Vaginal itching and discharge - adult and adolescent

  • Definition
    • Vaginal discharge refers to secretions from the vagina. The discharge may be:

      • Thick, pasty, or thin
      • Clear, cloudy, bloody, white, yellow, or green
      • Odorless or have a bad odor

      Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It can also occur on its own.

  • Alternative Names
    • Pruritus vulvae; Itching - vaginal area; Vulvar itching

  • Causes
    • Glands in the cervix and the walls of the vagina normally produce a clear mucus. This is very common among women of childbearing age.

      • These secretions may turn white or yellow when exposed to the air.
      • The amount of mucus produced varies during the menstrual cycle as hormone levels in the body change.

      The following factors can increase the amount of normal vaginal discharge:

      • Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle)
      • Pregnancy
      • Sexual excitement

      Different types of infections may cause itching or an abnormal discharge in the vagina. Abnormal discharge is characterized by abnormal color (brown, green), and odor. It is associated itching or irritation.

      These include:

      • Infections spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis.
      • Vaginal yeast infection, caused by a fungus.
      • Normal bacteria that live in the vagina that overgrow, causing a gray discharge and fishy odor. This is called bacterial vaginosis (BV). BV is not spread through sexual contact.

      Other causes of vaginal discharge and itching may be:

      • Menopause and low estrogen levels, which may lead to vaginal dryness and other symptoms (atrophic vaginitis).
      • Forgotten tampon or foreign body, which may cause a foul odor.
      • Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams, which may irritate the vagina or the skin around the vagina

      Less common causes include:

      • Cancer of the cervix, vagina, uterus, or fallopian tubes
      • Skin conditions, such as desquamative vaginitis and lichen planus
  • Home Care
    • Keep your genital area clean and dry when you have vaginitis. Make sure to seek help from health care provider for the best treatment.

      • Avoid soap and just rinse with water to clean yourself.
      • Soak in a warm but not hot bath may help your symptoms. Dry thoroughly afterward.

      Avoid douching. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.

      Other tips are:

      • Avoid using hygiene sprays, fragrances, or powders in the genital area.
      • Use pads and not tampons while you have an infection.
      • If you have diabetes, keep your blood sugar levels in good control.

      Allow more air to reach your genital area. You can do this by:

      • Wearing loose-fitting clothes and not wearing panty hose.
      • Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Cotton increases air flow and decreases moisture buildup.
      • Not wearing underwear.

      Girls and women should also:

      • Know how to properly clean their genital area while bathing or showering.
      • Wipe properly after using the toilet -- always from front to back.
      • Wash thoroughly before and after using the bathroom.

      Always practice safe sex, and use condoms to avoid catching or spreading infections.

  • When to Contact a Medical Professional
    • Call your provider right away if:

      • You have vaginal discharge
      • You have fever or pain in your pelvis or belly area
      • You may have been exposed to STIs

      Changes that could indicate a problem such as infection include:

      • You have a sudden change in the amount, color, odor, or consistency of discharge.
      • You have itching, redness, and swelling in the genital area.
      • You think that your symptoms may be related to a medicine you are taking.
      • You are concerned that you may have a STI or you are unsure if you have been exposed.
      • You have symptoms that get worse or last longer than 1 week despite home care measures.
      • You have blisters or other sores on your vagina or vulva.
      • You have burning with urination or other urinary symptoms. This may mean that you have a urinary tract infection.
  • What to Expect at Your Office Visit
    • Your provider will take a medical history and perform a physical exam including a pelvic exam.

      Tests that may be performed include:

      Treatment depends on the cause of your symptoms.

  • References
    • Eckert LO, Lentz GM. Infections of the lower genital tract. In: Lentz GM, Lobo RA, Gershenson DM, et al, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23.

      Hoefgen HR, Merritt DF. Vulvovaginitis. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 549.

      Schrager SB, Paladine HL, Cadwallader K. Gynecology. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 25.