A dry, itchy vagina can occur when the vagina is not effectively lubricated. In addition to the distress caused by itching, the vaginal dryness can make sexual intercourse painful. There are many causes of vaginal dryness and itching but it is most commonly encountered in women undergoing menopause, when it is known as menopausal atrophic vaginitis.
Symptoms of Vaginal Dryness
- Painful intercourse.
- Light bleeding during intercourse.
- General discomfort.
Women going off hormone replacement therapy (HRT) or those under severe stress may find the symptoms of vaginal dryness worsening.
- Decreased estrogen levels which occur during menopause, either normal menopause or following removal of the ovaries. During menopause the estrogen level drops and this results in making the vulvar and vaginal tissues thinner, drier and less elastic.
- Diminished vaginal secretions during menopause result in less lubrication of the vagina.
- Decreased estrogen also reduces the acidic environment of the vagina, making it more susceptible to infections, causing vaginal itching.
- Prepubertal atrophic vaginitis, seen in girls before they reach puberty, may occur similarly due to lack of endogenous estrogen.
- Chronic vaginal infections – bacterial, fungal (candidiasis) or protozoal (trichomonal).
- Sexually transmitted diseases.
- Genital herpes.
- Vaginal warts.
- Certain skin diseases – the labia are covered with normal skin, so it can be affected by skin conditions such as :
- Psoriasis. Sometimes, only the skin around the vulva is affected in psoriasis, with no other sign on the rest of the body. It can cause severe itching.
- Lichen sclerosus is an extremely itchy skin condition which can affect the vulva. Although it can occur at any age, it is more common in menopausal women or in young girls before the onset of puberty. The vulvar skin becomes thin and whitish and if no treatment is undertaken, the labia may ultimately shrink, with narrowing of the vaginal opening.
- Sjogren’s syndrome is an autoimmune disease characterized by inflammation of the glands, mainly of the eyes and mouth, leading to extreme dryness of the mouth and eyes. Less commonly, the glands lining the vagina may become inflamed, causing vaginal dryness and itching, manifested as pain during intercourse and recurrent vaginal infections.
- Allergies to chemicals present in sprays, soap, bubble bath, toilet paper, deodorant tampons.
- Latex condoms or spermicide gels may cause irritation, leading to vulvar and vaginal itching.
- Inadequate personal hygiene.
- Frequent vaginal douching can cause vaginal dryness and itching.
- Certain medication such as antihistamines, antihypertensives, antidepressants and corticosteroids.
- Vulval intraepithelial neoplasia is a precancerous lesion of the vulva, affecting mainly older women. Itching may be the first sign.