Vulvar Itching and Pain: Common Causes

Vulvar Itching and Pain: What Could Be Causing It?

Key Things to Know About Vulvar Itching and Pain

• The vulva is the external genital area, including the labia and the opening of the vagina, and it is different from the vagina itself
• Yeast infections, contact irritation and bacterial vaginosis are the most common causes of vulvar itching
• Lichen sclerosus is a chronic skin condition that causes persistent itching and needs a doctor's diagnosis
• Scented soaps, detergents, synthetic underwear and heavy sweating are common everyday irritants
• Hormonal changes, particularly around menopause, can cause dryness and thinning of vulvar skin
• Symptoms lasting more than a week, or recurring repeatedly, are worth having assessed rather than self-treated

Getting the Terms Right

The vulva refers to the external genital area — the labia, clitoris and the opening of the vagina. The vagina is the internal canal. Symptoms can affect either area, or both, and identifying which is involved helps narrow down the cause. Itching and irritation are most often vulvar, on the skin itself, while unusual discharge more often points to something happening inside the vagina.

Yeast Infections

A yeast infection, caused by an overgrowth of candida, is one of the most common causes of vulvar itching. It typically comes with a thick, white discharge, redness and swelling, and a burning sensation, particularly during urination or sex. Yeast infections are common, not a sign of poor hygiene, and usually respond well to antifungal treatment, available over the counter or by prescription for recurrent cases.

Bacterial Vaginosis

Bacterial vaginosis happens when the natural balance of bacteria in the vagina shifts. It often causes a thin, grey discharge with a strong odour, sometimes described as fishy, along with mild itching. Unlike a yeast infection, burning is less common. It needs a specific antibiotic treatment, so a proper diagnosis matters before treating symptoms.

Irritation and Contact Dermatitis

Vulvar skin is sensitive, and everyday products can trigger irritation or an allergic reaction. Scented soaps, bubble baths, laundry detergent, fabric softener, synthetic or tight underwear, and even some lubricants or condoms are common culprits. This type of irritation usually causes redness and itching without discharge, and tends to improve once the irritant is removed.

Lichen Sclerosus

Lichen sclerosus is a chronic skin condition that causes persistent itching, along with thin, white, patchy skin around the vulva. It can lead to changes in the shape of the labia over time if untreated. It is not caused by poor hygiene or an infection, and does not resolve on its own. Diagnosis and treatment, usually a topical steroid, come from a doctor, and ongoing monitoring matters because the condition carries a small increased risk of skin changes if left unmanaged.

Hormonal Changes and Dryness

Falling oestrogen levels, most often around perimenopause and menopause, thin and dry the vulvar and vaginal skin, a change known as vaginal atrophy. This can cause itching, discomfort and pain during sex. It is a direct result of hormonal change rather than infection, and responds well to targeted treatment, including vaginal moisturisers or, when needed, local oestrogen therapy.

Sexually Transmitted Infections

Some STIs, including herpes and trichomoniasis, can cause vulvar itching, pain or sores. Herpes typically causes painful blisters or ulcers, while trichomoniasis often causes itching alongside a frothy, unusual-smelling discharge. Testing is the only reliable way to confirm or rule these out, and treatment differs from the causes above.

When to See a Doctor

Speak with a healthcare provider if you are:

• Experiencing itching or pain that lasts more than a week or keeps returning
• Noticing sores, blisters, or skin that looks white, thin or different from usual
• Having discharge with an unusual colour, texture or smell
• Unsure what is causing the symptoms, especially before trying repeated home treatment

The Eshe Doctors & Clinics directory can help you find a gynaecologist near you, and the Symptom Tracker lets you log when symptoms started and how they've changed, which is useful information to bring to an appointment.