Vaginal Itching and Pain: Causes and Treatments - Internal Medicine

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Vaginal itching and pain can be caused by a variety of factors, including infections, irritations, and underlying medical conditions. Given your history of oral and manual sexual activities, it is essential to consider sexually transmitted infections (STIs), as well as non-infectious causes such as allergies or irritants.


Common Causes of Vaginal Itching and Pain:
1. Yeast Infections: These are caused by an overgrowth of Candida, a type of fungus. Symptoms typically include itching, burning, and a thick, white discharge resembling cottage cheese.

2. Bacterial Vaginosis (BV): This condition occurs when there is an imbalance of bacteria in the vagina. Symptoms may include a fishy odor, unusual discharge, and irritation.

3. Sexually Transmitted Infections (STIs): Infections such as chlamydia, gonorrhea, and herpes can cause itching, pain, and abnormal discharge. Herpes, in particular, can lead to painful sores in the genital area.

4. Contact Dermatitis: This can occur due to allergic reactions to soaps, lotions, or even condoms. Symptoms include redness, itching, and swelling.

5. Hormonal Changes: Fluctuations in hormones, especially during menstruation or menopause, can lead to dryness and irritation.


Recommended Treatments:
1. Antifungal Medications: If a yeast infection is diagnosed, over-the-counter antifungal creams (e.g., clotrimazole or miconazole) or prescription medications (e.g., fluconazole) may be recommended.

2. Antibiotics: For bacterial vaginosis or certain STIs, antibiotics such as metronidazole or clindamycin may be prescribed.

3. Topical Steroids: For contact dermatitis, a mild topical steroid cream may help reduce inflammation and itching.

4. Hydration and Moisturizers: Using vaginal moisturizers can help alleviate dryness and discomfort, especially if hormonal changes are a factor.

5. Avoiding Irritants: Identifying and avoiding potential irritants, such as scented products, can help reduce symptoms.


When to Seek Medical Attention:
If your symptoms persist or worsen despite over-the-counter treatments, it is crucial to consult a healthcare provider. A gynecologist can perform a thorough examination, conduct necessary tests (such as swabs or blood tests), and provide a definitive diagnosis and treatment plan.


Medications:
- Clotrimazole (克霉唑): An antifungal cream used for yeast infections.

- Miconazole (米康唑): Another antifungal option available over-the-counter.

- Metronidazole (甲硝唑): An antibiotic used for bacterial vaginosis and certain STIs.

- Fluconazole (氟康唑): An oral antifungal medication for yeast infections.

- Hydrocortisone Cream (氫化可的松): A mild topical steroid for inflammation and itching.


Conclusion:
Understanding the underlying cause of your vaginal itching and pain is essential for effective treatment. Given your sexual history, it is wise to consider the possibility of STIs and consult a healthcare professional for appropriate testing and treatment. Early intervention can help alleviate discomfort and prevent complications. Always remember to communicate openly with your partner about any symptoms and seek medical advice together if necessary.