Patient's question:
Two days before menstruation, I suddenly felt a strange itching and pain in the external genitalia, accompanied by redness and swelling, but there was no cottage cheese-like discharge. Just as I was about to go to the hospital for a check-up, my period started again. I could only buy a bottle of Jie'er Yin to wash with. After washing for three days, there was some improvement. This kind of situation recurs two or three times a year. I don't know if it's candidiasis or vulvitis. I take a shower every day and maintain good personal hygiene, but I don't know what's going on.Doctor's answer:
There are many causes of vulvar itching, such as the irritation from physical and chemical factors in daily life, systemic diseases, local vulvar lesions, and infections, which can all be pathogenic factors. However, there are also cases of vulvar itching with no identifiable cause.Guidelines:
(1) Infection factors: Trichomoniasis infection or fungal infections are the most common causes of vulvar itching. During trichomoniasis vaginitis or bacterial vaginosis, or cervical erosion, an increase in vaginal discharge and inflammatory secretions can irritate the vulvar skin and mucosa, causing itching. Additionally, pubic lice, scabies in the genital area, and some sexually transmitted diseases can also lead to vulvar itching. Pinworm disease is more common in young girls, primarily causing itching around the anus, which can extend to the vulva and occur at night.
(2) Local vulvar lesions: Vulvar skin diseases such as eczema, neurodermatitis, chronic vulvar dystrophy, and vulvar tumors can all be causes of vulvar itching.
(3) Poor hygiene habits: Failure to clean the vulva properly, allowing vaginal discharge or menstrual blood to accumulate in the genital area, can cause itching. Conversely, frequent washing of the vulva multiple times a day, or using soaps with strong alkali or potassium permanganate baths, can make the vulvar skin excessively dry, also leading to itching.
(4) Inappropriate clothing: Preferring synthetic underwear or using menstrual pads made of rubber or plastic can hinder vulvar skin ventilation, leading to sweat retention and itching.
(5) Allergies: Allergic reactions to systemic or local vulvar medications can cause vulvar itching.
(6) Systemic diseases: Vulvar itching caused by systemic conditions such as vitamin A and B deficiencies, jaundice, anemia, or leukemia is part of general itching. The diabetic condition's glucose irritation to the vulva is also a common cause of itching. Additionally, obese individuals may experience vulvar itching due to excessive sebum and sweat gland secretion, which irritates the vulva.
(7) Stool and urine irritation: In very rare cases, patients with ureterovaginal fistula, incontinence, or anal fistula may experience chronic irritation from stool or urine, leading to itching.
(8) Psychological factors: Some patients may have unidentifiable causes of vulvar itching, possibly due to excessive stress.
(9) In a few cases, itching may occur before menstruation or during pregnancy due to vulvar congestion, with no abnormal clinical findings.