Vaginal itching is a tingling or uneasy irritation of the skin of the vagina and the surrounding area (vulva). The itching may cause a desire to scratch the affected area.

Common causes of vaginal itching include:

• Chemical irritants -- such as detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies.
• Vaginal yeast infection -- often includes a discharge that is white and curd-like. Vaginal yeast infections can be brought on by antibiotics, birth control pills, pregnancy, menstruation, condom use, sexual intercourse, diabetes, and a weakened immune system.
• Vaginitis -- inflammation, itching, discharge, and odor caused by other infections (including sexually transmitted diseases). Vaginitis in girls before puberty is common. If a young girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed.
• Menopause -- the drop in estrogen causes thinning of the vaginal wall and less lubrication.
• Stress -- may increase vaginal itching and make you more susceptible to infections.

Other possible, but less common, causes of vaginal or vulvar itching include:

• Pinworms (a parasitic infection mainly affecting children)
• Certain skin conditions affecting the vulvar skin, some of which may be precancerous

To prevent and treat vaginal itching:

• Keep your genital area clean and dry. Use plain, unscented soap.
• Avoid colored or perfumed toilet tissue and bubble bath.
• Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from synthetic materials. For infants and toddlers, change diapers often.
• Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible.
• Avoid feminine hygiene sprays and douches.
• Eat yogurt with live cultures or take lactobacillus acidophilus tablets when using antibiotics. Check with your doctor.
• Cleanse by wiping or washing from front to back (vagina to anus) after urinating or having a bowel movement.
• Lose weight if you are over weight.
• Keep your blood sugars under good control if you have diabetes.

It is also helpful to:

• Avoid scratching, which will only aggravate the problem.
• Avoid overexertion, heat, and excessive sweating.
• Delay sexual activity until your symptoms get better or at least use a lubricant during intercourse.
• Use condoms to avoid catching or spreading sexually transmitted diseases.

If you know that you have a yeast infection because your symptoms are exactly the same as those in the past, try over-the-counter creams or vaginal suppositories.

Yeast infections are not considered sexually transmitted. However, sometimes men also develop itching and redness following sexual contact. If this is the case or you get recurrent infections for unclear reasons, both you and your partner may require treatment. Talk to your doctor.

For itching related to menopause, your doctor may consider estrogen cream or tablets to insert vaginally.

Teach children to resist and report any attempted sexual contact by another person. Don't try to remove any foreign object from a child's vagina. Take the child to a doctor right away for removal.

Call your doctor right away if:

• You have pelvic or lower abdominal pain or fever.
• You have increased thirst or appetite, unexplained weight loss, frequent urination, or fatigue -- these may be signs of diabetes.

Call your doctor if:

• Your symptoms worsen, last longer than 1 week, or recur despite self-care.
• You have unusual vaginal bleeding, swelling, or discharge.
• Your partner also has symptoms or you think you may have a sexually transmitted disease.
• You have burning with urination or other urinary symptoms -- you may have a urinary tract infection.
• You have blisters or ulcers on your vagina or vulva.

Your doctor will exam you, including a pelvic exam, and ask questions to help diagnose the cause of your vaginal itching. These questions may include:

• When did the itching begin?
• Have you had it before?
• Is the itching severe?
• Does it limit your activities?
• Where exactly is the itching? On the inside of the vagina or on the outside (vulva) as well?
• How often do you bathe or shower?
• Do you use scented soap, scented or colored toilet paper, or bubble bath?
• Do you frequently swim or participate in water sports? Do you change your clothes soon after such activities?
• Do you wear cotton panties or synthetic ones?
• Do you wear tight pants or tight pantyhose?
• Do you use douches or feminine hygiene spray?
• Are you sexually active? Do you use contraception? What type?
• Does anything make you feel better?
• Does anything make you feel worse?
• Have you tried any over-the-counter creams? Which ones?
• Do you have any other symptoms like vaginal bleeding,  swelling, rash, or pain on urination?
• Do you have a personal or family history of diabetes?
• What medications do you take?
• What is your menstrual history? Including questions like: How old were you when your periods began? How often do your periods usually come? How long do they generally last?

• Do you have any allergies?

Diagnostic tests that may be performed include:

• Culture and microscopic exam of vaginal discharge
• Pap smear
• Urine and blood studies (including hormone levels)
• Skin biopsies of the vulvar area

Antifungal drugs may be prescribed for yeast infections. When indicated, steroid creams or lotions may be prescribed to reduce inflammation. Ointments containing hormones may be ordered, and benzodiazepines or antihistamines may be prescribed for nighttime relief.

Antibiotics may be prescribed for bacterial vaginal infections, including sexually transmitted diseases.

Clark LR, Atendido M. Group B streptococcal vaginitis in postpubertal adolescent girls. J Adolesc Health. 2005; 36(5): 437-440.

Edwards L. The diagnosis and treatment of infectious vaginitis. Dermatol Ther. 2004; 17(1): 102-110.

Reid G, Bruce AW. Urogenital infections in women: can probiotics help? Postgrad Med J. 2003; 79(934): 428-432.z