Vulva itches at night

It is very normal for women to suffer from gynecological diseases. Some women do not develop good habits in their daily lives. They do not pay attention to their private hygiene, do not clean their private parts and change their underwear every day, which can easily lead to the growth of bacteria. After the growth of bacteria, they will feel vulvar itching, and may even develop vulvar folliculitis. So what should I do if my vulva itches at night?

Bacterial vaginosis refers to a non-inflammatory disease of the vaginal mucosa caused by multiple pathogens such as Gardnerella and certain anaerobic bacteria. It is mostly transmitted through sexual contact and is now classified as a sexually transmitted disease. Frequent and chaotic sexual life has become the main route of transmission of bacterial vaginosis. The presence of reproductive tract infection and poor vaginal hygiene are the triggering factors of the disease.

[Clinical manifestations]

The typical clinical symptoms of this disease are a significant increase in abnormal vaginal secretions, which are thin, homogeneous or thin, pasty, grayish white, grayish yellow or milky yellow, and have a special fishy odor. Since alkaline prostatic fluid can cause the release of amines, the odor will worsen during or after sexual intercourse. The pH value of the vagina increases during menstruation, so the odor may also increase during or after menstruation. The patient has discomfort in the vulva, including varying degrees of vulvar itching, which generally has no obvious time limit, but the itching is more obvious when resting or under stress. There is also varying degrees of external burning sensation, and some patients experience pain during sexual intercourse. Very few patients experience lower abdominal pain, difficulty in sexual intercourse, and abnormal urination. The vaginal mucosal epithelium shows no obvious congestion when the disease occurs.

This disease can often be combined with other vaginal sexually transmitted diseases, so its clinical manifestations may vary depending on the comorbidities. For example, when combined with gonococcal infection, vaginal discharge may appear obviously purulent, and urinary tract irritation symptoms such as dysuria and dysuria may occur; when combined with Trichomonas infection, foamy vaginal discharge may appear, and the itching may be aggravated and extremely itchy; when combined with Candida infection, vaginal discharge may appear curd-like or tofu-like.

〔Differential diagnosis〕

1. Trichomonas vaginitis: severe vulvar itching, vulvar discharge is foamy rather than pasty, and has no fishy odor. Microscopic examination shows an increase in leukocytosis and active Trichomonas can be seen.

2. Candidal vaginitis: It may also be accompanied by obvious itching of the vulva. The vaginal discharge is thicker white or yellowish-white curd-like or tofu-like. The vaginal wall is often congested, and microscopic examination shows an increase in leukocytosis. Candida spores and hyphae can be found and cultured.

3. Gonococcal cervicitis: When gonococcal cervicitis occurs, the cervix is ​​obviously congested, and a large amount of yellow viscous purulent secretions can be seen in the cervical opening and vagina. Patients often have urinary tract irritation symptoms, and microscopic examination shows the presence of Gram-negative diplococci in the epithelial cells.

4. Sexual psychological abnormalities or venereal disease hypochondriasis: Patients often have a history of unclean sexual life or know that their spouse has a history of transmitted diseases, and they feel discomfort in the vulva, such as varying degrees of itching and pain and insect bites, but there are no abnormalities in vaginal secretions, no clue cells or occasional ones, and no other pathogens are detected.