What is Vaginal and Vulval Discomfort?

Vaginal and/or vulva discomfort is very common with most women experiencing it at least once in their lifetime. Symptoms that may occur include pain, itching, discomfort or burning. The skin in this area is very sensitive resulting in the increased chance of irritation (Healthdirect, 2021).

There are many things that can cause irritation which may include:

• an imbalance of the bacteria and microorganisms that normally live inside the vagina
• lubricants and spermicides and latex products used during sex, such as condoms
• Bartholin’s cysts
• hormonal changes, such as after having a baby or during menopause
• a skin condition such as dermatitis or eczema
• excess washing or vaginal douching (washing out the vagina)
• allergy or a reaction to hygiene products such as soaps, shower gels, shampoos, or hygiene sprays
• disinfectants, antiseptics and ointments
• washing powders or liquids
• perfumed toilet paper
• sanitary pads or tampons
• sweating
• an ingrown hair
• some medications
• discharge from the vagina
• removing pubic hair
• swimming in a chlorine pool
• wearing new underwear, especially if it is not made of cotton
• very rarely, vulval cancer.

Whilst thrush is the most common cause of vaginal and vulva discomfort in woman, unfamiliarity of other causes can result in self misdiagnosis, delays in appropriate treatment or increased incidence of adverse effects. In a study of women, half of the participants had symptoms that could be caused by something other than thrush and 25% had symptoms that required assessment by a medical professional (Sihvo et al., 2000). With this in mind, it is important to speak with a pharmacist or GP about the most appropriate treatment based on your symptoms. The more common causes of irritation are discussed below

Eczema/dermatitis

Eczema is one of the most common causes of vulval discomfort. The symptoms are very similar to that of thrush with patients experiencing itchiness and redness. Often eczema is self-misdiagnosed as thrush. It may be triggered by irritants such as sanitary pads, soaps, fragrant toilet paper or by stress. Avoiding triggers is the mainstay of treatment, however, topical corticosteroid creams may be prescribed by your GP to control flare ups. If stress is identified as a trigger, counselling may be recommended (The Royal Women’s Hospital, n.d.).

Thrush

Thrush is caused by a yeast called Candida albicans which normally occurs on the skin of the genitals. It is not a sexually transmitted disease (Jean Hailes for Women’s Health, 2021). Patients with thrush may experience itching, redness, swelling and a white cottage-cheese-like discharge. Symptoms are experienced when there is an overgrowth of this naturally occurring yeast. Causes of overgrowth include recent antibiotic use, hormone changes resulting from pregnancy or oral contraceptive use and other health conditions such as diabetes, immune system disorders or iron deficiency (Better Health Channel, 2020). Thrush is usually treated with over-the-counter treatments following a consultation with a pharmacist. However, if you have experienced two or more episodes in the space of 6 months, it is recommended you visit your GP for further investigation.

Bacterial Vaginosis

Bacterial Vaginosis (BV) is a bacterial infection caused when there is an imbalance in the bacteria found in the genital area. Symptoms of BV include a grey-white, thin discharge accompanied by a fishy odour. Untreated BV can increase the risk premature labour, spontaneous abortion, pelvic inflammatory disease, infection in the placenta or amniotic fluid or after childbirth and acquiring some sexually transmitted diseases (Better Health Channel, 2020).

Treatments

Self-management

There are some simple measures you can take to help prevent and manage the symptoms of vaginal and vulval discomfort.

• Wipe your bottom from front to back after going to the toilet.
• Wear loose fitting cotton underwear. Avoid G-strings and pantyhose.
• Use a fragrance-free washing powder/detergent and avoid fabric softeners.
• Do not apply any creams or lotions you might have at home or have used in the past without first speaking with your pharmacist or GP.
• Use 100% cotton pads or tampons.
• Rinse or remove swimwear immediately after swimming in chlorinated water.
• Avoid using soaps or shower gels in the genital area. Replace with a fragrance-free soap substitute.

Medicines

Some causes of discomfort require treatment with medication. Depending on the cause, treatments range from over the counter to prescription medicines and may be in the form of creams, ointments, pessaries or oral medicines. Speak to your pharmacist to help ensure you do not run out of your medication and to provide you with additional support and information to maximise the effects. If symptoms persist, please consult your doctor.

If you are experiencing vaginal and/or vulval discomfort, please see one of our friendly pharmacists or your GP.

REFERENCES

Better Health Channel. (2020). Bacterial Vaginosis. Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bacterial-vaginosis
Better Health Channel. (2020). Vaginal thrush. Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vaginal-thrush
Healthdirect. (2021) Vaginal and groin irritation and infection. Retrieved from https://www.healthdirect.gov.au/vaginal-irritation-and-infection
Jean Hailes for Women’s Health. (2021). Vaginal & vulval pain: know the different causes and when to seek help. Retrieved from https://www.jeanhailes.org.au/news/vaginal-vulval-pain-know-the-different-causes-and-when-to-seek-help
Sihvo, S., Ahonen, R., Mikander, H., & Hemminki, E. (2000). Self-medication with vaginal antifungal drugs: physicians' experiences and women's utilization patterns, Family Practice, Vol. 17, Issue 2, pp 145–149. Retrieved from https://doi.org/10.1093/fampra/17.2.145
The Royal Women’s Hospital. (n.d.) Eczema. Retrieved from https://www.thewomens.org.au/health-information/vulva-vagina/vulva-vagina-problems/eczema