6 Reasons You’re Itchy Down There

Sure, it could be a yeast infection — or it could be one of these other culprits. (GIF: Getty Images/DigitalVision Vectors/Yahoo Health)

Being itchy below the belt is anything but pleasant. For many women, when things get uncomfortable down there, “yeast infection” is often the immediate assumption.

“Everyone has ‘yeast infection’ in their vernacular,” Fahimeh Sasan, DO, assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai, tells Yahoo Health. But the problem is, itching doesn’t always mean yeast. And if you self-diagnose, self-treat (Monistat, here I come!), and wait for the symptoms to stop, you could end up waiting a long time.

“Yeast infections obviously are common — but the hallmark sign of yeast is a thick, cottage-cheesy discharge,” says Sasan. While irritation and itching can accompany that, if you typically only have itching (without the discharge), it’s probably not yeast, she says.

So what is it? Save yourself the agony and check these six common down-there reasons you’re irritated:

Bacterial Vaginosis (BV)

What it is: Bacterial Vaginosis, or BV, isn’t a sexually transmitted infection (STI), says Sasan — “it’s an overgrowth of the normal bacteria of the vagina.” With BV, you’ll usually have itching, a yellowish-watery discharge, and typically a foul, fishy smell. Unlike yeast — in which the discharge is the main symptom — the smell, discharge, and itching are all common complaints with BV. Another thing you may not realize: “I would say BV is almost just as common as yeast infections,” says Sasan.

How to treat it: Unfortunately Monistat — the popular OTC yeast infection treatment — won’t cut it for BV. You’ll need an antibiotic, says Sasan. Your doctor may treat you based on symptoms or test your discharge. You can either choose an oral or vaginal medicine. Vaginal meds — usually Metrogel or Clindamycin — are sometimes preferred over Flagyl (the oral antibiotic used to treat BV), as that can be tough on the stomach, Julianna Schantz-Dunn, MD, obstetrician and gynecologist at Brigham and Women’s Hospital in Boston, tells Yahoo Health.

Related: 5 Common Vaginal Odors (and Exactly What They Mean)

General Irritation

What it is: Maybe you used a new soap, lotion, or laundry detergent, or wore a different fabric than you usually do. Perhaps you have sensitive skin (or have eczema); you just waxed, shaved, or used a hair removal product; or you’re simply more allergy prone. You can always have itching due to a whole slew of irritants, says Sasan. “In particular, my patients who have sensitive skin tend to be more prone to external vaginal irritation, too. Sensitive skin can present anywhere,” she says. The key here: The itching tends to be external (on the outside of your vagina) and doesn’t come with any discharge, she says.

How to treat it: First, think about what you’ve changed up recently. Think a new soap, lotion, or detergent could be to blame? Ditch it, suggests Sasan. And if you just got waxed or just shaved, give it a few days. Then, stick to unscented beauty products for your feminine hygiene, Sasan says. And if the itching persists, pick up a Hydrocortisone cream to apply on the outside of your vagina to relieve the pain, she suggests. Note: If you’re itchy for over a week, see your doctor.

Trichomoniasis

What it is: A common and curable STI caused by a protozoan parasite called Trichomonas vaginalis. The problem: The Centers for Disease Control and Prevention (CDC) estimates that 3.7 million people in the US have the infection, but only 30 percent see symptoms. If you do have symptoms, Sasan says trichomoniasis (known as “trich”) can present with “a very foul smelling discharge and a lot of itchiness or pain.” That said, you want to think about your risk factors before assuming an STI: “If you’ve had new or multiple sexual partners and are experiencing itchiness, you should see a doctor and be tested.” Gonorrhea and chlamydia can have symptoms of itchiness, too, Sasan says. But again, since so many STIs fly under the radar sans symptoms, it’s best to see your doc if you’re worried at all.

How to treat it: An STI test will reveal if you do indeed have trichomoniasis — in which case, you’ll need a prescription antibiotic to treat the infection. It’s usually treated with Flagyl — the same oral antibiotic used to treat BV. “The difference is that we usually give one larger dose for a shorter amount of time to treat trichomoniasis,” says Schantz-Dunn. And remember: “Because this is an STI, both you and your partner need to be treated. Treating both people and abstaining from sex for a week cuts down risk of re-infection, Schantz-Dunn advises.

Related: 5 Things You Definitely Should Not Be Doing To Your Vagina

Herpes

What it is: The herpes simplex virus (HSV) is an STI that can also be transmitted by skin-to-skin contact, says Schantz-Dunn. And while — similarly to other STIs — there can be a lack of symptoms, infected people who do see side effects tend to feel burning or itching down below, she says. And know this: If you have herpes, you can start shedding (when the virus becomes active on your body) before an outbreak of lesions. In other words, even if you don’t see an outbreak, you could still be infected.

How to treat it: See your doctor if you think herpes could be to blame. While there is no cure, antiviral medicines like Valtrex can help ease symptoms, shorten the course of an outbreak, and even suppress outbreaks, says Schantz-Dunn. It’s important to take these measures, too, as herpes can be passed down to your children. “If you’re pregnant, it can be transmitted to the baby, so you’ll want to tell your doctor.” Sometimes, doctors give a preventive dose of medication a month or so before childbirth to deter an outbreak — which, if present, could force a woman to have a C-section to avoid transmission, Schantz-Dunn says.

Your Workout

What it is: Typically, Sasan says that a wet bathing suit and workout clothes aren’t to blame for down-there discomfort or yeast infections. But if you know that certain activities bother you down there (Sasan says some of her patients do swear bathing suits give them yeast infections!), take precautions, she says.

How to treat it: Your best bet is to lose the clothes and shower post-workout or post-swim. “More likely than not, that’ll make you feel much better,” says Sasan. Otherwise, to beat a moist, sweaty, humid environment below the belt (hello, perfect environment for bacteria to thrive!), add a little bit of baby powder to your underwear or to the outside of your vagina pre-workout. You could also try a panty liner to keep yourself dry.

Cancer of the Vulva

What it is: It’s not uncommon for post-menopausal women to have itching due to a lack of estrogen, says Schantz-Dunn. But if you’re older than 60 and have any kind of itching, don’t make assumptions: Sometimes vaginal itching at this age can be cancer of the vulva. Why the itch? The cancer, Schantz-Dunn explains, can present as rash-like due to changes in squamous cells.

How to treat it: To make a diagnosis of cancer of the vulva, you’ll need to get a biopsy — and that will help direct the course of treatment, Schantz-Dunn says. Lesions that are pre-cancerous can sometimes be treated with topical medication, she explains. But the biopsy — and the grade and stage of the cancer — will ultimately help determine the right treatment plan.

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