Worried about this constant itching

DEAR DR MITCHELL,

I observed since last year that I have constant itching in my clitoris. This has been observed since working from home and constant sweating in the pubic area. I have been to the doctor many times and was treated for yeast infections. None of these treatments worked. I am frustrated. I am 51 years old.

The constant itching that you experience in the clitoris is of concern and should definitely be investigated. This may be due to several underlying factors. The lack of response to treatment with antifungal medications for years is strongly suggestive that this is not a yeast infection. However, the use of antifungal tablets by mouth in addition to the use of topical creams or ointments can sometimes help in reducing symptoms due to resistant yeast infections. The additional use of an antifungal powder can reduce moisture and also help in alleviating the symptoms if it is due to a resistant yeast infection.

Other possible causes of the constant itching of the clitoris include an allergy to soaps, body wash, and scented panty shields. It is important to get a proper evaluation to ensure that there are no genital warts present since small warts can be present and contribute to the itching. These warts are usually caused by the human papillomavirus. Warts due to syphilis can also contribute to this problem. If you are sexually active then you should get a comprehensive screening test done for sexually transmitted infections. Pre-cancerous changes and vulval cancer can also present with persistent itching of the skin, and proper evaluation with the appropriate biopsy should be done if there are any suspicious-looking areas.

As women get older the vaginal and vulval areas become very sensitive due to the fact that the tissues become thinner, dry, and are irritated by the extra sweating. This is due to declining oestrogen levels with the onset of menopause. Proper personal hygiene with bathing twice daily and wearing cotton underwear will definitely help in reducing the irritation. The vulva and vagina should be washed with unscented, clear, or white soap to reduce any irritation due to the dyes or chemicals.

In some women the use of a cream containing a mild steroid can help in significantly reducing the irritation. If the skin is broken from constant scratching, then a cream with a mild steroid, antibiotic, and antifungal can be applied with a good outcome.

Consult your gynaecologist, who will advise you further.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

Dr Sharmaine MITCHELL

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