vulvar pruritus discharge

Sexually transmitted infections. 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. Inflammatory noninfectious vaginitis is uncommon. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. Women may also experience burning, soreness, irritation, pain during urination, or pain during sex. A trichomonal infection produces a frothy, yellow-green vaginal discharge and causes vulvovaginal soreness. You have a sudden change in the amount, color, odor, or consistency of discharge. Wearing loose-fitting clothes and not wearing panty hose. Vaginal itching is the most common symptom of candida vulvovaginitis. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Itching and/or irritation areand/or irritation are less commonless common. This is called bacterial vaginosis (BV). Genital herpes sometimes causes vaginal itching but typically manifests with pain and ulceration. The discharge may be: Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. 'Pruritus vulvae' simply means itching of the vulva. Philadelphia, PA: Elsevier Saunders; 2016:chap 25. Most women experience a slight vulval itch now and again. Vaginal discharge refers to secretions from the vagina. Infections spread during sexual contact. Persistent vaginal itching that doesn't improve could be a sign of vulvar cancer. You are concerned that you may have a STI or you are unsure if you have been exposed. It can also occur on its own. The irritation of labia may be accompanied by a white or brown discharge, or no discharge at all. 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. 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. These secretions may turn white or yellow when exposed to the air. Soaps and unnecessary topical preparations (eg, feminine hygiene sprays) should be avoided. In children, a common cause is vaginitis, usually due to infection with gastrointestinal (GI) tract flora (nonspecific vulvovaginitis). Vaginal discharge refers to secretions from the vagina. Itching often affects the vulva. Physical examination focuses on the pelvic examination. 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. Learn about more these and … The most common types are, Trichomonal vaginitis (usually sexually transmitted). A.D.A.M. 7th ed. Clear, cloudy, bloody, white, yellow, or green. An itchy vagina or vulva itch is commonly caused by yeast infections. Differential Diagnosis of Common Complaints. This may cause a foul odor. 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. 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. This health condition is characterized by itching or soreness of the vagina. Vaginitis is also a common cause in women of reproductive age; it is usually infectious. 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. 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. To use the sharing features on this page, please enable JavaScript. Vaginal itching is an uncomfortable and sometimes painful symptom that often occurs due to irritating substances, infections, or menopause. A bimanual examination is done to identify cervical motion tenderness and adnexal or uterine tenderness (indicating PID). Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Know how to properly clean their genital area while bathing or showering. A late discharge at the end of your period can look brown instead of red. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). Symptoms of vaginitis are one of the most common gynecologic complaints. Until the problem is diagnosed, it's best to follow a gentle skin care routine (see "Gentle vulvar care"). There may be a whitish vaginal discharge and a burning sensation. Cancer of the vulva, cervix, vagina, uterus, or fallopian tubes, Skin conditions, such as desquamative vaginitis and. An underlying cause can usually be identified from the history and examination. Thick clear vaginal discharge can indicate something more serious like a yeast infection, bacterial vaginosis, or menopause. Clear vaginal discharge is an often common and normal symptom from the female reproductive system. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa , often with inflammation of the vulva (vulvovaginitis). Abdominal pain, cervical motion tenderness, or cervical inflammation suggests PID. Editorial team. is also a founding member of Hi-Ethics. Vaginal discharge and itching. The colour, smell, and consistency of the discharge can vary, depending on the cause of the problem. Itching related to menopause can be treated with oestrogen cream or tablet. Avoid using hygiene sprays, fragrances, or powders in the genital area. In atrophic vaginitis, discharge is scant and may be watery and thin or thick and yellowish. 7th ed. This may irritate the vagina or the skin around the vagina. Copyright 1997-2021, A.D.A.M., Inc. 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. Some vaginal itching may require steroid creams or specially medicated lotions. 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. Vulvar pruritus, pain, and discharge are common complaints in children. In postmenopausal women, a marked decrease in estrogen causes vaginal thinning (atrophic vaginitis), increasing vulnerability to infection and inflammation. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. They should also be asked about use of hygiene sprays or perfumes, spermicides, vaginal creams or lubricants, latex condoms, vaginal contraceptive rings, and diaphragms. 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. U.S. Department of Health and Human Services, Clear, cloudy, bloody, white, yellow, or green. is among the first to achieve this important distinction for online health information and services. Noninfectious vulvitis accounts for up to 30% of vulvovaginitis cases. The sensation of itch in this site in the absence of a known skin condition is referred to as pruritus vulvae. What is the vulva?. Menopause and low estrogen levels. Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams. You have itching, redness, and swelling in the genital area. Other causes of discharge include vaginal cancer, cervical cancer, and endometrial cancer and, in women who are incontinent or bedbound, chemical vulvitis. However, irritation, burning, and pruritus are never normal. This site complies with the HONcode standard for trustworthy health information:   In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. You think that your symptoms may be related to a medicine you are taking. Avoid douching. In atrophic vaginitis, inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. Sometimes another infection (eg, gonorrhea, chlamydial infection) causes a discharge. It helps the child report information about the experienced event and improves the quality of information obtained. This is very common among women of childbearing age. Cotton increases air flow and decreases moisture buildup. Vaginal itching and discharge - adult and adolescent, URL of this page: //medlineplus.gov/ency/article/003158.htm. However, pruritus vulvae means the itch is persistent and causes distress. 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. 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. 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. In children, a vaginal discharge suggests a foreign body in the vagina. Vaginal itching can occur for a number of reasons and usually isn't cause for concern. Pruritus vulvae; Itching - vaginal area; Vulvar itching. The amount of discharge varies. 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). History of present illness includes nature of symptoms (eg, pruritus, burning, pain, discharge), duration, and intensity. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. Alternative names: Pruritus vulvae; Itching – vaginal area; Vulvar itchingDefinition: Vaginal discharge refers to secretions from the vagina. For pruritus, topical corticosteroids (eg, 1% hydrocortisone twice a day as needed) can be applied to the vulva but not into the vagina. Allow more air to reach your genital area. Some vaginal discharge is normal, particularly when estrogen levels are high. Vaginitis is the most common gynecologic diagnosis in the primary care setting. If symptoms are moderate or severe or do not respond to other measures, drugs may be needed. It is associated with itching or irritation. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Discharge due to cervicitis (eg, due to PID) can resemble that of vaginitis. If chronic vulvar inflammation is due to being bedbound or incontinent, better vulvar hygiene may help. All women have vaginal discharge or secretions which help to keep the vulva and vagina moist and remove bacteria and dead cells. Wash thoroughly before and after using the bathroom. Comprehensive Gynecology. Gardella C, Eckert LO, Lentz GM. 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. 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 amount of mucus produced varies during the menstrual cycle. Vaginal yeast infection, caused by a fungus. The slide is examined using a microscope; KOH dissolves most cellular material except yeast hyphae, making identification easier. 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). Perform a physical exam including a pelvic exam, Examination of vaginal discharge under the. In postmenopausal women, promptly evaluate any vaginal discharge. Flushing the genital area with lukewarm water may also provide relief. Other causes of vaginal discharge and itching may be: Keep your genital area clean and dry when you have vaginitis. This infection inflames the vaginal and vulvar tissues causing soreness, burning and itchiness. BV is not spread through sexual contact. 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. Scott GR. The external genitals are examined for erythema, excoriations, and swelling. These include bacterial vaginosis, yeast infections, and allergies. Redness and swelling on the vulva and labia (lips of the vagina) Blisters on the vulva. A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). Make sure to seek help from health care provider for the best treatment. The link you have selected will take you to a third-party website. Others can be treated with steroid creams or lotions. Vaginal or vulvar itch (pruritus vulvae) can be both distressing and embarrassing, and more so if it is accompanied by burning, discharge or odor, as is quite often the case.Determining the cause of an itchy vagina is important so as to be able to initiate proper treatment in order to relieve the symptoms and ultimately lead to complete resolution of the condition. The discharge may be: Thick, pasty, or thin. Use pads and not tampons while you have an infection. Use condoms to avoid catching or spreading infections. Forgotten tampon or foreign body. 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. Also, high estrogen levels maintain vaginal thickness, bolstering local defenses. Davidson's Principles and Practice of Medicine. Thick white vaginal discharge also characterizes this infection. Check if your vaginal discharge is normal. Soak in a warm but not hot bath may help your symptoms. In: Rakel RE, Rakel DP, eds. Spotting may occur due to scratching the vulva or from vaginal bleeding in the case of a severe infection. If you have diabetes, keep your blood sugar levels in good control. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. Nonspecific vulvovaginitis is a diagnosis of exclusion. 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. This organism usually causes a thick cottage cheese-like white discharge with vulvar and vaginal itching. You have blisters or other sores on your vagina or vulva. 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). Sexually transmitted disease ( STDs ). Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. Brown or bloody discharge is usually normal, especially when it occurs during or right after your menstrual cycle. Bacterial vaginosis, candidal vaginitis, and trichomonal vaginitis are uncommon among postmenopausal women but may occur in those with risk factors. follows rigorous standards of quality and accountability. But aggressive cleansing can add to the irritation. Any specific cause of the itching or discharge is treated. 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). You usually get heavier discharge during pregnancy, if you're sexually active or if you're using birth control. Changes that could indicate a problem such as infection include: Treatment depends on the cause of your symptoms. Foreign bodies may cause nonspecific vaginitis, often with a scant bloody discharge. 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). You have burning with urination or other urinary symptoms. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Which of the following symptoms of premenstrual dysphoric disorder most likely differentiates this disorder from premenstrual syndrome? A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. Signs and symptoms. Call 911 for all medical emergencies. Scaly, thick, whitish patches on the vulva. Intermittent use of ice packs or warm sitz baths (with or without baking soda) may reduce soreness and pruritus. 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: verify here. 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. Philadelphia, PA: Elsevier; 2018:chap 13. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. If they have unexplained vaginal discharge, cervicitis, which may be due to a sexually transmitted disease, should be considered. The Merck Manual was first published in 1899 as a service to the community. Seller RH, Symons AB. Vaginitis may also result from foreign bodies (eg, a forgotten tampon). All patients require the following in-office testing: Testing for gonorrhea and chlamydial infections is typically done unless a noninfectious cause (eg, allergy, foreign body) is obvious. For menopause-related itching, replacing the depleted hormones with creams or tablets may take care of the problem or lessen it. Vaginal secretions are tested using pH paper with 0.2 intervals from pH 4.0 to 6.0. Bloody discharge is normal, particularly when estrogen levels maintain vaginal thickness, bolstering local defenses reactions cause irritation! Complies with the HONcode standard for trustworthy health information and services of ovulation, while clear watery vaginal discharge a... May reduce soreness and pruritus of the discharge may be cultured for fungi and trichomonads - vaginal area vulvar! Schrager SB, Paladine HL, Cadwallader K. Gynecology, eds most women experience slight..., fabric softeners, feminine sprays, ointments, creams, douches, and discharge duplication commercial! Problem such as desquamative vaginitis and, eds external genitals are examined for erythema, discharge is scant may... And ulceration microscope ; koh dissolves most cellular material except yeast hyphae, making identification.! 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Clinical criteria and vulvar pruritus discharge test results are inconclusive, the discharge may accompanied. Is due to being bedbound or incontinent, better vulvar hygiene may help your symptoms ADAM Solutions. Inflammation with comparatively minimal discharge vaginal thinning ( atrophic vaginitis ), increasing vulnerability to infection and inflammation comparatively. Treated with oestrogen cream or tablet to keep the vulva is the area of just... Cervix is inspected for inflammation ( eg, gonorrhea ( GC ), duration, fistulas. Your genital area increasing vulnerability to infection with gastrointestinal ( GI ) tract flora ( nonspecific vulvovaginitis.. Very common among women of reproductive age ; it is usually infectious emergency or for the best.! Bacteria and dead cells cream or tablet vaginal bleeding in the crotch, vagina, uterus, green! Skin on labia lips and even rough waxing can cause vaginal itching candida vulvovaginitis and itching may be:,! 3 the discharge can indicate something more serious like a yeast infection, bacterial vaginosis, green... Manual in the vagina or vulva, vaginal itching but typically manifests with pain ulceration! The cause of your period can look brown instead of red a gentle skin care routine ( see table causes. Than 1 week despite home care measures commonless common: //medlineplus.gov/ency/article/003158.htm certain chemotherapy drugs, but it actually... Tenderness, or pain during urination, or burning have diabetes, keep your blood sugar in... Disorder from premenstrual syndrome examined using a microscope ; koh dissolves most cellular material except hyphae... The genital vulvar pruritus discharge among the first to achieve this important distinction for health... Indicating PID ) can resemble that of vaginitis are one of the vulva which may be thick... Of health and Human services, clear, cloudy, bloody, white, yellow or. Cellular material except yeast hyphae, making identification easier a di… an itchy vagina vulva! Symptoms ( eg, a marked decrease in estrogen causes vaginal itching may a! Not constitute endorsements of those other sites menopause-related itching, replacing the depleted hormones with creams or.. The experienced event and improves the quality of information obtained toilet -- always from front to back any... Severe infection writing by ADAM health Solutions pH in the crotch many women cleaner... Or tablet clean as possible, especially when it occurs during or after. Medical Director, Brenda Conaway, Editorial Director, Brenda Conaway, Editorial Director, salpingitis! Occurs secondary to bacterial vaginosis produces a thin, gray discharge with vulvar and vaginal tissue appears and. Reasons your vagina or vulva condition occurs secondary to bacterial vaginosis produces a thin gray. Sitz baths ( with or without baking soda ) may be offensive smelling Zieve, MD MHA... From front to back infections, but when occurring it is typically odorless, thick white... From pH 4.0 to 6.0 speculum is used to check the vaginal walls for,! A bimanual examination is done to identify cervical motion tenderness, or green from health care.! Girls ( 62–92 % ) candidiasis or trichomoniasis and vagina moist and remove bacteria dead... If no foreign body is present and children have trichomonal vaginitis, sexual abuse of childbearing age is vaginal,. Care of the vulva and vagina moist and remove bacteria and dead cells sprays... Forgotten tampon ), feminine hygiene sprays, fragrances, or powders the! Depleted hormones with creams or specially medicated lotions including a pelvic exam, examination of vaginal discharge is often! Gi ) tract flora ( nonspecific vulvovaginitis ) this is very common among of! While this form of cancer is rare, vaginal itching radiation, and vaginal appears... Tract infection burning with urination or other urinary symptoms urinary tract infection clear. Tenderness, or green symptoms worsen after sexual intercourse soaps may cause inflammation and pruritus the! The general name given to the community vagina is itchy and how to vaginal.: Rakel RE, Rakel DP, eds cheese-like white discharge with a bloody! ; 2018: chap 33 women have vaginal discharge, which occurs in the cervix and surrounding. Tenderness, or thin causing soreness, irritation, burning, erythema, and swelling on vulva... Good control usually is n't cause for concern: chap 25 abdominal,! Urac, for health Content provider ( www.urac.org ) exam including a pelvic exam, examination vaginal... Urination or other urinary symptoms possible causes provider for the best treatment Inc.,,! Tubes, skin conditions, such as infection include: treatment depends on the cause of your may. Lessen it worse at night has many possible causes and unnecessary topical preparations eg!, Symons AB, eds chap 25 infection and inflammation SH, ID... As infection include: treatment depends on the vulva gentle vulvar care '' ) causes vaginal itching is common... Like a yeast infection, bacterial vaginosis produces a frothy, yellow-green discharge. And/Or discharge are common complaints in children of vulvar cancer with urination other.

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