Itching, burning and dryness are uncomfortable on their own, and even more confusing when they happen together. Is it an infection? Irritation? Hormones? The cause makes a big difference to what will help, so here’s how to tell the common culprits apart.
Key takeaways
- Low estrogen (from menopause, breastfeeding or some medicines) is a common cause of itching and burning with dryness and little discharge.
- Yeast infections, bacterial vaginosis and trichomoniasis usually come with noticeable changes in discharge or odor.
- Skin irritation from soaps, wipes or detergents is common and easy to fix. Persistent or unusual symptoms should be checked.
By the numbers
- In the REVIVE survey (Kingsberg et al., Journal of Sexual Medicine, 2013, 3,046 U.S. postmenopausal women), 55% of women with menopause-related vaginal symptoms reported dryness and 37% reported irritation.
- Only 56% had ever discussed their symptoms with a healthcare provider.
Common causes compared
| Cause | Typical signs | Discharge |
|---|---|---|
| Dryness or low estrogen (GSM) | Dryness, burning, itching, pain with sex, urinary symptoms | Little or none; sometimes light spotting |
| Yeast infection | Itching, redness, soreness | Thick, white, “cottage cheese,” usually no odor |
| Bacterial vaginosis (BV) | Sometimes mild itching; often no symptoms | Thin, milky or gray, “fishy” odor |
| Trichomoniasis | Itching, burning, soreness, burning with urination | May be frothy and gray-green with a bad smell |
| Contact irritation | Burning or itching after a new soap, wipe, pad or detergent | Usually none |
| Skin conditions (such as lichen sclerosus) | Persistent itching, white or thin patches, cracking | Usually none |
Infection symptom descriptions are from the National Institute of Child Health and Human Development [1]. Many women with BV or trichomoniasis have no symptoms at all [1].
When it’s dryness
Lower estrogen makes the vaginal and vulvar skin thinner and more easily irritated. The result is itching or burning, often worse after sex or exercise, with little discharge. This is common in perimenopause and after menopause, while breastfeeding, and with some medicines. Doctors call the menopause-related form vaginal atrophy, or GSM [2].
Moisturizers, lubricants and, when needed, prescription treatments usually help. See our treatment options.
When it’s an infection
Yeast infections, BV and trichomoniasis each need different treatment, and BV and trichomoniasis need a prescription. Because symptoms overlap, testing is the most reliable way to know [3]. Don’t keep using over-the-counter yeast treatments if they haven’t worked.
When it’s irritation
Scented soaps, bubble baths, wipes, douches, pads, spermicides and laundry products can all trigger burning and itching. Switch to fragrance-free products, wash with plain warm water, and see if symptoms settle within a week or two. Avoid putting petroleum jelly inside the vagina, which one study linked to a higher risk of BV [4].
Simple steps for relief
- Wash the vulva with warm water only and pat dry.
- Wear breathable cotton underwear and avoid tight, damp clothing.
- Skip douches, scented products and wipes.
- Use a fragrance-free moisturizer or lubricant if dryness is part of the picture.
- Avoid scratching, which can further irritate delicate skin.
Looking for hormone-free comfort?
AIRS Advanced Intimate Renewal Serum is a hormone-free cosmetic serum that helps moisturize, soothe and comfort delicate intimate skin. It comes in single-use applicators, twelve to a box.
When to see a clinician
Get checked if symptoms last more than a week or two, keep coming back, or come with unusual discharge, odor, sores, blisters, white patches, pelvic pain, fever or bleeding, especially after menopause.
Frequently asked questions
Can vaginal dryness cause itching?
Yes. When the vaginal and vulvar skin is dry and thin, it can itch, burn and feel raw, even without an infection.
How do I know if it’s a yeast infection or dryness?
Yeast infections usually cause thick, white, cottage-cheese-like discharge along with itching and redness. Dryness typically causes itching or burning with little or no discharge. If you’re unsure, get tested.
Should I use an over-the-counter yeast treatment?
Only if you’ve had a diagnosed yeast infection before and recognize the symptoms. Using yeast treatments when the cause is dryness or BV won’t help and can delay the right care.
When is vaginal itching an emergency?
Seek prompt care for fever, pelvic pain, sores or blisters, heavy or foul-smelling discharge, or any bleeding after menopause.
Related reading
- What is vaginal atrophy?
- Vaginal dryness: causes, symptoms and when to get help
- Natural remedies for vaginal dryness
- Medications that cause vaginal dryness
- Vaginal dryness treatment options compared
- Diabetes and vaginal dryness
- Can vaginal dryness cause bleeding?
Sources
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). What are the symptoms of vaginitis?
- Cleveland Clinic. Vaginal atrophy (genitourinary syndrome of menopause).
- Cleveland Clinic. Vaginitis: causes, symptoms and treatment.
- Brown JM, et al. Intravaginal practices and risk of bacterial vaginosis and candidiasis infection. Obstet Gynecol. 2013;121(4):773–780.
