Vaginal itching and discharge - Adult and adolescent
Vaginal discharge refers to secretions from the vagina. The discharge may be:
- Thick, pasty, or thin
- Clear, cloudy, bloody, white, yellow, or green
- Odorless or have a bad odor
Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It can also occur on its own.
Pruritus vulvae; Itching - vaginal area; Vulvar itching
Glands in the cervix and the walls of the vagina normally produce a clear mucus. This is very common among women of childbearing age.
- These secretions may turn white or yellow when exposed to the air.
- The amount of mucus produced varies during the menstrual cycle as hormone levels in the body change.
The following factors can increase the amount of normal vaginal discharge:
- Feeling stressed
- Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle)
- Sexual excitement
Different types of infections may cause itching or a discharge in the vagina. These include:
- Infections spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis.
- Vaginal yeast infection, caused by a fungus.
- Normal bacteria that live in the vagina that overgrow, causing a gray discharge and fishy odor. This is called bacterial vaginosis (BV). BV is not often spread through sexual contact.
Other causes of vaginal discharge and itching may be:
- Menopause and low estrogen levels, which may lead to vaginal dryness and other symptoms (Atrophic vaginitis).
- Forgotten tampon or foreign body, which may cause a foul odor.
- Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams, which may irritate the vagina or the skin around the vagina
Less common causes include:
- Cancer of the cervix or vagina
- Skin conditions, such as desquamative vaginitis and lichen planus
Keep your genital area clean and dry when you have vaginitis.
- Avoid soap and just rinse with water to clean yourself.
- Soak in a warm, not hot, bath may help your symptoms. Dry thoroughly afterward.
Avoid douching. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.
Other tips are:
- Avoid using hygiene sprays, fragrances, or powders in the genital area.
- Use pads and not tampons while you have an infection.
- If you have diabetes, keep your blood sugar levels in good control.
Allow more air to reach your genital area. You can do this by:
- Wearing loose-fitting clothes and not wearing panty hose
- Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Cotton increases air flow and decreases moisture buildup.
- Not wearing underwear at night when you sleep.
Girls and women should also:
- Know how to properly clean their genital area while bathing or showering.
- Wipe properly after using the toilet -- always from front to back.
- Wash thoroughly before and after using the bathroom.
Always practice safe sex, and use condoms to avoid catching or spreading infections.
When to Contact a Medical Professional
Call your health care provider right away if you have vaginal discharge and:
- Fever or pain in your pelvis or belly area.
- You had a sexual partner with gonorrhea, chlamydia, or other STI.
Changes that could indicate a problem such as infection include:
- Have a sudden change in the amount, color, odor, or consistency of discharge
- Have itching, redness, and swelling in the genital area
- Think that your symptoms may be related to a medicine you are taking
- Are concerned that you may have a STI or you are unsure if you have been exposed
- Have symptoms that get worse or last longer than 1 week despite home care measures
- Have blisters or other sores on your vagina or vulva.
- Have burning with urination or other urinary symptoms. This may mean that you have a urinary tract infection.
What to Expect at Your Office Visit
Your doctor will take a medical history and perform a physical exam including a pelvic exam.
Tests that may be performed include:
- Cultures of your cervix
- Examination of vaginal discharge under the microscope (wet prep)
- Pap smear
- Skin biopsies of the vulvar area
Treatment depends on the cause of your symptoms.
Eckert LO, Lentz GM. Infections of the lower genital tract. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds.Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 23.
Merritt DF. Vulvovaginitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 543.
Schrager SB, Paladine HL, Cadwallader K. Gynecology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.