What should I do if I have vulvar itching during the epidemic?

This is the 3809th article of Da Yi Xiao Hu

During the epidemic, many people "enjoyed" a period of happy fat house at home. Unknowingly, it is the rainy season again. Because the air humidity is high, the temperature is high, and clothes are prone to mold during the rainy season, it is also called "mold" rain. Therefore, some gynecological problems will also easily come to the door. "Vulvar itching" is actually a very common problem for us gynecologists, but many women find it difficult to talk about it, and due to the impact of the epidemic, they don't want to go to the hospital. However, this problem makes many women very troubled, so today we will talk about the topic of "vulvar itching".

Normal leucorrhea

When talking about vulvar itching, we must first understand the "barometer" of our female health - leucorrhea. Leucorrhea is a mixture of vaginal mucosal exudates, cervical canal and endometrial gland secretions, and its formation is related to the action of estrogen. To put it bluntly, leucorrhea is vaginal discharge during non-menstrual period. Normal physiological leucorrhea is white and thin or egg white-like, sticky, small in quantity, and has no fishy smell. Especially during the ovulation period, leucorrhea will be more obvious, transparent, slightly sticky or egg white-like. 2-3 days after ovulation, leucorrhea will become slightly turbid, the viscosity will increase, and the amount will decrease. Before the menstrual period, due to pelvic congestion, the vaginal mucosal exudates will increase, and the leucorrhea will increase again. Therefore, simply having a lot of leucorrhea is not an abnormal situation, so don't be too nervous.

Abnormal vaginal discharge

Generally, women who experience vulvar itching often have abnormal leucorrhea.

If the leucorrhea is grayish yellow or yellowish white, foamy, and thin in texture, it is generally considered to be related to Trichomonas vaginitis.

If the leucorrhea is in the shape of tofu dregs or curds, the vulva is extremely itchy, and there is even vulvar edema, this situation is generally considered to be related to candidal vaginitis.

If the leucorrhea is grayish white or grayish yellow with a fishy smell, or if it is purulent, yellowish green with a foul odor, it is generally considered to be related to bacterial vaginosis.

If vulvar itching occurs and is combined with the above abnormal leucorrhea, it is recommended that you see a doctor in time, have a routine leucorrhea check, and take symptomatic medication to solve the urgent problem.

Is vinegar really a magic medicine for washing?

Some female friends also said, "I usually have itchy vulva, and I just wash it with vinegar!"

No! This is also wrong.

There are more than 20 kinds of bacteria in the vagina of healthy women, and most of them are lactobacilli. As we all know, the yogurt we usually drink also contains lactobacilli, which has a good regulating effect on our intestines. Lactobacilli also have a protective effect on our vaginal environment, which can inhibit or kill other bacteria or microorganisms that over-grow, allowing the vaginal flora to coexist harmoniously. This is the "self-cleaning" function and balance state of our vagina. These lactobacilli can secrete lactic acid, so the normal vagina is in an acidic environment (pH3.8-4.4), which can prevent various vaginitis.

Some female friends will ask, shouldn't we use vinegar to wash? No! If you use acidic wash to wash the vagina for a long time, it will cause the pH value of the vagina to decrease. Such an environment is conducive to the growth of yeast and may cause candidal vaginitis! If it is candidal vaginitis, you should use alkaline wash. Using vinegar to wash will aggravate the symptoms.

Different types of vaginitis require different treatment drugs, and you should not blindly buy drugs for treatment. Moreover, if the drugs are used in the wrong way, the infection will be aggravated. For example, bacteria and fungi inhibit each other. If you mistakenly use drugs to kill bacterial vaginitis when you are suffering from fungal vaginitis, the fungal vaginitis will become more and more serious. Therefore, you should be cautious when using drugs for external washing.

Leukoplakia vulvae

This is also a type of vulvar itching that is easily overlooked. The vulvar itching in this case is particularly unbearable, and the course of the disease is long and prone to recurrence. This disease is also called "vulvar lichen sclerosus" and "vulvar dystrophy". It is a chronic disease in which the skin tissue of the female vulva undergoes degeneration and pigmentation changes. Menopausal women are a high-risk group for this disease. Upon examination, it will be found that the mucous membrane turns white, the skin becomes rough, and even cracks and atrophy occur. At this time, it is also recommended to visit a gynecological clinic. You can consider using local glucocorticoids or Chinese medicine external washes to control itching. If the disease recurs, a vulvar biopsy is recommended to rule out malignant diseases if necessary.

Senile vaginitis

For elderly female friends, vulvar itching is also prone to occur, which is also called "atrophic vaginitis". This is due to the decrease in estrogen levels, which has destroyed the balance of vaginal microecology. It is often manifested as persistent vulvar and vaginal itching, increased leucorrhea, white or light yellow, and a burning sensation, and is often accompanied by urinary system symptoms such as frequent urination, urgency and pain. Therefore, senile vaginitis has no direct relationship with poor hygiene habits and chaotic sexual life. Clinical studies have found that 25%-50% of postmenopausal women will have obvious symptoms and signs of vaginitis, but 75% of them will refuse to see a doctor for various reasons, such as being embarrassed to speak up. Moreover, unlike other menopausal symptoms, the symptoms of senile vaginitis will not disappear with the passage of time, and continuous drug treatment is required to maintain the efficacy. Therefore, you cannot hide your illness and avoid medical treatment, and you still need to see a doctor in time.

Daily hygiene at home

During the epidemic, although the range of activities is reduced, we still need to pay attention to hygiene issues, which can avoid most vulvar itching problems.

√ Wear loose, breathable and comfortable outer pants and cotton underwear to avoid stuffiness and airtightness.

√ Wash the vulva every day with warm water, do not rinse the vagina; also wash the vulva before and after sex

√ Change sanitary napkins frequently during menstruation to prevent blood from becoming the best culture medium for bacteria

√ If you have vulvar itching, see a doctor as soon as possible to identify the cause, then treat the symptoms. Do not blindly use medication or abuse lotions.

Author: Shanghai First Maternity and Infant Health Care Hospital

Wu Shengnan, attending physician of the Department of Integrated Traditional Chinese and Western Medicine