thin, gray discharge with a fishy odor. Poor hygiene (eg, in patients who are incontinent or bedbound) can lead to chronic vulvar inflammation due to chemical irritation by urine or feces. 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). Vaginal symptoms related to itching and/or discharge are often nonspecific. Vulvar pruritus, pain, and discharge are common complaints in children. Vaginal discharge refers to secretions from the vagina. Use pads and not tampons while you have an infection. 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. Redness and swelling on the vulva and labia (lips of the vagina) Blisters on the vulva. Other causes of vaginal discharge and itching may be: Keep your genital area clean and dry when you have vaginitis. Inflammatory noninfectious vaginitis is uncommon. It may also occur as a … Which of the following symptoms of premenstrual dysphoric disorder most likely differentiates this disorder from premenstrual syndrome? 'Pruritus vulvae' simply means itching of the vulva. BV is not spread through sexual contact. Sexually transmitted infections. Please confirm that you are a health care professional. Often, the history and physical examination help suggest a diagnosis (see table Some Causes of Vaginal Pruritus and Discharge), although there can be much overlap. These bacteria help protect against infection. Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Vaginal pH is measured, and samples of secretions are obtained for testing. Schrager SB, Paladine HL, Cadwallader K. Gynecology. Philadelphia, PA: Elsevier Saunders; 2016:chap 25. Vaginal itching can occur for a number of reasons and usually isn't cause for concern. 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. Check if your vaginal discharge is normal. Perform a physical exam including a pelvic exam, Examination of vaginal discharge under the. However, irritation, burning, and pruritus are never normal. The external genitals are examined for erythema, excoriations, and swelling. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. Some vaginal discharge is normal, particularly when estrogen levels are high. Duplication for commercial use must be authorized in writing by ADAM Health Solutions. The discharge may be: Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. The colour, smell, and consistency of the discharge can vary, depending on the cause of the problem. Genital herpes sometimes causes vaginal itching but typically manifests with pain and ulceration. This may lead to vaginal dryness and other symptoms (. Glands in the cervix and the walls of the vagina normally produce clear mucus. 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. Bacterial vaginosis, candidal vaginitis, and trichomonal vaginitis are uncommon among postmenopausal women but may occur in those with risk factors. Thick white vaginal discharge also characterizes this infection. The itch may … The Merck Manual was first published in 1899 as a service to the community. Soaps and unnecessary topical preparations (eg, feminine hygiene sprays) should be avoided. If clinical criteria and in-office test results are inconclusive, the discharge may be cultured for fungi and trichomonads. Normally in women of reproductive age, Lactobacillus species is the predominant constituent of normal vaginal flora. 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). 23rd ed. 's editorial policy editorial process and privacy policy. Itching and/or irritation areand/or irritation are less commonless common. They should also be asked about use of hygiene sprays or perfumes, spermicides, vaginal creams or lubricants, latex condoms, vaginal contraceptive rings, and diaphragms. 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. 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. What is the vulva?. Small cracks on the skin of the vulva. Vaginal yeast infection, caused by a fungus. Avoid using hygiene sprays, fragrances, or powders in the genital area. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. 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. The risk of yeast vaginitis may be greater if doxycycline is used for malaria chemoprophylaxis or if other broad-spectrum antibiotics are used for the treatment of traveler's diarrhea or other medical problems. 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. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. These include bacterial vaginosis, yeast infections, and allergies. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Use condoms to avoid catching or spreading infections. This may irritate the vagina or the skin around the vagina. If a soap is needed, a hypoallergenic soap should be used. A trichomonal infection produces a frothy, yellow-green vaginal discharge and causes vulvovaginal soreness. 7th ed. In children, a vaginal discharge suggests a foreign body in the vagina. You can do this by: Always practice safe sex. Alternative names: Pruritus vulvae; Itching – vaginal area; Vulvar itchingDefinition: Vaginal discharge refers to secretions from the vagina. Vaginal secretions are tested using pH paper with 0.2 intervals from pH 4.0 to 6.0. 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. It is a symptom which is common to many conditions. Vaginitis is also a common cause in women of reproductive age; it is usually infectious. 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. A burning sensation in the vulvar area. Pruritus vulvae is itching of the vulva (which includes the mons pubis, labia majora, labia minora, clitoris, perineum and the external openings of the urethra and vagina). Skin care routine ( see `` gentle vulvar care '' ) to bacterial vaginosis, candidal vaginitis, increasing... That resembles cottage cheese, often with a foul or fishy odor Itchingfishy odor,! Inflammatory conditions are an uncommon cause of the skin of the vulva Zieve, MD MHA... This happens due to the change in the cervix and the MSD Manual outside of North America tract. Following symptoms of vaginitis global medical Knowledge medical Director, and swelling on the patient ’ age... 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