It Might Not be Thrush; Our Guide to Vulva Itchiness

There are few discomforts greater than an itchy vulva in public. We’ve all done the fast walk, the awkward dance on the spot, the dash to the loo for some relief. Nearly every vulva owner has had a day overrun by a looping mantra of don’t scratch, don’t scratch, where sitting, standing, and concentrating all seem impossible. 

It happens to the best of us, and it’s nothing to be embarrassed about, but it isn’t something to tolerate either. 

Here is our guide to vulva itchiness: common causes, treatments, and preventions. 

The most widely known cause of itchiness is thrush, but there are actually several possible explanations for itchiness, all with their own treatments and remedies. It might not be thrush – and treating it as such might make your symptoms worse, or at least mean you’re itchy for longer. 

Thrush, or candidiasis, is the most common yeast infection that causes vaginal and vulva itchiness. It happens when too much of the yeast (Candida albicans) that is naturally on your genital skin grows. Other symptoms include redness, swelling of the vagina or vulva, burning while you pee, and the characteristic “cottage cheese” discharge that is as unpleasant as it sounds. Never fear! Thrush can be easily treated using antifungal creams or tablets. 

There are many factors that might cause an upset to your delicate yeast balance, like pregnancy, menstrual cycle changes, oral contraceptive use or other illnesses like iron deficiency and diabetes. Thrush can also occur after taking some antibiotics, as the tablets kill off the good bacteria that prevent yeast overgrowth. 

Bacterial vaginosis (BV) is often confused with thrush, but has different causes and treatments. This time, the itchiness is caused by an overgrowth of bacteria that are naturally found in the vagina. The symptoms of BV are similar to thrush, with itching, and burning during urination, but differential factors are a foul and fishy odour and thin grey, white or green discharge. Lovely! Again, BV is treatable. A course of antibiotics is generally all you’ll need. 

The causes of BV are a little unclear, but anything that upsets your vagina’s equilibrium is a risk factor. Things like douching or using scented sprays on your vulva can lead to BV. BV is also linked to sexual activity, being more common in people that have multiple sexual partners, after being with a new partner, and among women who sleep with women.

Contact dermatitis is an itchy rash on the genital skin. It happens when you have an allergic reaction to some kind of product your vulva is in contact with. It could be a scented soap, bubble bath, detergents, fabric softeners, or scented toilet paper. It could also be a reaction to latex condoms and diaphragms, lubricants, tampons and sanitary pads. Once you’ve worked out what’s causing the upset, contact dermatitis should go away on its own. But as a rule, keep scented products away from your vagina. 

Eczema and psoriasis are skin conditions that cause red, scaly patches on the skin and can spread to the vulva. Eczema is common in crevices on the body, like the inner elbow, folds, groin area, but it can also spread to the labia. Psoriasis can present on the skin around the vagina too. Both conditions require a treatment plan that should be developed with your doctor. 

Some sexually transmitted diseases, like chlamydia, herpes, gonorrhoea and genital warts can cause itchiness. Itching can be the first sign that something is up, so if you’re itchy and you’ve been having unprotected sex it’s a good idea to go for a sexual health check-up. It’s probably a good idea to go for a sexual health check-up anyway. It’s always a good idea to go for a sexual health check-up. 

Hormonal changes can also cause itchiness as your vagina becomes drier throughout certain points of the menstrual cycle. Itchiness of this kind is common throughout and after menopause, as your estrogen levels drop, affecting the moisture levels of your vagina. The joys of womanhood. 

If you’re feeling itchy, it’s always a good idea to see your GP. Even if you think you know the reason, and can get over the counter medication. A doctor will be able to properly identify the cause of your itchiness and make sure you’re getting the right meds to treat it. 

When you go to the GP, you can expect your doctor to talk to you about your symptoms, to do a pelvic exam, and to discuss the treatment options. In some cases they might also want to do a blood or a urine test. Just remember there’s no reason to be embarrassed. Chances are you won’t be the only itchy vulva they see that week, or even that day. 

To keep your vagina staying healthy, note that it is self-cleaning. You should wash with warm water, and avoid scented products and misguided “beauty” practises like vagina facials, steams, and douching. If your vulva is sensitive, make sure to get changed out of wet clothes after swimming and sweaty clothes after exercising, and only wear cotton underwear. Sticking to a natural water-based lube is also a good idea for sensitive vaginas.

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