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19 years
I have chronic itching in my vaginal area though I wash up very well three times a day. what might be the reason?
Aug 12, 2014

Dr. Zakia Dimassi Pediatrics
This could be due to:
-the use of soaps or intimate washes, which alter the naturally acidic vaginal medium (the pH becomes alkaline ie above 7) rendering it more prone to irritation and can favor overgrowth of bad bacteria and kill the good bacteria (some good bacteria exist in the vagina and function to maintain an acidic medium). The fact that you wash up frequently can sometimes end up be not as good a habit as you may assume. Decrease the frequency of washing, avoid intimate washes, and use soap-free products with a low pH value (like Sebamed).
If however the itchiness is associated with vaginal secretions, we could be dealing with an infectious process. Infections in the vagina produce symptoms of pruritus (itchy sensation), pain/burning with urination, abnormal secretions (not the clear normal vaginal secretions) that can have a foul smell. These infections can be due to imbalance in the normal bacteria found in the vagina due to altered pH (vaginal pH tends to be low ie acidic, the use of intimate washes alters this acidic pH and increases it so it becomes alkaline -goes above 7- which renders the vagina more prone to overgrowth of bacteria and fungi), hygiene issues, or sexual activity.
Possible causes are:
1- Vaginal candidiasis: caused by a fungus called Candida. Not a sexually transmitted infection (STI). Causes severe itching (sometimes you itch so hard you injure yourself and bleed a bit), burning, and cotton wool whitish secretions.
Can be treated with itraconazole or fluconazole (topical cream plus oral tablets).

2-Bacterial vaginosis: can be due to more than one type of bacteria. This is Not an STI but is more likely with sexual intercourse. The infection has a propensity to progress upward and result in pelvic inflammatory disease (PID), which is the inflammation of the uterus and ovaries; it's characterized by the following signs and symptoms:
-Dull pain or tenderness in the stomach or lower abdominal section, or pain in the right upper abdomen.
-Abnormal vaginal discharge that is yellowish or greenish in color and that smells funny (abnormal)
-Pain upon urination ( Dysuria)
-Chills or high fever.
-Nausea and vomiting.
-Pain during sex (dyspanreunia)
Bacterial vaginosis also causes itchiness, burning, and a fish-like smelling secretions.
Culture of those is needed to identify the causing agent &give the right treatment.

3-STI: three very common infections are:
- Trichomoniasis: produces green frothy foul smelling secretions and causes pain during intercourse,
-Chlamydia infection: common in women with multiple sexual partners and is characterized by some vaginal bleeding that is worse with intercourse.
-Neisseria gonorrhea: the most common presenting symptom of gonorrhea is vaginal discharge that is usually described as thin, thick (looks like pus), and mildly odorous; however, many patients have minimal or no symptoms; dysuria; Intermenstrual bleeding; dyspareunia (painful intercourse); mild pain in the lower abdomen.
Diagnosis of these infections is made based on vaginal exam and culture of vaginal swab/secretions, plus a urine analysis and culture to rule out associated urinary tract infection.
Treatment of these infections is with the appropriate antimicrobial agents for both the patient and the sexual partner(s).