Having a vagina is awesome for many reasons. Like, the fact that we can have multiple orgasms is incredible and oh, yeah, that whole growing and birthing a human thing, too. But the complicated magic of our lady parts is also what makes ’em aggravating not just once a month but when they’re irritated by all manner of things—from carb overload, stress, or chemical-laden laundry detergent.
You might be convinced that the urge to claw at your vag signals a yeast infection. Up to 75 percent of women have to deal with at least one vaginal yeast infection in their lifetime, and for many of us, they’re annoyingly common. One study from 2013 found that more than one-fifth of women diagnosed with yeast reported a 12-month period with 4 or more infections. But “everything isn’t yeast,” says Angela Jones, MD, OB/GYN aka Dr. Angela.”If that over-the-counter Monistat isn’t working, perhaps it isn’t yeast that you have. I see this all the time!”
Here, 6 reasons your lady parts may be irritating TF out of you—and what to do.
1. Bacterial vaginosis (BV)
What it is: BV is often mistaken for yeast, because the symptoms may feel similar, and both issues stem from naturally-occurring bacteria in the vagina being out of whack. Usually, you have more good bacteria (lactobacilli) than “bad” (anaerobes). When the balance of these microorganisms gets thrown off—often for a variety of reasons, from douching to having a new or multiple sex partners to emotional stress or some foods—you could end up with BV.
BV is associated not only with itching but specific symptoms like thin, gray, white or green vaginal discharge, a “fishy” vaginal odor, and burning during urination.
What to do: See your OB/GYN for a proper diagnosis. They can usually confirm whether you have BV or not by doing a quick swab and examination of discharge. The typical treatment involves antibiotics, either taken as pills or a gel that you insert into your vagina. If you are treated with antibiotics, you may also want to consider taking probiotics containing the strains Lactobacillus rhamnosus and Lactobacillus reuteri simultaneously. In a 2006 study, 88% of women with BV were cured after taking antibiotics and probiotics, compared to just 40% in a group that took antibiotics and a placebo.
2. Contact dermatitis
What it is: It’s possible your vag is just aggravated by a skin allergy, triggered by a perfume or additive in your new body spray, body wash, new laundry detergent, or even a chemical in the lube or condoms you’re using, etc. Shaving may do it, too. If you’re red, swollen, and there’s skin thickening anywhere around your vulva, it may be contact or irritant dermatitis—also referred to vaginitis.
What to do: First, get rid of whatever product is causing the issue. You can also soak in a lukewarm bath with 4-5 tablespoons of baking soda to help soothe vulvar itching and burning, according to experts at Drexel Medicine in Philadelphia, PA. From that point on: “Less is more!” Dr. Jones says. “Use boring soaps with no perfumes or scents. Go commando! Wear clothes that allow your vagina to breathe.” That means choosing cotton undies and backing off of restrictive shapewear (probably a good practice if your itching is caused by any of the things listed here!).
What it is: If you suffer from this inflammatory skin condition, it’s possible you could end up suffering from itchiness and red patches on your vulva, just as easily as other parts of your body. According to the Harvard Women’s Health Watch, eczema may initiate a cycle of vulvar itching and scratching that leads to lichen simplex chronicus—thickened and intensely itchy skin. If eczema affects an area of the vulva called the vestibule, it may cause stinging and burning. Sometimes eczema appears in early childhood and its cause is unknown. More often, it begins with exposure to an irritant or allergens (see #2).
What to do: See your OB/GYN, who will be able to diagnose you and prescribe a topical corticosteroid ointment which you’ll likely be told to apply twice a day for two to four weeks and then gradually reduce the frequency until the symptoms are gone.
4. A sexually-transmitted disease
What it is: Not trying to freak you out, but the fact is that unprotected sex can lead to all manner of STDs—from chlamydia to herpes, gonorrhea to trichomoniasis. Any of these can cause itching down there. You may also have symptoms like burning when you urinate, unusual discharge, sores, pain during sex, etc.
“If you are having funky, yellow or green discharge, pain, and it doesn’t seem to be going away, you need to go get checked out!” Dr. Angela says. “No one thinks it can happen to them. Part of the reason we screen women 25 and under for gonorrhea and chlamydia at the time of their annual exam.”
What to do: You’ll take a test for an STD and if you test positive, your doctor will treat you with antibiotics (or an antiviral drug, if you have herpes).
5. An autoimmune disease
What it is: Lichen sclerosus is an uncommon skin condition that may be triggered by an overactive immune system. It’s marked by patchy, white skin that’s thinner than normal and can affect skin anywhere on your body, according to the Mayo Clinic. Usually, though, you’ll notice it on the vulva or skin around the anus. (Guys can get it too on their foreskin.)
What to do: Your doctor can diagnose lichen sclerosus with a physical exam and/or looking at a sample of the affected skin under a microscope. The usual treatment plan involves corticosteroid ointments or creams that help reduce itching and irritation.
What it is: Yeast, including candida, and bacteria usually coexist in balance in the vagina. But when that balance is disrupted, you can end up with a yeast infection, which can cause itching, burning, vaginal pain and soreness, watery vaginal discharge, a rash, and a thick, white, odor-free discharge.
Moisture and heat spur the growth of yeast, so beware wearing those Spanx too often or staying in sweaty yoga pants too long after the gym. There’s also evidence that eating or drinking too many simple carbs/sugars can trigger an infection, so you may need to back off of the wine and pizza.
“Antibiotics can shift the balance of organisms in the vagina which can indirectly affect its pH,” Dr. Angela says. “And poorly-controlled diabetes lends itself to women getting lots of yeast infections.” She also notes that being overweight, suffering from a compromised immune system, pregnancy and any other states where there is hormonal flux—like taking birth control pills—are all risk factors.
What to do: “If you aren’t 100% sure what is going on, you should contact your OB/GYN,” Dr. Angela says. Even if you get yeast infections all the time, your doctor can make sure that you’re not battling a treatment-resistant strain, like C. glabrata or C. krusei, which would require a different protocol than the usual antifungal pill (fluconazole) and/or antifungal cream (one of the azoles, like over-the-counter Monistat which is Miconazole, or Gyne-Lotrimin which is clotrimazole).
Even if it is the typical C. albicans strain, your doctor can help you figure out the best treatment plan, like taking antifungal drugs, as well as targeted probiotics (like Garden of Life RAW Probiotics Vaginal Care) and adjusting your diet and lifestyle.