Pelvic health 101: 6 common vulvar disorders

Posted November 08, 2021 by Sevasti Yeropoli, MD

When women experience pain or discomfort in their pelvic region, many times their first thought is the dreaded yeast infection. That’s not a surprise because most women — as many as 75 percent — will be diagnosed at least once with a vaginal yeast infection during their lifetimes.

However, there are vulvar disorders other than yeast —  that can cause similar symptoms, including redness and swelling, intense itching, discolored discharge, blisters and white, scaly patches.

That’s why it’s important to contact your gynecologist for diagnosis and treatment if you’re discomfort or pain in your vaginal and vulvar areas. With age and the decline in estrogen after menopause, you can become more susceptible to a variety of conditions that irritate the vulvar skin.

The vulva is the external female genital area that covers and protects a female’s sexual organs and urinary opening. It includes the outer and inner folds of the skin, sometimes referred to as “lips.”

There are many triggers that can cause an infection or irritation of the vulva, from yeast and sexually transmitted diseases to parasites and environmental factors. Some conditions cause minor discomfort, while others can make urination and sex very painful.

The good news is most vulvar skin problems are able to be managed but treatment can differ based on the condition. Summa Health discusses six common vulvar disorders, so you get proper treatment and quickly find relief — and avoid passing on the infection to others.

Yeast infection

Candida, better known as a yeast infection, is extremely common in women. Your vagina naturally has a certain amount of Candida yeast, but an overgrowth can cause an infection. Antibiotics also can increase your risk because they can kill the naturally occurring antifungal bacteria in that area.

Symptoms include vulvar swelling and redness, itching, burning and even painful urination and sex. In addition, you may experience a thick, white vaginal discharge that can look similar to cottage cheese.

Yeast infections can be treated with over-the-counter antifungal creams or oral tablets prescribed by your doctor. However, if you have recurrent yeast infections three or more within a year—your healthcare provider may recommend a longer treatment plan.

Vulvitis/dermatitis

Environmental factors can cause inflammation and irritation of the vulva. Hygiene practices, allergens or chemicals found in household soaps, detergents and feminine products can cause chronic itching, redness, swelling and a rash.

In addition, tight clothing can rub against the skin and create irritation. Even riding a bicycle or on horseback can lead to irritation

Treatment typically includes a topical corticosteroid cream or antihistamines. Avoiding the trigger, such as switching to hypoallergenic detergents and soaps, can resolve the issue, as well.

Genital herpes and warts

Genital herpes and warts that can develop on the vulva are common sexually transmitted diseases. While there is no cure for these viruses, they can be treated.

Genital herpes, caused by the herpes virus, can cause blistering and painful lesions on the vulva and surrounding areas. . Antiviral medications can reduce the frequency and severity of attacks.            

Genital warts, caused by HPV (human papillomavirus), can vary in size, shape and color on the vulva, but are usually painless. They can cause itching, burning and even bleeding during intercourse. Treatment for this STD includes removing the warts through freezing or burning them.

Trichomoniasis

Parasites, such as pinworms, scabies and lice, can cause inflammation of the vulva. Trichomoniasis is one of the most common sexually transmitted diseases caused by a parasite.

Symptoms vary, but you may experience vulvar itching, burning, redness or soreness. You also may notice white, yellow or green discharge with an unusually foul smell. Trichomoniasis can make urinating or sex uncomfortable.

The condition can be treated with antibiotics. You can contract it again, so be sure both you and your sexual partner are treated with antibiotics and engage in protected sex.

Lichen Sclerosus

Lichen sclerosus is an inflammatory skin disorder that is more common in postmenopausal women and is not contagious. The cause is unknown, but some doctors believe overactive immune systems or hormone issues are to blame.

Symptoms can include intense itching, tenderness and painful sex. Patches of the vulvar skin can become white, wrinkled and even split, causing bleeding and scarring.

Treatment typically includes corticosteroid cream for several weeks. While there is no cure, you can reduce and manage the symptoms. Regular monitoring is important because the affected skin can increase your risk for vulvar cancer if not treated properly.

Bacterial Vaginosis

Bacterial vaginosis (BV) occurs when there is an imbalance of “good” and “harmful” bacterial in the vagina, caused by an excess of a certain bacteria in the vagina. While the cause of BV is unknown, the condition typically occurs in sexually active women. Symptoms can include a thin white grey discharge and fish-like odor, itching around the outside of the vagina, burning while urinating a strong fish-like odor and pain, itching or burning inside of the vagina.

Treatment usually includes an antibiotic that is prescribed by a physician. In some cases, bacterial vaginosis can return after treatment.