Why do I have chronic vaginal itch? IKYANMD

September 9, 2014 11:19 PM

I have had off and on vaginal itch for 2 years. I am a virgin in my mid twenties and have seen OBGYN many times, I don't have any disease or infection that they could find with urine tests, and from swabbing my vagina. The doctor yesterday said it's probably a skin problem, they just recommended me a 0.5% hydrocortizone cream, which from my understanding only treats the symptoms, and should only be used for a short time. I mostly wear skirts to keep the area dry, and I wear cotton underwear. I shower regularly, and my job is sitting in an office, and I live in a warm city. During my menstruation the itching usually gets more intense. What other things can I try? I just came from seeing a 4th OBGYN who also prescribed me a hydrocortizone cream. Thanks.
posted by anonymous to Health & Fitness (41 answers total)

It could just be sweat from sitting all day in a warm place. Have you tried putting some baby powder or something similar on your underwear to keep things extra dry?
posted by ohisee at 11:31 PM on September 9, 2014

Do you use hypoallergenic, perfume free toilet paper, soap, sanitary products and laundry detergent? This could be a simple allergy. Keep in mind that many supposedly hypoallergenic products still contain perfume, which doesn't help if it's the perfume you're allergic to. Even using the wrong soap on my hands can lead to the symptoms you're describing (including being quite mild and random and difficult to pin down in that case), mucous membranes are crazy sensitive. I also had a try all kinds of sanitary pads and things until I found some I'm not allergic to, which could link up with your being worse during menstruation. So switch things up and see if you can find a cause that way.
posted by shelleycat at 11:31 PM on September 9, 2014 [6 favorites]

I get this a lot. Have you considered that it's a yeast infection? There are over the counter drugs. Symptoms are that there are lint like white clumps, and it's really itchy.
posted by pando11 at 11:37 PM on September 9, 2014 [1 favorite]

Using a soap-free wash and hypoallergenic toilet paper have made a positive difference in my life.

If you're in my part of the world, try QV Wash. Otherwise, your chemist should be able to recommend you something.
posted by Georgina at 11:39 PM on September 9, 2014 [1 favorite]

I had something like this for years, tried loads of different things, and it was finally solved by using a hairdryer on a cool setting to completely dry my vulva after every shower/bath I have. I think it was a pretty constant low grade yeast infection that was perpetuated by excess moisture in the area. I also make sure I always wear cotton underwear and sew crotch holes into all my leggings etc. But it was the hairdryer thing that really stopped it. Might not be the same for you, but worth a try!
posted by amerrydance at 11:44 PM on September 9, 2014 [6 favorites]

Is it possible that your pH-balance is off? I'm pretty sure that menstruation makes the vagina less acidic, so if the itching gets worse then it could be making the problem more pronounced.

You could try taking probiotics, if you don't already, which will increase the number of bacteria that help regulate the pH.
posted by kinddieserzeit at 11:46 PM on September 9, 2014 [1 favorite]

Don't use soap. Use all cotton pads during your period (if you are using Always, stop, those things work great but are murder on your skin).

I turned out to also have a dye allergy, which meant that washing my underwear with my regular clothes made me itch even if my panties were white cotton. I wash my underwear alone, on high, with All Free and Clear detergent and the problem has mostly subsided for me.

Soak in a tub with Epsom salts if you're itchy or sore, it's wonderful to calm the skin down and help it heal.
posted by lydhre at 1:24 AM on September 10, 2014 [1 favorite]

Do you shave or trim your pubes? When they're short they can poke you and make you itch.
posted by Jacqueline at 2:12 AM on September 10, 2014

Have you tried 2-3 months of using no soap in the shower (except a tiny pinch of soap on the upper body) and no-fragrance castille soap for laundry detergent only (with a second rinse cycle) and switching to a pretty extreme alkaline diet incl. zero sugars whatsoever.

Do you think it might be diet related? If so, have you looked into anti-candida diets or alkaline-forming food diets? If you're at an endroad it might be worth a stint at these diets. If you were to follow them (combined) for 8 weeks or so, then you could reintroduce things from your normal diet, slowly to see what the problem foods might be for you.
posted by Under the Sea at 3:38 AM on September 10, 2014 [1 favorite]

This may be a bit TMI... Firstly, I don't have a vagina. Secondly, I do have a lifelong eczema problem that has cropped up everywhere, including my whatsits. You don't describe if the itching has any visual symptoms (or at least, visible to the naked eye), but if it is excema, please don't be afraid of cortisone cream.

Yes, it's not great to be using it every day over and over, and yes, it does just "treat the symptoms".

But, the symptoms are horrible and completely annoying and debilating, getting them to go away is glorious!

Secondly, I find, for my eczema, at least, the cortisone creams (of decent concentration, the weak stuff is a complete waste of time for my angry angry skin) clear up the excema and symptoms, and then with rigorous maintenance I can be trouble free for quite some time. I mean, it's not like a face cream you slap on every time after you shower. You might use it once or twice a day for a few days and then be okay for a few weeks.

But even if you're not. I've used a lot of cortisone cream at times, and on areas no one really sees, any skin changes you might see (not guaranteed, in my experience, minor: can darken a bit, and make the skin feel a bit "thinner", or very very fine wrinkles and this is after, like chronic regular use for ages. Months, over a year.) are totally worth it - for me, at any rate. They would not be noticeable on any genitals I've ever witnessed.

The other thing to consider is mild bleach baths - which have been proven to have good outcomes for people with eczema (eczema peeps have low level staff infections on skin which exacerbate eczema. Bleach kills the staff, skin can heal better).

Best of luck I hope you can get this resolved.
posted by smoke at 3:45 AM on September 10, 2014 [2 favorites]

Oh yeah, PS I can't use the vast majority of soaps etc. Ego's QV, and those special skin products are all I can do. And no synthetic clothing on skin but it sounds like you have that covered.
posted by smoke at 3:47 AM on September 10, 2014

You said that you've done urine tests, but did they test for diabetes? High blood sugar can lead to persistent thrush. Even if you're not diabetic, a high sugar diet can encourage persistent and recurring thrush so try going sugar free for a week or two and see if it makes a difference.
posted by ninazer0 at 3:56 AM on September 10, 2014 [3 favorites]

Probiotics worked for me! We can all get a little out of whack down there. It is a fairly acidic environment. Sperm has something in it that counters the acidity, allowing it to survive long enough to get us pregnant (not the medical explanation). I find that when I'm going in long bouts without any happy swimmers keeping my acidity down, I get very irritated down there. The probiotics help keep me more in balance. I use Raw Probiotics for Women (Garden of Life), from the refrigerated section on the vitamin isle at Whole Foods.
posted by myselfasme at 4:53 AM on September 10, 2014

You're a virgin, but are you doing anything sexual? Please talk to the doctor about any sexy - time activities.

I have a friend who treats people who were told that mild bleach baths are harmless. And those patients are people with eczema in less delicate areas.

Good luck. Low-grade persistent problems are a beast.
posted by Lesser Shrew at 4:56 AM on September 10, 2014

HAve you tried anything like vaseline or even some baby diaper rash type creams?
posted by WeekendJen at 4:58 AM on September 10, 2014

Itching is worse during menstruation - what kind of pads are you using? Always with dry weave are TOO absorbent and can leave you itchy. Try changing up your products and see what happens.
posted by St. Peepsburg at 5:08 AM on September 10, 2014

Do your symptoms get better AFTER your period? Some women have chronic yeast overgrowth due to the hormonal changes before menstruation. The pH changes during menstruation can resolve those kinds of yeast infections but then the cycle starts back up again the next month, making it seem like you're always itching. The itching can feel more intense during menstruation especially if you're using tampons. You've been to the OBGYN so maybe they've addressed this, but this is my best guess and I would bring it up to your OBGYN. You said it 's worse during your period, if you're still using tampons, definitely stop until this gets resolved. Good luck.
posted by Katine at 5:15 AM on September 10, 2014

You could try epsom salt baths to relieve the symptoms temporarily.
posted by chickenmagazine at 6:04 AM on September 10, 2014

Depending on where exactly the itching is and what the OBGYN thinks is going on, getting a referral to a dermatologist might be a helpful step in getting this taken seriously. Keep firing doctors until you get one who listens and is willing to keep working on the problem until something works.
posted by Dip Flash at 6:38 AM on September 10, 2014

I had this problem. It went away when I stopped bringing my laundry to the local wash & fold and switched to an unscented/hypoallergenic detergent.
posted by Sara C. at 6:49 AM on September 10, 2014 [1 favorite]

I had this problem and I went to a dermatologist. She prescribed me a super-moisturizing cream but also switched my anxiety meds. I was basically in an anxiety loop about the problem. The itching gave me anxiety which made me itch more. I don't take SSRI's anymore but if I am having major itching I take a little Clonapin along with using the cream.
posted by radioamy at 7:07 AM on September 10, 2014 [1 favorite]

If you haven't changed to non-allergen/non-perfumed laundry soap (and skip dryer sheets and softeners too), do so. Lots of people react to those.

If that doesn't have a effect, try changing your diet and trying to pin down possible allergens (and too much sugar definitely can cause yeast issues). There are lots of guides online for how to approach this.

There's a pattern somewhere that's creating this situation; you just have to find it.
posted by emjaybee at 8:23 AM on September 10, 2014

Forgot to ask; are you using any kind of hormonal treatment/birth control, even for your PMS or what have you? Some women react badly to those.
posted by emjaybee at 8:25 AM on September 10, 2014

As an alternative to hydrocortizone cream, have you tried live yogurt and a garlic clove? Which sounds like a recipe to ward of vampires but is a totally mainstream treatment, I promise!
posted by DarlingBri at 8:30 AM on September 10, 2014

Are there any environmental changes that happened around the same time as the start of your itchiness?

I had an issue where I was getting all sorts of problems in that area (itchiness, discomfort, hate), and nothing my doctor prescribed/suggested worked. Until I moved to a different city and pouf it went away!

I ended up wondering if it was literally the water there.
posted by that girl at 9:11 AM on September 10, 2014 [1 favorite]

Prolonged hydrocortisone use isn't a great idea as it thins the skin over time. Get yourself a bottle of Balneol. That stuff is basically a safe comfy fluffy pillow for the genitals.
posted by theraflu at 9:16 AM on September 10, 2014

Another TMI question - how's your hygiene in the rectal area? I get terrible itchiness in front if I've had a day of loose stool or not-quite clean in back. Make sure you always wipe from front to back. Consider a separate wipe for each area, and clean thoroughly in back. Don't wear thongs.
posted by CathyG at 10:20 AM on September 10, 2014

Have you considered that you might have a mild case of jock itch? I get that sometimes, especially if I'm working out a lot. Ample regular use of Lotrimin seems to do the job.
posted by suelac at 11:14 AM on September 10, 2014

Corn starch is good at absorbing moisture and reducing itch. In the summer, when things are sweaty glowy, that's what I use.
posted by theora55 at 12:47 PM on September 10, 2014

I had the same problem in my late twenties and early thirties, and four doctors couldn't help me. Each one asked if I'd started using a new soap, laundry detergent, or any other products that came in contact with the area -- I hadn't. The culprit turned out to be (Clorox-type) bleach, which I used when laundering towels. I'd been using bleach since I entered college, but didn't become sensitive to it till I was 28.

Try making some changes in things you've taken for granted as being okay.
posted by wryly at 1:28 PM on September 10, 2014

I had trouble with this and it vanished after I started drinking (a lot) more water - I had been chronically underhydrated.
posted by bile and syntax at 4:27 PM on September 10, 2014

Welcome to TMI theater.

Get a mirror and look at your vagina. If you have patches of white, you may have lichen. I had your symptoms for years and just used the hydrocortisone cream and it worked...ok. Then my GYN told me I had lichen, it's a chronic thing, and she prescribes a cream that I use three times a week. It's a combination of steroids and anti-fungals. It's so nice not to sit in discomfort.

You might want to see a dermatologist rather than a GYN. My GYN is a wonderful lady who apparently has seen everything! Thank goodness.
posted by Ruthless Bunny at 5:54 PM on September 10, 2014 [1 favorite]

Where I live, there is a Vulva Clinic in the women's health section of a hospital. This is a specialty within a specialty. They have a booklet with some recommendations. Would highly recommend seeking out a similar specialist if possible. Alternatively, or in addition, a dermatologist is also a good suggestion.
posted by analog at 6:25 PM on September 10, 2014

Nthing all-cotton everything and the hairdryer trick. Some dematitis-type reactions are due in part to the presence of or an overgrowth of fungus on the skin, plus your immune system's reaction to it. Another problem/common irritant may be sodium lauryl or laureth sulfate, a common ingredient in soaps. You can combat both of these issues by using an SLS-free tea tree oil soap. I like The Soap Works, and in googling to remind myself of the name of the company, came across this, so apparently I'm not the only one. I have very sensitive skin, and I don't find it too harsh or drying. Other options include glycerin soap, or other SLS-free soaps available at your local health-food store or farmers market...or frankly, drugstore, since both Dove and Ivory are SLS-free, although they have other potential irritants.
posted by sarahkeebs at 7:08 PM on September 10, 2014

Ah man. I've been through this. See if someone will prescribe you topical nystatin/triamcinolone (Mycolog II) ointment. That's a combination antifungal and corticosteroid that's fairly mild (it sounds like that might be what Ruthless Bunny mentions), but pretty much knocks out whatever ails you in that area; I was eventually able to wean myself off of it entirely after a year and a half or so of roughly monthly use. Before that, people had prescribed me all manner of crap—hydrocortisone cream, antifungal cream, long-term doses of oral Diflucan—that did nothing to keep the problem from recurring.

Also, make sure that you keep your fingernails cut short and wash gently down there, without digging or scratching—I used to sometimes scrub and/or scratch extra-hard down there, and I also happened to have longer fingernails, so I was inadvertently scratching the hell out of myself, which made me itch more...

You should also try going to a dermatologist and/or an allergist to get a patch test and a prick test on your back to find out what you might be allergic to. In my case, a few years after I experienced these problems, a patch test diagnosed me with a formaldehyde allergy, an allergist diagnosed me with dermatographism (in which scratching itself begets itching)—and then I found out just how many skin-care items and soaps have formaldehyde-releasing products in them. Once I eliminated products and things in my environment that released that allergen, and was prescribed a strong antihistamine (hydroxyzine) to use as needed and a combo of over-the-counter items (the antihistamine fexofenadine and the H2 blocker ranitidine) for those times when avoidance wasn't enough, I no longer regularly had the problems you're describing.

In the meantime, if you don't want to go to the doctor again so soon, that's one thing you might try—pick up some over-the-counter Allegra (fexofenadine) and Zantac (ranitidine) and take that combo when you're especially itchy, to shut down that cycle of itching and scratching. To address potential causes, try switching to all-natural soaps and/or lotions and/or detergents, to see if you can eliminate a potential problem product.

Good luck!
posted by limeonaire at 8:40 PM on September 10, 2014 [1 favorite]

P.S. If you go to pick up an over-the-counter antihistamine, don't get cetirizine, a.k.a. Zyrtec. A lot of people recommend it—my allergist wanted to prescribe it to me—but I had a disastrous month when I previously tried it at the recommendation of my primary-care physician, then tried to stop taking it. For many people, myself included, the withdrawal itching from cetirizine is worse than the initial problem!

Oh, and the plain yogurt and garlic thing never worked for me at all, by the way. I'd save your money.
posted by limeonaire at 8:47 PM on September 10, 2014

OK, one more thing: Please note that the alkaline diet is a fad and probably will not actually fix your problem.
posted by limeonaire at 9:00 PM on September 10, 2014 [2 favorites]

Maybe cranberry pills would help if it's an internal problem. Read the reviews on amazon.
posted by PeaPod at 10:06 PM on September 10, 2014

Seconding everyone who recommends using a hair dryer on the area after showering and switching to hypoallergenic soaps and detergents. I have vulvodynia* (which feels like burning, doesn't sound like what you have) and am prone to yeast infections and non-specific irritation and itching.

Wearing a panty liner everyday has made a huge difference for me. I use Natracare (no bleach, pesticides, etc.) There are other crunchy granola brands out there at health food stores and online. I also use their pads during my period and don't use tampons. I read somewhere that it's impossible to totally get yeast out of underwear even using very hot water, which is why I started with the liners (and no reusable menstrual pads). When it's hot and/or I've been sweating, I change the liner to keep the area dry.

There's unbleached, un-dyed, organic cotton underwear out there too if you want to knock out every possible source of allergens.

Don't wear underwear to bed and avoid tight, non-breathable clothing (tights, polyester pants, etc.)

I know you said you've had swab tests to check for yeast, but if you ever do develop a yeast infection, ask the doctor for two doses of Diflucan (fluconazole) 150mg taken 3 days apart. This dosage works better for women with stubborn yeast than just taking one pill. Also, I'll mention that when I do have a yeast infection, I don't have any discharge, just the dry itchy feeling.

*On the off-chance this is some manifestation of vulvodynia, the condition is diagnosed by the doctor touching your vulva with a dry cotton bud. If that's painful, you've go vulvodynia. Feel free to memail me if you want to know more.

Good luck!! This stuff is a major drag, I know.
posted by fozzie_bear at 7:27 AM on September 11, 2014

More TMI:

Like Ruthless Bunny, I had chronic itching for years, and it turned out to be lichen. I had to go to a vaginal specialist to get the diagnosis--my old GYN was just throwing antibiotics and anti-yeast creams at me because she didn't know what else to do. My new GYN has at least heard of lichen but doesn't really have experience with it, to the point where she asked me to come in when I had a flare-up so she could see how it manifests. (I am in fact waiting right now for my appointment date to roll around so she can satisfy her scientific curiosity and I can get a refill on my prescription creams.)

I don't have distinctive white patches, but it's still some form of lichen, so even if you don't see anything, it might be worth discussing the possibility with your GYN or going to see a specialist. I was *so* relieved when I finally got the right treatment that I cried. Seriously!
posted by velvet_n_purrs at 10:31 AM on September 11, 2014

I have eczema for which the long-term treatment is 0.5% hydrocortisone cream. My flares are stress-triggered, so when it happens I try to catch it early with one or two applications and then I'm good (until I get stressed again, sigh). Point being that you should definitely try the hydrocortisone cream--I get immediate relief within 24 hours--and you might not even have to use it that frequently.
posted by serelliya at 4:52 PM on September 22, 2014