Vaginal discharge. This may cause a foul odor. Dyspareunia is common, and vaginal tissue appears thin and dry. Vaginal yeast infection, caused by a fungus. Philadelphia, PA: Elsevier; 2017:chap 23. A water-lubricated speculum is used to check the vaginal walls for erythema, discharge, and fistulas. Soaps and unnecessary topical preparations (eg, feminine hygiene sprays) should be avoided. You usually get heavier discharge during pregnancy, if you're sexually active or if you're using birth control. Pruritus vulvae is itching of the vulva (which includes the mons pubis, labia majora, labia minora, clitoris, perineum and the external openings of the urethra and vagina). Vaginal secretions are tested using pH paper with 0.2 intervals from pH 4.0 to 6.0. Sometimes another infection (eg, gonorrhea, chlamydial infection) causes a discharge. Vaginitis is the most common gynecologic diagnosis in the primary care setting. Learn more about our commitment to Global Medical Knowledge. Soak in a warm but not hot bath may help your symptoms. There may be a whitish vaginal discharge and a burning sensation. If symptoms are moderate or severe or do not respond to other measures, drugs may be needed. Itching and/or irritation areand/or irritation are less commonless common. The KOH preparation is sniffed (whiff test) for a fishy odor, which results from amines produced in trichomonal vaginitis and bacterial vaginosis. The itch may … BV is not spread through sexual contact. This site complies with the HONcode standard for trustworthy health information: is among the first to achieve this important distinction for online health information and services. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. Some vaginal itching may require steroid creams or specially medicated lotions. 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). Other symptoms of vulvovaginitis include redness and soreness (74–82%), 3 pruritus (45–58%) 1, 3 and dysuria (19%). Forgotten tampon or foreign body. Avoid soap and just rinse with water to clean yourself. Symptoms of vaginitis are one of the most common gynecologic complaints. 7th ed. Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Philadelphia, PA: Elsevier Saunders; 2016:chap 25. 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. In atrophic vaginitis, inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. 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. 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. All women have vaginal discharge or secretions which help to keep the vulva and vagina moist and remove bacteria and dead cells. You have blisters or other sores on your vagina or vulva. Other causes of vaginal discharge and itching may be: Keep your genital area clean and dry when you have vaginitis. This health condition is characterized by itching or soreness of the vagina. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. If chronic vulvar inflammation is due to being bedbound or incontinent, better vulvar hygiene may help. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 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. Abnormal discharge means abnormal color (brown, green), and odor. 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. 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. Symptoms of vulvar itching (or pruritus vulvae) include itching, stinging, or … Itching often affects the vulva. Allow more air to reach your genital area. 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). Clear stretchy discharge is a sign of ovulation, while clear watery vaginal discharge occurs between periods, sexual arousal, or pregnancy. The amount of mucus produced varies during the menstrual cycle. Bacterial vaginosis, candidal vaginitis, and trichomonal vaginitis are uncommon among postmenopausal women but may occur in those with risk factors. 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. 'Pruritus vulvae' simply means itching of the vulva. The cervix is inspected for inflammation (eg, trichomoniasis) and discharge. Which of the following symptoms of premenstrual dysphoric disorder most likely differentiates this disorder from premenstrual syndrome? 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 most common types are, Trichomonal vaginitis (usually sexually transmitted). Depending on the reason for the irritating vaginal itch, you may also experience burning, swelling, irritation, and an unpleasant vaginal odor with thicker discharge. This site complies with the HONcode standard for trustworthy health information: verify here. Vaginal itching is an uncomfortable and sometimes painful symptom that often occurs due to irritating substances, infections, or menopause. Symptoms may also include irritation, burning, erythema, and sometimes dysuria and dyspareunia. Cotton increases air flow and decreases moisture buildup. The evaluation of vaginitis requires a di… Poor hygiene (eg, in patients who are incontinent or bedbound) can lead to chronic vulvar inflammation due to chemical irritation by urine or feces. Please confirm that you are a health care professional. Davidson's Principles and Practice of Medicine. It may result from hypersensitivity or irritant reactions to various agents, including hygiene sprays or perfumes, menstrual pads, laundry soaps, bleaches, fabric softeners, and sometimes spermicides, vaginal creams or lubricants, latex condoms, vaginal contraceptive rings, and diaphragms. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. The most common causes of vaginal itching and discharge vary by patient age (see table Some Causes of Vaginal Pruritus and Discharge). 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