In atrophic vaginitis, inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. The link you have selected will take you to a third-party website. Wearing loose-fitting clothes and not wearing panty hose. Glands in the cervix and the walls of the vagina normally produce clear mucus. Genital herpes sometimes causes vaginal itching but typically manifests with pain and ulceration. An itchy vagina or vulva itch is commonly caused by yeast infections. Most often, symptoms involve irritation or eruption of the vulvar … It helps the child report information about the experienced event and improves the quality of information obtained. If clinical criteria and in-office test results are inconclusive, the discharge may be cultured for fungi and trichomonads. This site complies with the HONcode standard for trustworthy health information: verify here. 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). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The cervix is inspected for inflammation (eg, trichomoniasis) and discharge. If they have unexplained vaginal discharge, cervicitis, which may be due to a sexually transmitted disease, should be considered. The amount of mucus produced varies during the menstrual cycle. Other causes of discharge include vaginal cancer, cervical cancer, and endometrial cancer and, in women who are incontinent or bedbound, chemical vulvitis. 7th ed. A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). Vaginal secretions are tested using pH paper with 0.2 intervals from pH 4.0 to 6.0. Soak in a warm but not hot bath may help your symptoms. Schrager SB, Paladine HL, Cadwallader K. Gynecology. Gardella C, Eckert LO, Lentz GM. Itching and/or irritation areand/or irritation are less commonless common. This may mean that you have a urinary tract infection. In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. All women have vaginal discharge or secretions which help to keep the vulva and vagina moist and remove bacteria and dead cells. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. Signs and symptoms. The discharge may be: Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. The amount of discharge varies. This site complies with the HONcode standard for trustworthy health information:   Depending on the reason for the irritating vaginal itch, you may also experience burning, swelling, irritation, and an unpleasant vaginal odor with thicker discharge. The most common symptom is vaginal discharge, which occurs in the majority of girls (62–92%). Vaginal itching is a symptom that may signify something is occurring with your vagina.Signs and symptoms of itching can involve the vagina or the genital area called the vulva. The trusted provider of medical information since 1899. Pruritus vulvae; Itching - vaginal area; Vulvar itching. The symptoms of vulvitis can also suggest other disorders or diseases of the genitals. You are concerned that you may have a STI or you are unsure if you have been exposed. KOH = potassium hydroxide; PCR = polymerase chain reaction. A.D.A.M. Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. You have burning with urination or other urinary symptoms. The vulva should be kept as clean as possible. For pruritus, topical corticosteroids (eg, 1% hydrocortisone twice a day as needed) can be applied to the vulva but not into the vagina. Wipe properly after using the toilet -- always from front to back. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. 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). Small cracks on the skin of the vulva. A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. Comprehensive Gynecology. It may also occur as a … Colonization by these bacteria keeps vaginal pH in the normal range (3.8 to 4.2), thereby preventing overgrowth of pathogenic bacteria. Clear vaginal discharge is an often common and normal symptom from the female reproductive system. Vaginitis may also result from foreign bodies (eg, a forgotten tampon). Scaly, thick, whitish patches on the vulva. In: Rakel RE, Rakel DP, eds. 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 external genitals are examined for erythema, excoriations, and swelling. Vaginal itching is the most common symptom of candida vulvovaginitis. Past medical history should note risk factors for the following: Candidal infection (eg, recent antibiotic use, diabetes, HIV infection, other immunosuppressive disorders), Fistulas (eg, Crohn disease, genitourinary or gastrointestinal cancer, pelvic or rectal surgery, lacerations during delivery), Sexually transmitted diseases (eg, unprotected intercourse, multiple partners). Redness and swelling on the vulva and labia (lips of the vagina) Blisters on the vulva. Textbook of Family Medicine. Chemicals in bubble baths or soaps may cause inflammation and pruritus of the vulva, which often recur. Menopause and low estrogen levels. However, irritation, burning, and pruritus are never normal. Learn more about our commitment to Global Medical Knowledge. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). 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. Vaginal itching is an uncomfortable and sometimes painful symptom that often occurs due to irritating substances, infections, or menopause. Last full review/revision Mar 2020| Content last modified Mar 2020, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Some Causes of Vaginal Pruritus and Discharge, Musculoskeletal and Connective Tissue Disorders, National Institute of Child Health and Human Development (NICHD) Protocol. Vaginal discharge. 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. The most common causes of vaginal itching and discharge vary by patient age (see table Some Causes of Vaginal Pruritus and Discharge). Nonspecific vulvovaginitis is a diagnosis of exclusion. What is 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. Normally in women of reproductive age, Lactobacillus species is the predominant constituent of normal vaginal flora. Vaginal itching can occur for a number of reasons and usually isn't cause for concern. Avoid using hygiene sprays, fragrances, or powders in the genital area. Dry thoroughly afterward. Rather than using a towel to dry, you may find that gentle use of warm or cold air from a hair dryer may result in less irritation than the use of a towel. Women may also experience burning, soreness, irritation, pain during urination, or pain during sex. 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). Some vaginal discharge is normal, particularly when estrogen levels are high. This happens due to the change in hormone levels in the body. If your vulva feels irritated, however, it is important to seek advice from your doctor as to what might be causing the irritation. 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). Sometimes another infection (eg, gonorrhea, chlamydial infection) causes a discharge. 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. In postmenopausal women, atrophic vaginitis is a common cause. Pruritus, vulvovaginal erythema, vaginal odor, sometimes dysuria, no discharge, Vaginal discharge, usually with a foul odor and vaginal spotting, Clinical evaluation (may require a topical anesthetic or procedural sedation), Infections (eg, candidal, pinworm, streptococcal, staphylococcal), Pruritus and vaginal discharge with vulvar erythema and swelling, often with dysuria, Worsening of pruritus at night (suggesting pinworm infection), Significant erythema and vulvar edema with discharge (suggesting streptococcal or staphylococcal infection), Microscopic examination of vaginal secretions for yeast and hyphae and culture to confirm, Examination of vulva and anus for pinworms, Vulvovaginal soreness, bloody or malodorous vaginal discharge, Often, vague and nonspecific medical complaints (eg, fatigue, abdominal pain) or behavior changes (eg, temper tantrums), Cultures or PCR for sexually transmitted diseases, Measures to ensure the child’s safety and a report to state authorities if abuse is suspected, Malodorous (fishy), thin, gray vaginal discharge with pruritus and irritation, Clue cells seen during microscopic examination, Vulvar and vaginal irritation, edema, pruritus, Discharge that resembles cottage cheese and adheres to the vaginal wall, Sometimes worsening of symptoms after intercourse and before menses, Sometimes recent antibiotic use or history of diabetes, Yeast or hyphae identified on a wet mount or KOH preparation, Yellow-green, frothy vaginal discharge, often with a fishy odor, Often soreness, erythema, and edema of the vulva and vagina, Sometimes punctate, red “strawberry” spots on the vaginal walls or cervix, Mild cervical motion tenderness often detected during bimanual examination, Motile, pear-shaped flagellated organisms seen during microscopic examination, Rapid diagnostic assay for Trichomonas, if available, Foreign bodies (often a forgotten tampon), Extremely malodorous, often profuse vaginal discharge, often with vaginal erythema, dysuria, and sometimes dyspareunia, Cervical motion and/or adnexal tenderness, Dyspareunia, scant discharge, thin and dry vaginal tissue, Increased number of neutrophils, parabasal cells, and cocci and decreased number of bacilli seen during microscopic examination, Vaginal cancer, cervical cancer, or endometrial cancer, Gradual onset of pain, a watery or bloody vaginal discharge (which precedes bleeding), abnormal vaginal bleeding (eg, postmenopausal bleeding, premenopausal recurrent metrorrhagia), Often no other symptoms until the cancer is advanced, Pelvic ultrasonography or sometimes MRI or CT, Chemical vulvitis due to irritation from urine or feces, Risk factors (eg, incontinence, restriction to bed rest), Vulvovaginal erythema, edema, pruritus (often intense), vaginal discharge, History of recent use of hygiene sprays or perfume, bath water additives, topical treatment for candidal infections, fabric softeners, bleaches, or laundry soaps, Inflammatory (eg, pelvic radiation, oophorectomy, chemotherapy)‡, Purulent vaginal discharge, dyspareunia, dysuria, irritation, Sometimes pruritus, erythema, burning pain, mild bleeding, Diagnosis of exclusion based on history and risk factors, Granulocytes and parabasal cells seen during microscopic examination, Enteric fistulas (complication of delivery, pelvic tumors, pelvic surgery, or inflammatory bowel disease), Malodorous vaginal discharge with passage of feces from vagina, Direct visualization or palpation of the fistula in the lower part of the vagina, Skin disorders (eg, psoriasis, lichen sclerosus, tinea versicolor), Characteristic genital and extragenital skin findings. 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