By Dr. Rachna Pande
Mrs. R, a 35 year old woman started having itching over her private parts. She found it very embarrassing and avoided talking about it to anyone. She tried some antiseptic powders, douches, creams, etc. on her own, but nothing changed. Finally as the problem persisted, she had to consult a doctor. After examination and tests, she was told that it was a fungal infection. After taking prescribed medicines for about 4 weeks, she became alright.
Itching over the private parts becomes very embarrassing, particularly for a woman. It causes much discomfort as she cannot scratch it for obtaining some relief publicly. There are many reasons for this problem, fungal infection being one of the most common. Dampness caused due to wetness, particularly during menses, sexual intercourse, are risk factors for causing candidiasis, a kind of fungal infection.
Along with itching, there may be vaginal discharge and white curd like plaques. Those with immune depression like HIV/AIDS patients or those suffering from uncontrolled diabetes, are more vulnerable to develop this condition. This can be diagnosed clinically as well as with laboratory tests. It is curable with anti-fungal treatment. Other infections causing genital itching like viral warts, trichomoniasis, Chlamydia, can be acquired by sexual intercourse. These are curable conditions with suitable anti microbial. Bacterial infections can also cause itching. Here, itching may be associated with pain in the lower abdomen, boils, genital discharge, one or more of these symptoms. This is also easily diagnosed by microscopic examination of the discharge and is curable with antibiotics.
Infection over the private parts can be prevented by improving sexual and menstrual hygiene. One should avoid intercourse with a partner having genital sores, itching and or discharge. After sex, a woman should pass urine and clean the vagina. This ensures that any infective germs deposited or just entered, will be washed off. During menstruation, a lady should ensure that she does not become “damp”. The sanitary pads used should be changed frequently.
The skin over vulva and vagina is very delicate. Using hot water over it can cause irritation of the skin, resulting in discomfort and even itching. Chemicals present in soaps, douches, scented wipes, etc products used over the private parts can also irritate the skin and cause itching. Itching can also be due to allergy to one or more of these products. One should avoid using hot water to clean these parts. Also products with strong chemicals should be avoided. After a shower, the delicate genital parts should not be scrubbed dry. It should be patted dry softly with a soft towel. Vaginal tampons are yet another source for both infection and irritation of the private parts. Hence unless absolutely necessary as participating in sports like swimming during menses or long travel, they should be avoided.
Nylon undergarments increase the risk of this problem and aggravate it. Hence one should avoid them. Soft cotton under garments is always a better and healthy choice. With advancing age, the level of estrogen reduces in the body of a woman. This hormone is responsible for the feminizing features of a woman and also keeping the vagina moist. Around menopause, the moisture of the vagina reduces and dryness sets in. This also leads to uncomfortable itching in middle aged and elderly women. Some good lubricating creams or even estrogen containing creams are helpful in this regard.
Moreover, a woman should understand that itching over her private parts is a health related problem like in any other part of the body. Hence faced with it, she should come forwards and seek medical advice. Delay in treatment can lead to complications like pelvic infections and its sequel. Persistent itching carries the risk of secondary infection due to scratching.
Dr. Rachna Pande, Internist-former H.O.D. internal medicine, Ruhengeri Hospital.
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