Vaginal irritation has many causes. According to doctors M. Egan and M. Lipsky in "American Family Physician", vaginal irritation, or vaginitis, is the most common gynecologic diagnosis in primary care. About 90 percent of affected women develop the irritation from bacterial (ref #1, pg1), fungal or protozoan infections, although other causes may be discovered. A physician evaluation of your medical history, as well as a physical examination leads to the most accurate diagnosis.
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Reviewing Vaginal Environment
The physiological environment within the vagina consists of normal bacterial flora, vaginal secretions and lactic acid (ref #2). Lactic acid is made by typical vaginal bacteria to keep vaginal tissues at an acidic pH, which is toxic to most pathogens like foreign bacteria, yeast, parasites and viruses. Any alterations of this normal vaginal flora have the potential to allow pathogens entrance to the vaginal environment (ref #3). Potential practices that allow pathogens to proliferate in the vagina include antibiotics, contraceptives, intercourse, douching, stress and hormones. (ref #1pg3 pathophysio, ref #4 pg1+figure6-1)
Observing Physical Irritation
Irritation to the vaginal tissues may be caused by physical contact. If your tissues seem irritated and painful after sexual intercourse or you have been vigorously wiping your vaginal area, the irritation is likely due to those types of activities. Alternatively, physical irritation can simply occur from clothing that is too tight or cloth that is irritating. Simply switching to loose-fitting clothing and cotton underwear may alleviate vaginal irritation. Visit your physician if the irritation does not resolve.
Using Chemically Irritating Products
Certain types of hygienic practices may be responsible for vaginal irritation. Tissues can become irritated by particular chemicals present in some personal products. Douching, or cleaning the vagina with solution, is a procedure that many women practice. The American College of Obstetricians and Gynecologists recommend that women don't douche as it can irritate sensitive vaginal tissues (ref #5). Also, applying soaps, lotions and deodorants to the vaginal area may cause irritation.
Introducing Infective Agents
Abnormal changes in vaginal flora induced by infections can cause vaginal itching, irritation and discharge. If you have these symptoms, make an appointment to see your physician. According to C. Nardis in "Annali Di Ingiene" bacterial vaginosis is the most common vaginal syndrome of fertile women (re #3,pg445 last paragraph). Also, yeast, viral and parasitic infections can cause vaginal irritation (ref #4 figur6-1). Diseases like herpes simplex virus, chlamydia or gonorrhea bacteria, and trichomonas parasites cause vaginal irritation and spread to others through sexual contact.
Finding Hormonal Changes
Sometimes, lactating and postmenopausal women have vaginal irritation caused by declining estrogen. Symptoms of painful urination, itching, bleeding and painful intercourse have been associated with with about 25 to 50 percent of postmenopausal women (ref#6pg1). A 2014 article in "Menopause" finds that bacterial flora is significantly different between premenopausal, perimenopausal and postmenopausal women (ref #6, pg7 conclusion). Work with your physician to manage vaginal homeostasis, thus eliminating vaginal irritation caused by changes in estrogen.
REFERENCES & RESOURCES
- American Family Physician: Diagnosis of Vaginitis
- Centers for Disease Control and Prevention: STD Curriculum for Clinical Educators
- Annali di Igiene: Medicina Preventiva e di Comunita: Vaginal Microbiota and Viral Sexually Transmitted Diseases
- The Seattle STD/HIV Prevention Training Center: The Practitioners Handbook for the Management of Sexually Transmitted Diseases, Chapter 6 Vaginitis
- Office on Women's Health, United States Department of Health and Human Services: Douching Fact Sheet
- Menopause: Association Between the Vaginal Microbiota, Menopause Status and Signs of Vulvovaginal Atrophy
- Illinois Department of Public Health: Facts About Vaginitis and Vaginal Infections
- Mayo Clinic: Vaginitis
- Merck Manual Home Edition: Vaginal Infections