Vaginal Itching During Pregnancy and Remedies

Key takeaways:

• Vaginal itching occurs when the skin in and around the vagina is irritated, swollen, and itchy.
• Vaginal itching during pregnancy can be caused by candidiasis (yeast infection), bacteria vaginosis (imbalance of the natural bacteria in the vagina), skin conditions like eczema, dermatitis, and irritation from soaps and scented body products.
• Your doctor can prescribe medications like Metronidazole, which is effective in treating bacterial vaginosis and sexually transmitted parasitic infections like Trichomoniasis. 
• If you have severe vaginal itching during pregnancy, see a healthcare provider for proper diagnosis and treatment, as recurrent candidiasis in pregnancy can be due to gestational diabetes.

Vaginal itching during pregnancy happens when the skin in and around the vagina is irritated, swollen, and itchy. 

Sexually transmitted infections like Trichomoniasis, an allergic reaction to detergent, lotion, or soap used during pregnancy, and candidiasis (yeast infection) can cause vaginal itching.

Read on to learn the possible causes of vaginal itching during pregnancy and how you can get rid of it.

Is vaginal itching a sign of pregnancy? Is it normal?

No, vaginal itching is not considered a sign of pregnancy. The signs of pregnancy include missed periods, nausea and vomiting (morning sickness), breast tenderness, and fatigue.

But while vaginal itching is not a sign of pregnancy, many people experience it during pregnancy. It may also be considered normal during pregnancy in that hormonal changes during pregnancy can cause PH imbalances, which can lead to vaginal itching.

Causes of vaginal itching during pregnancy

Here are some common causes of vaginal itching during pregnancy. 

1. Candidiasis

Candida is a fungus naturally present in the vagina of women and causes no harm when the vaginal environment is healthy. However, during pregnancy, several changes take place in a person’s body, which increases the risk of developing candidiasis (commonly called vaginal yeast infection). 

Such changes include higher levels of estrogen and progesterone, leading to increased glycogen production. This can make the vaginal pH less acidic, thereby increasing your chances of having an itchy vagina due to candida overgrowth.

Additionally, Lactobacillus bacteria, which usually keeps the vaginal environment healthy, can be disrupted. These changes and a weaker immune response make it easier for candida to overgrow and cause symptoms like vaginal itching and discomfort during pregnancy.

2. Bacterial vaginosis

Bacterial vaginosis is a common condition among women in their childbearing years, especially in Africa. It occurs as a result of an overgrowth of certain bacteria in the vagina. 

This imbalance causes symptoms such as vaginal itching and discharge that smells fishy and is usually thin and gray or white. Pregnant women who have bacterial vaginosis have a higher risk of giving birth to premature babies.

3. Skin conditions

Skin conditions like eczema, dermatitis, or lichen planus (a disease that affects the skin and mucous membranes) can cause itchy and sore patches on the body, including the vulva. These can give rise to soreness, pain, and itching. Pregnancy can sometimes worsen these symptoms.

4. Allergic reactions and irritations

During pregnancy, the skin becomes more sensitive due to hormonal changes and increased blood flow, making it more susceptible to irritation. Harsh soaps and scented products can disrupt the natural balance of the vagina and cause you to itch.

Tight clothing can also trap moisture and cause irritation, discomfort, and itchiness.

5. Sexually transmitted infection

Sexually transmitted infections like Trichomoniasis can cause abnormal vaginal discharge that may appear thick, thin, or frothy, and often has a yellow-green color. 

This discharge is usually heavier than normal and may have a fishy odor. Such changes in vaginal discharge can irritate the sensitive tissues around the vagina, resulting in soreness, swelling, and persistent itching. Sometimes, the itching extends to the inner thighs, adding to the discomfort.

6. Intrahepatic cholestasis of pregnancy (ICP)

Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC), is a liver condition that is more common in women of South Asian origin, affecting around 1 in 70 to 80 pregnancies. ICP symptoms typically start around 28 weeks of pregnancy and go away after your baby is born.

Bile (a fluid the liver produces to help digest food) flows typically from the liver to the gut. But in ICP, the bile doesn't flow properly and builds up in the body, causing itchiness.

The itching can occur on any part of the body; however, it is more common on the hands and feet and worsens at night.

7. Vulvar varicosities in pregnancy

Vulvar varicosities are swollen, dilated veins that can be seen in the vulva and perineal area of women. These varicose veins often appear in pregnant women around 18–20 weeks.

According to research, one of the primary symptoms experienced by pregnant women with vulvar varicosities is intense itching in the genital area. The swollen, irritated veins put pressure on the delicate skin in that area, which causes the itching. The swollen veins can also cause the skin around the genital area to break down, worsening the condition.

Can hormone imbalance cause vulva itching?

Yes, hormone imbalances can cause vulva itching. The vulva, which includes the external female genitalia, can be particularly sensitive to hormonal fluctuations.

Estrogen plays a crucial role in maintaining the health of vaginal and vulva tissues. When estrogen levels drop, such as during menopause, postpartum, or due to certain medical conditions, the vulva tissues can become thin, dry, and less elastic. This condition is known as atrophic vulvovaginitis and can lead to itching, burning, and discomfort around the vulva area.

Hormonal fluctuations throughout the menstrual cycle can also cause vulva itching. For example, some women notice increased itching just before their period when estrogen levels are lower.

Also, during pregnancy, the body undergoes significant hormonal changes, including elevated levels of estrogen and progesterone. These changes can alter the vaginal pH and lead to an increased rate of discharge, which can cause irritation and itching.

Symptoms that accompany vaginal itching during pregnancy

Other symptoms that may accompany vaginal itching include:

• Pain when peeing 
• Pain when having sex
• Foul-smelling vaginal discharge
• Light vaginal bleeding or spotting
• Thick, white, or gray vaginal discharge
• Sore, swollen, or cracked skin around your vagina and vulva area

Treatment for itchy vagina during pregnancy

There are several treatment approaches for itchy vagina during pregnancy, including the following.

Prescription medications

The Centers for Disease Control and Prevention (CDC) recommends Metronidazole (Flagyl) or its gel for treating bacterial vaginosis. Clindamycin cream can also be used. Your doctor may also prescribe suppositories that you will insert into the vagina.

Topical antifungal medications, such as clotrimazole or miconazole, can be used to treat uncomplicated vulvovaginal candidiasis. A single 150 mg oral dose of fluconazole has also demonstrated high cure rates of 80% to 90%.

Management of recurrent candidiasis requires a longer period of treatment. Your doctor will prescribe an oral fluconazole regimen that may last as long as six months.

Treating sexually transmitted infections such as Trichomoniasis requires antibiotics like Metronidazole (Flagyl).

When treating STIs like Trichomoniasis, it is essential to complete the course of antibiotic medications and avoid having sex until the infection clears up to prevent reinfection. Also, your sexual partner or partners should be treated as well.

Over-the-counter (OTC) medications

OTC medications are available in creams and ointments, which are applied to the affected site. 

Over-the-counter antifungal intravaginal agents commonly used to treat vaginal itching include terconazole, miconazole, clotrimazole, and tioconazole.  Oral antifungal tablets are best avoided during pregnancy.

When to speak to a doctor

See a doctor if you are experiencing persistent vaginal itching and any of its accompanying symptoms during pregnancy. It is especially important to do so when:

• Your symptoms get worse after a few days of treatment with OTC medications. 
• The vaginal itching returns even after treatment.

Wrap up

Mild vaginal itching is a fairly common occurrence during pregnancy and is usually nothing to worry about. It’s mostly associated with normal hormonal changes. 

More severe itching and other symptoms may indicate an infection or an underlying medical condition. Always consult a doctor if you have any concerns.