But aggressive cleansing can add to the irritation. A.D.A.M. Less commonly, a vaginal discharge in children results from sexual abuse. They should also be asked about use of hygiene sprays or perfumes, 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. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. Avoid douching. Dyspareunia is common, and vaginal tissue appears thin and dry. Alternative names: Pruritus vulvae; Itching – vaginal area; Vulvar itchingDefinition: Vaginal discharge refers to secretions from the vagina. A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). Noninfectious vulvitis accounts for up to 30% of vulvovaginitis cases. 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. Some vaginal itching may require steroid creams or specially medicated lotions. Allow more air to reach your genital area. The most common causes of vaginal itching and discharge vary by patient age (see table Some Causes of Vaginal Pruritus and Discharge). 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. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. Chemicals in bubble baths or soaps may cause inflammation and pruritus of the vulva, which often recur. A late discharge at the end of your period can look brown instead of red. Abdominal pain, cervical motion tenderness, or cervical inflammation suggests PID. It helps the child report information about the experienced event and improves the quality of information obtained. The sensation of itch in this site in the absence of a known skin condition is referred to as pruritus vulvae. 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. Genital herpes sometimes causes vaginal itching but typically manifests with pain and ulceration. 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. Vaginitis is also a common cause in women of reproductive age; it is usually infectious. This site complies with the HONcode standard for trustworthy health information:   Scott GR. Thick white vaginal discharge also characterizes this infection. Dyspareunia is common, and vaginal tissue appears thin and dry. 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. If symptoms are moderate or severe or do not respond to other measures, drugs may be needed. Here are 10 reasons your vagina is itchy and how to stop vaginal itching. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. In atrophic vaginitis, inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. Davidson's Principles and Practice of Medicine. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Itching often affects the vulva. Seller RH, Symons AB. Persistent vaginal itching that doesn't improve could be a sign of vulvar cancer. This is very common among women of childbearing age. Vaginal symptoms related to itching and/or discharge are often nonspecific. The amount of discharge varies. You think that your symptoms may be related to a medicine you are taking. These infections often also cause pelvic inflammatory disease. You have burning with urination or other urinary symptoms. In: Ralston SH, Penman ID, Strachan MWJ, Hobson RP, eds. Thick clear vaginal discharge can indicate something more serious like a yeast infection, bacterial vaginosis, or menopause. If chronic vulvar inflammation is due to being bedbound or incontinent, better vulvar hygiene may help. This happens due to the change in hormone levels in the body. Sexually transmitted infections. Small cracks on the skin of the vulva. 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. This organism usually causes a thick cottage cheese-like white discharge with vulvar and vaginal itching. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa (vaginitis), often with inflammation of the vulva (vulvovaginitis). A burning sensation in the vulvar area. Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams. A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. In children, a vaginal discharge suggests a foreign body in the vagina. An itchy vagina or vulva itch is commonly caused by yeast infections. Abnormal discharge means abnormal color (brown, green), and odor. However, irritation, burning, and pruritus are never normal. Vaginal itching is the most common symptom of candida vulvovaginitis. However, pruritus vulvae means the itch is persistent and causes distress. Oral antihistamines lessen pruritus and cause drowsiness, helping patients sleep. Use pads and not tampons while you have an infection. Vaginal itching is an uncomfortable and sometimes painful symptom that often occurs due to irritating substances, infections, or menopause. The following findings are of particular concern: Trichomonal vaginitis in children (suggesting sexual abuse), Fecal discharge (suggesting a fistula, even if not seen). URAC's accreditation program is an independent audit to verify that A.D.A.M. Vulvar itching that gets worse at night has many possible causes. Vaginal itching can occur for a number of reasons and usually isn't cause for concern. 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). verify here. Symptoms of vaginitis are one of the most common gynecologic complaints. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Flushing the genital area with lukewarm water may also provide relief. Philadelphia, PA: Elsevier; 2018:chap 13. The cervix is inspected for inflammation (eg, trichomoniasis) and discharge. An underlying cause can usually be identified from the history and examination. Other common causes of decreased estrogen in older women include oophorectomy, pelvic radiation, and certain chemotherapy drugs. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. Comprehensive Gynecology. Copyright 1997-2021, A.D.A.M., Inc. Others can be treated with steroid creams or lotions. Colonization by these bacteria keeps vaginal pH in the normal range (3.8 to 4.2), thereby preventing overgrowth of pathogenic bacteria. Call 911 for all medical emergencies. Avoid using hygiene sprays, fragrances, or powders in the genital area. Vaginal secretions are tested using pH paper with 0.2 intervals from pH 4.0 to 6.0. Schrager SB, Paladine HL, Cadwallader K. Gynecology. In postmenopausal women, atrophic vaginitis is a common cause. † 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. Vaginitis is the most common gynecologic diagnosis in the primary care setting. The link you have selected will take you to a third-party website. Spotting may occur due to scratching the vulva or from vaginal bleeding in the case of a severe infection. If a soap is needed, a hypoallergenic soap should be used. This is called bacterial vaginosis (BV). Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). The most common symptom is vaginal discharge, which occurs in the majority of girls (62–92%). 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. Any specific cause of the itching or discharge is treated. Please confirm that you are a health care professional. Some vaginal discharge is normal, particularly when estrogen levels are high. It can also occur on its own. The amount of mucus produced varies during the menstrual cycle. What is the vulva?. In: Rakel RE, Rakel DP, eds. Changes that could indicate a problem such as infection include: Treatment depends on the cause of your symptoms. Then, a cotton swab is used to place secretions on 2 slides; secretions are diluted with 0.9% sodium chloride on one slide (saline wet mount) and with 10% KOH on the other (KOH preparation). In: Seller RH, Symons AB, eds. 's editorial policy editorial process and privacy policy. The slide is examined using a microscope; KOH dissolves most cellular material except yeast hyphae, making identification easier. The discharge may be: Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. BV is not spread through sexual contact. Vaginal pH is measured, and samples of secretions are obtained for testing. Vaginal itching can be due to bacterial or yeast infections, eczema, or using harsh soaps and body washes that irritate the delicate skin around the vulva. Vaginal discharge is not always present in yeast infections, but when occurring it is typically odorless, thick, white, and clumpy. For menopause-related itching, replacing the depleted hormones with creams or tablets may take care of the problem or lessen it. The symptoms are a vaginal discharge with a foul or fishy odor Itchingfishy odor. While this form of cancer is rare, vaginal itching is a common symptom. Clear stretchy discharge is a sign of ovulation, while clear watery vaginal discharge occurs between periods, sexual arousal, or pregnancy. It is associated with itching or irritation. The trusted provider of medical information since 1899. Learn more about A.D.A.M. If you have diabetes, keep your blood sugar levels in good control. 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