Diseases

Pruritus Vulvae – Causes, Symptoms & Treatment

Itching of the vulva

The so-called pruritus vulvae is an itching of the vulva, which can be triggered by various diseases. In addition to itching, pain or burning can also occur as symptoms. The itching should be clarified by a doctor.

What is Itching of the Vulva?

Pruritus vulvae is an itching of the external female genitalia , the so-called vulva. This itching (Latin “pruritus”) usually occurs episodically, i.e. temporarily. Itching can be both acute and chronic. The vulva, where itching occurs, is the outer part of the female genitals.

It includes the external, primary sexual organs of the woman. These include the mons pubis, the large outer labia, the small inner labia, the clitoris and the vestibule with the exits of the vagina, the urethra and the vestibular glands.

causes

Both primary and secondary causes are possible as causes for itching of the vulva (pruritus vulvae). In the case of the primary causes, the pruritus of the vulva is in the foreground; in the case of a secondary cause of the disease, it occurs as a side effect of an already existing pre-existing condition. With vulvitis, an inflammation of the vulva, itching is one of the main symptoms.Vulvitis is an inflammation of the external female genitals . Vulvitis can be caused by bacteria, viruses, fungi or parasites. In addition to the itching mentioned, inflammation of the vulva causes redness , swelling and pain in the vulva area. A warmth in this area can also often be felt.

The female sexual organ is limited in its functionality due to the symptoms. Vulvitis can be primary, caused by a direct infection of the vulva with the pathogen, or secondary, caused by a spreading infection of the neighboring organs, such as the anus, urethra or vagina.

In addition to vulvitis, other causes of pruritus vulvae are possible. For example, various metabolic diseases can lead to itching in the vulva area. These include diabetes mellitus , estrogen deficiency , uremia (poisoning of the blood by urinary substances), obesity (obesity), liver diseases and avitaminosis (the complete lack of certain vitamins).

If the pruritus vulvae occurs as part of one of these metabolic diseases, there is a secondary cause. Other causes are allergic reactions , for example to medication, soap or contact eczema through laundry and/or clothing. Lichen scelorsus et atrophicus vulvae (vulva dystrophy), a degenerative disease of the skin of the vulva, also causes itching.

The disease occurs mainly in young women after puberty and is one of the possible precancerous conditions. Other possible causes are other precancerous lesions, vulva carcinoma , leukemia , pernicious anemia , poor or excessive hygiene, excessive sweating and mechanical irritation, for example from masturbation.

It can be observed that different triggers of pruritus vulvae predominate in different age groups. In children, pruritus is often caused by fungal infections , allergies, diabetes mellitus or infections caused by pinworms ( oxyuriasis ). In the sexually mature age, the main causes are fungal infections, contact eczema and infections. In old age, it is primarily skin dysmorphism, neoplasia and diabetes mellitus that trigger vulvar itching.

Symptoms, Ailments & Signs

The main symptom of pruritus vulvae (Latin: “itching of the vulva”) is itching on the outer labia (labia majora pudendi), which is usually not persistent – it usually only lasts for a short time. The itching can turn into a painful, burning condition.

Furthermore, it can be observed that it is often intensified by warmth and is increasingly observed or perceived by the patients after they have gone to bed. Due to the itching, the patients tend to scratch, which, however, aggravates the condition. Furthermore, scratching usually leads to small tears and abrasions, which maintains or aggravates the painful condition.

Scratching also makes medical diagnosis more difficult, since any primary skin changes that could cause pruritis can no longer be seen or can only be seen with difficulty due to the changes caused by scratching.

Diagnosis & disease progression

The diagnosis by the doctor consists of a thorough anamnesis and a physical examination. Particular attention is paid to existing changes in the skin of the vulva. Based on the anamnesis and the physical examination, the doctor arrives at a suspected diagnosis, which must be confirmed by suitable laboratory diagnostics.

Depending on the suspected diagnosis, there are various methods to choose from. These include, for example, a blood test in which the concentrations of glucose (suspected diabetes mellitus), urea, cholesterol or any bacterial toxins (suspected bacterial vulvinitis) are determined. In addition, a vaginal swab is often taken .

With the help of this smear, various causes can be tested and, if necessary, confirmed or ruled out. The course of the disease depends on the diagnosis made and can therefore not be explained in general terms. It should be noted that pruritus vulvae is a symptom and not a disease. In most cases it is harmless, but a medical diagnosis and possibly therapy should take place in any case.

complications

The itching of the female genitals can be triggered by certain diseases as well as by fragrances in cosmetics or by too much histamine in food. Depending on whether the cause of the itching can be found, complications such as inflammation or soreness can be prevented. If necessary, care should be taken to use fragrance-free cosmetics.If the vulva is sore due to itching, bacteria, fungi, viruses or parasites can lead to skin diseases that require treatment. Genital fungal infection in particular is a complication that requires medical attention. If the treatment is not carried out early, the fungus may spread in the vagina. There is an increased risk of infection during sexual intercourse.

Complications can also occur with pruritus vulvae due to a skin condition called lichen sclerosus et degenerans. As a result of the constantly irritated skin, scarring, whitish hardening and spots can occur here. Skin tears and pain occur during sexual intercourse.

The risk of genital fungal diseases is increased by soreness and a reduced immune system. With an increased risk of bladder problems, there may also be an increased risk of developing malignant cells. In order to prevent such complications, treatment with cortisone and estrogen ointments is usually carried out.

When should you go to the doctor?

Pruritus vulvae often indicates inflammation, which is why the symptom should usually be presented to a doctor. Pruritus vulvae can sometimes occur during puberty; the cause can be found in hormonal changes in the body and not in an infection. However, since the itching can be irritating and unsettling for young girls, there is nothing wrong with seeing a doctor for clarification. After all, various infections that need to be treated can also occur in young women.

In women with existing underlying diseases such as diabetes mellitus, pruritus vulvae can occur as a symptom or side effect of the disease. Nevertheless, you should also have the itching clarified, because even if it turns out that there is no infection, you can do something about the unpleasant itching.

In girls who have not yet reached puberty and feel itching in the vulva area, it may be an indication of a malformation that may not be visible at all. For this reason, they should also be presented to the pediatrician outside of the regular U-examinations . Girls of this age are also already susceptible to fungal infections, which should be treated in good time to protect their immune system.

As a sensitive reaction of the body, pruritus vulvae also occurs after frequent masturbation or irritation from sexual intercourse – you can wait a few days to see whether the symptoms improve on their own before consulting a doctor.

Treatment & Therapy

The therapy depends on the cause of the itching. Therapy should be as causal as possible, i.e. eliminate the causes of the underlying disease. Glucocorticoid ointments are primarily used to treat the symptom of pruritus . In the case of allergic causes, antiallergic drugs are used.

Underlying infections are treated with an appropriate medication based on the type of pathogen. So, with a bacterial vulvinitis, antibiotic treatment is carried out, with a fungal infection – antifungal. If there is a lack of estrogen, estrogens are administered. In summary, however, it can be said that causal therapy should take place, which requires comprehensive medical diagnostics.

prevention

Prevention is only possible to a limited extent. It is important to ensure adequate hygiene without overdoing it.

aftercare

Pruritus vulvae, itching in the external genital area in women, can have various causes. Clarification of the symptoms and diagnosis should therefore be left to an experienced gynecologist. The women concerned must consequently comply with the medical prescriptions. To relieve the itching or burning, the region should be kept as cool as possible.

Loose clothing is therefore recommended, as heat only increases the symptoms unnecessarily. For daily personal hygiene, cleaning with mild, pH-neutral products is recommended. Intimate wash lotions and special deodorants should not be used as they can further irritate and dry out the area.

Even if the itching is very severe, the patient should refrain from vigorously scratching the region. The skin of the vulva is very sensitive and therefore easily injured or rubbed sore. Small injuries can allow bacteria and viruses to enter and make the infection worse. During sexual intercourse, the woman should definitely protect herself with a condom during this time.

This not only prevents reinfection, but also possible contamination of the partner. If fungi or bacteria are the trigger of pruritus vulvae, it is advisable to support the immune system. A balanced diet, sufficient sleep and moderate exercise in the fresh air contribute to well-being and help to avoid such infections.

You can do that yourself

This itching can have a variety of causes, so the affected girls and women should have their gynecologist clarify exactly what is behind the symptom. The corresponding prescriptions of the doctor should now be followed consistently.

As long as the itching or burning persists, the area should be kept cool because heat unnecessarily exacerbates the symptoms. Scratching would also aggravate the situation because the delicate skin of the vulva is easily bruised or chafed. Scratches, tears and sores can quickly become infected with bacteria, fungi, viruses or parasites and should therefore be avoided. Sexual intercourse should only take place with a condom during this time . This prevents reinfection as well as infection.

pH-neutral cleaning products should be used for daily personal hygiene . Intimate deodorants or perfumes are better taboo in the pubic area. Excessive hygiene is not indicated, because too many washes unnecessarily irritate the tissue.

If the trigger of pruritus vulvae is not hormone-related, but rather fungi or bacteria, it is advisable to support the immune system . A perfectly functioning, active immune system accelerates healing and prevents the episode from repeating itself. A balanced diet rich in vitamins, plenty of exercise in the fresh air and some sport support the immune system, as do regular bedtimes and sufficient sleep.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.