Vaginal or vulval itching: is it always a yeast infection?

English version

Itching around the vagina or vulva—the external genital area—may have several causes. A yeast infection is one possibility, but itching does not automatically confirm a fungal infection. Repeatedly using antifungal medicine without confirming the cause may delay appropriate treatment.

What can cause vaginal or vulval itching?

• A vaginal yeast infection, another vaginal infection or a sexually transmitted infection.
• Irritation from perfumed soap, intimate wash, deodorant or sanitary products.
• Sensitivity to detergents, condoms or lubricants.
• Moisture, sweating or tight clothing.
• Vaginal dryness during breastfeeding, perimenopause or menopause.
• Skin conditions such as eczema, psoriasis or lichen sclerosus.
• Changes associated with diabetes or some medicines.
• Less commonly, abnormal changes affecting the vulval skin.

Itching, soreness, burning, swelling and redness may occur with candidiasis, but these symptoms alone are not specific enough to confirm the diagnosis.

Are discharge and smell important?

• Thick white discharge with itching may occur with a yeast infection.
• Thin discharge with a fishy smell may be associated with bacterial vaginosis.
• Yellow, green or frothy discharge requires assessment for infection.
• Sores, blisters or ulcers may require infection testing or skin assessment.
• Itching without discharge can occur with irritation, dryness or a skin condition.

Symptoms overlap, so examination or laboratory testing may be needed before selecting treatment.

When should you consult a gynaecologist?

• This is your first significant episode, or symptoms are severe, persistent or repeatedly return.
• Non-prescription treatment has not helped.
• There is unusual discharge, unpleasant smell, sores, swelling or a skin-colour change.
• Passing urine or having sex is painful.
• Symptoms began after unprotected sex or with a new partner.
• You are pregnant, have diabetes or have reduced immunity.
• Symptoms began during breastfeeding or after menopause.
• One patch remains itchy, thickened, pale, dark or painful.

What can you do while awaiting advice?

• Wash the external area gently with water or a mild, unscented substitute.
• Avoid vaginal douching and perfumed intimate products.
• Keep the area dry, change damp clothing promptly and wear breathable underwear.
• Avoid scratching and stop any new product that worsens irritation.
• Avoid sexual contact if it is painful or an infection is possible.

Do not put household remedies, antiseptics or food products inside the vagina. Avoid repeatedly using antifungal creams unless the diagnosis is reasonably clear or a clinician has advised them. Hormonal treatment for menopausal dryness is not appropriate for everyone and requires individual advice.