Vulvar Symptoms

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DEFINITION

• Itching or dryness of external female genital area (vulva)
• Rashes of external female genital area including: sores, redness, blisters, lumps

General Information

Common Causes of Vulvar Itching

• Contact Dermatitis - Soaps/detergents, douches, and perfumed toilet products can cause local irritation. The treatment for this is to avoid these products and maintain good genital hygiene.
• Menopause - At menopause the ovaries stop functioning, and as a result the body produces less estrogen. Without estrogen, the skin in the genital area can become thin and women notice increased dryness. There are estrogen-based vaginal crèmes or lubricants that your physician can prescribe to reduce this itching and dryness.
• Yeast Infection: Sometimes itching can be caused by a yeast infection (Candida). Often there is a new or increased vaginal discharge (thick, white, cottage cheese-like, non-odorous discharge). There are a number of over the counter medications for the treatment of vaginal yeast infections.

Other Causes of Vulvar Symptoms

• Any preexisting skin disorders/rashes can also occur on the vulva (e.g., psoriasis, eczema, drug rashes)
• Bartholin's cyst
• Irritation after sexual intercourse (e.g., inadequate lubrication causing friction abrasion, latex-condom allergy)
• Skin cancer and skin dermatoses (e.g., lichen sclerosis, squamous hyperplasia)
• Sexually Transmitted Diseases (e.g., STD's like Herpes simplex, Syphilis, pubic lice, genital warts)

See More Appropriate Topic (instead of this one) If

• PUBIC LICE
• URINATION PAIN, FEMALE
• If vaginal discharge is the main symptom, see VAGINAL DISCHARGE

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WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Severe pain
• Fever and genital area looks infected (e.g., draining sore, ulcer, rash is painful to touch)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen
• Itching that is moderate-severe (i.e., it interferes with school, work, or sleep)
• Genital area looks infected (e.g., draining sore, ulcer, rash is painful to touch)
• Rash with painful tiny water blisters

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• You are worried you might have a sexually transmitted disease
• Antibiotic treatment for 3 or more days for a Sexually Transmitted Disease (STD) and you are not improving
• Home treatment for 3 or more days for a "yeast infection" and you are not improving
• All other vulvar symptoms (EXCEPTION: feels like prior yeast infection, or painless rash present less than 24 hours)

Self Care at Home If

• Symptoms of a yeast infection (i.e. itchy, white discharge, not bad smelling), which feels like prior vaginal yeast infections, and you don't think you need to be seen
• Painless rash (e.g. redness, tiny bumps, sore) of genital area present less than 24 hours, and you don't think you need to be seen
• Mild itchiness, and you don't think you need to be seen

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HOME CARE ADVICE FOR VULVAR SYMPTOMS

1. Cleansing: Wash the area once thoroughly with un-scented soap and water to remove any irritants.
2. Genital Hygiene:
   • Keep your genital area clean. Wash daily.
   • Keep your genital area dry. Wear cotton underwear or underwear with a cotton crotch.
   • Do not douche.
   • Do not use feminine hygiene products.
3. Antifungal Medication for Yeast Infection: There are a number of over the counter medications for the treatment of yeast infections.
   • Available in the U.S.:  Femstat-3, miconzale (Monistat-3), clotrimazole (Gyne-Lotrimin-3, Mycelex 7), butoconazole (Femstat-3)
   • Available in Canada: miconazole (Monistat-3) and clotrimazole (Canesten-3, Myclo-Gyne)

   • If you are pregnant, speak with your doctor before using.

   • Do not use yeast medication during the 24 hours prior to a physician appointment (Reason: interferes with examination).

   • Read and follow the package instructions closely.

4. Expected Course: If there is no improvement within 3 days, then you will need to be examined.
5. Pregnancy test, when in doubt:
   • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
   • Follow the instructions included in the package.
6. Call Your Doctor If:
   • Pregnancy test is positive; or if you have difficulties with the home pregnancy test.
   • Rash lasts longer than 24 hours
   • Rash spreads or becomes worse
   • Fever occurs
   • No improvement after 3 days
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

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