Vulvitis is an inflammation of the vulva, which is the external part of the female genitalia, including the labia majora, labia minora, and clitoris. The main symptoms include intense itching, burning or stinging sensations, and swelling in the affected area.

This condition can be caused by several factors, such as bacterial, viral, or fungal infections; allergic reactions to irritants like scented soaps or feminine sprays; friction injuries from physical activities; or hormonal changes, especially during menopause.

Treatment for vulvitis depends on the cause and may include topical creams or ointments, proper genital hygiene, and sitz baths. Hormone therapy may be recommended in cases of vulvitis related to menopause and should be prescribed by a gynecologist.

Main symptoms

Common symptoms of vulvitis include:

Intense itching of the vulva;
Redness and swelling in the genital area;
Burning or stinging sensation, especially when urinating or during sex;
Vaginal discharge that may vary in color, consistency, and odor, depending on the cause;
Small sores, cracks, or wounds on the vulva.

Some people may also experience pain or discomfort when sitting, walking, or wearing tight clothing.

Vulvitis vs vulvovaginitis

Vulvitis refers to inflammation of the vulva, which is the external part of the female genitalia, including the labia majora, labia minora, and clitoris. In contrast, vulvovaginitis affects both the vulva and the vaginal canal, meaning the inflammation involves both the external and internal genital areas.

Possible causes

Potential causes of vulvitis include:

1. Infections

Infection caused by Candida albicans, the fungus responsible for yeast infections, can lead to inflammation of the vulva. This is more common with frequent antibiotic use.

Certain bacteria, such as Gardnerella vaginalis and Escherichia coli, can also cause vulvitis, especially in cases of poor hygiene or following urinary tract infections. Infection with the herpes simplex virus can also be a cause of vulvitis.

2. Allergies

Using certain products or substances in the genital area can irritate the skin and trigger an allergic reaction, leading to vulvitis. This may happen after using scented soaps, feminine sprays, synthetic underwear, tight clothing, perfumed toilet paper, or exposure to chemicals like pool chlorine.

3. Lesions

Vulvitis may also result from small injuries to the genital area caused by activities like cycling or horseback riding, particularly when done frequently or for long periods.

Prolonged or incorrect use of tampons can also irritate the vulvar skin, leading to inflammation. During menopause, decreased estrogen levels can make the vulva thinner, drier, and more sensitive, making it more prone to irritation or injury from minor friction.

Confirming a diagnosis

To confirm a diagnosis of vulvitis, it is important to consult a gynecologist or primary care provider for an evaluation. A healthcare provider may perform a physical exam to check for redness, swelling, or lesions in the genital area.

In some cases, lab tests may be necessary to identify the specific cause of vulvitis. These may include cultures of vaginal secretions to detect fungi, bacteria, or viruses.

Treatment options

Treatment for vulvitis depends on the underlying cause and may include:

Topical medications, such as antifungal creams like clotrimazole or miconazole, antiviral ointments for genital herpes such as acyclovir or valacyclovir, and corticosteroid creams to reduce inflammation;
Proper hygiene, including washing the vulva with warm water and mild, unscented soap, while avoiding vaginal douches and perfumed products;
Wearing suitable clothing, such as cotton underwear, and avoiding synthetic fabrics that can cause irritation;
Sitz baths with warm water to help relieve itching and burning;
Hormonal treatment for estrogen deficiency, such as vaginal creams containing estrogen, especially in menopausal women.

In some cases, a doctor may also recommend oral antihistamines, such as diphenhydramine, to help relieve itching.

Tips for prevention

To prevent vulvitis, it’s important to maintain good genital hygiene by washing with warm water and mild, unscented soap. Avoid using vaginal douches, perfumed soaps, feminine sprays, and fragranced wipes.

It’s also recommended to wear cotton underwear and avoid tight-fitting or synthetic clothing, such as spandex, which can trap moisture and increase irritation.

Additionally, avoid staying in wet clothing, such as swimsuits or sweaty gym clothes, for long periods of time to reduce heat and moisture buildup in the genital area.

Vulvitis: Symptoms, Causes & Treatment