Thrush (yeast infection)

is a fungal infection caused by Candida albicans. About 1 woman in
5 has Candida in her vagina without it causing any symptoms. Hormones in the vaginal
secretions and the “friendly” vaginal bacteria keep it at bay. But problems can arise when this natural balance becomes upset, and the Candida multiplies.
The main symptom of thrush is itching or soreness, and this gets worse in the week before a
period. If there is a discharge, it is usually only slight, does not smell and looks like cottage
cheese.

Bacterial vaginosis

If your vulva smells fishy sometimes combined with itching, it is almost certain that you have bacterial vaginosis (also known as ‘anaerobic vaginosis’). This is an imbalance in the bacteria in the vagina. All women have harmless bacteria in their vaginal passage. In bacterial vaginosis, some of the bacteria multiply so that more are present than is normal (it is usually the Gardnerella and Mobiluncus bacteria that are the culprits). In other words, bacterial vaginosis is not an infection caught from your partner; it is due to bacteria that are normally present in the vagina.

Trichomoniasis

is an infection of the genitals that is caused by the bacterium trichomonas
vaginalis (TV). The condition often has no symptoms, but symptoms may include a yellow or
green discharge from the vagina with soreness, itching in or near the vagina and discomfort
with urination. Infection with Trichomonas vaginalis can be itchy.

Psoriasis

is a skin condition that can be extremely itchy when the genitals are involved. The
skin usually becomes bright red, often with painful cracks. The affected area may extend to the groin and to around the back passage (the anus) and between the buttocks. Psoriasis on other parts of the body is scaly (check your scalp, knees and elbows), but in the vulva area it tends to be smooth. You can have psoriasis on the vulva without having it anywhere else on your body.

Lichen sclerosus

is another extremely itchy skin condition affecting the vulva. The itching is
often so bad that it can affect a sufferer’s sleep. It is most common around the menopause
and in girls just before puberty, though it can occur at any age. Its cause is a mystery. The skin looks thin and pale, and the area around the anus may also be affected. If it is not treated, the lips of the vulva eventually shrink, the vaginal opening narrows and sex becomes painful. Treatment of this condition is simple, and your doctor can prescribe a special steroid cream.

Allergies and sensitivities

can cause redness and itching. The vulva area seems to be very
sensitive to chemicals, probably because the vulva is moist and warm – conditions that favour the absorption of chemicals by the skin. It is possible to develop an allergy to almost any chemical substance that comes into contact with the vulva, such as may be present in: skin creams, perfumes in soaps, bubble baths, shower gels and shampoos, disinfectants,
washing powders and fabric softeners, deodorants (including ‘intimate’ ones).

Excessive washing

can irritate the vulva area. Older women who may find it difficult to get into a bath may worry about personal hygiene, with the result that they wash the area too much. There is no need to wash several times a day – once is sufficient.

Stress or anxiety

can cause itching. When you are stressed or anxious, your nervous system is on alert, and small sensations can become amplified into unpleasant itching or even pain. So it is not imaginary, it is real.

TIPS How to avoid vaginal itching

	Avoid colored or perfumed toilet tissue and bubble bath;
	Avoid feminine hygiene sprays and douches;
	Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible;
	Cleanse the area by wiping or washing from front to back (vagina to anus) after urinating or having a bowel movement;
	Eat yogurt with live cultures or take lactobacillus acidophilus tablets when using antibiotics. Check with your doctor;
	Keep your genital area clean and dry. Use plain, unscented soap;
	Keep your blood sugar under good control if you have diabetes;
	Lose weight if you are overweight;
	Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from synthetic materials. For infants and toddlers, change diapers often;
	Avoid overexertion, heat, and excessive sweating;
	Avoid scratching, which will only aggravate the problem;
	Delay sexual activity until your symptoms get better, or use a lubricant during intercourse;
	Use condoms to avoid catching or spreading sexually transmitted diseases;
	If you know that you have a yeast infection because your symptoms are exactly the same as those you've had in the past, try over-the-counter creams or vaginal suppositories;
	Yeast infections are not considered sexually transmitted. However, sometimes men also develop itching and redness following sexual contact. If this is the case, or you get recurrent infections for unclear reasons, both you and your partner may require treatment. Talk to your doctor;
	For itching related to menopause, your doctor may consider estrogen cream or tablets to insert vaginally;
	If itching is disturbing your sleep, antihistamine medication at bedtime may help. Ask your pharmacist for a ‘sedating’ antihistamine.