Vaginal itching and burning are the most common symptoms that cause women to visit their gynecologist. Vaginitis is defined by the Merriam-Webster online dictionary as inflammation of the vagina that may be marked by irritation and vaginal discharge. Vaginitis may be infectious, allergic or hormonal.
Vaginal infections may or may not be sexually transmitted, and most respond to oral or vaginal medications. Vaginal allergic reactions often occur when a new soap, lubricant or vaginal medication is used for the first time. After infections are ruled out, hormonal or atrophic vaginitis can be confirmed and usually improves with hormones or lubrication.
Infection
Yeast and lactobacilli acidopholus normally inhabit the vagina, and when they are in balance, there is no problem. Sometimes, however, an imbalance occurs, such as after a round of antibiotics, and the winner, in this case yeast, takes over the environment and causes irritation. Good bacteria, the lactobacilli that inhabit the vagina, are also destroyed by antibiotics and the yeast has a chance to flourish. Yeast infection usually presents with a thick, yellow or white discharge and causes itching and burning.
The most common infectious vaginitis is gardnerella, or bacterial vaginosis. BV also occurs when there are fewer lactobacilli around to maintain the balance. In this case, anaerobic bacteria flourish. BV is not sexually transmitted, but the alkalinity of the vagina increases after intercourse or the menstrual cycle, and the bacteria produce amines and create a fishy odor and a gray discharge.
Trichomonas vaginalis is an infection that also causes a fishy odor, itching and discharge. It is caused by a sexually transmitted amoeba that can live or lie dormant for years in the vagina. These three infections can be diagnosed in an office visit and treated with antibiotics or antifungal medication.
The herpes simplex virus is sexually transmitted and may also cause vaginal irritation with an initial or recurrent outbreak. The predominant symptom is pain and burning. Open sores may be visible on the outer skin. HSV symptoms and outbreaks are managed with medication, but the virus remains in nerve cells and repeat outbreaks are common.
Allergic Reaction
Soaps, lubricants, laundry detergent and medications may cause an allergic reaction. With an allergic reaction, there is not much discharge, but the area feels irritated and may be red and inflamed. An allergic reaction usually occurs shortly after using a new product. Symptoms improve when the irritant is discontinued. If symptoms persist, an antihistamine or steroid cream may help.
Hormonal
Hormonal or atrophic vaginitis occurs when estrogen levels decline after menopause. There is little discharge, but there is vaginal itching and pain with intercourse. After infection is ruled out, this can be treated with vaginal moisturizers, lubricants or vaginal estrogen.
