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There are many similar vulvovaginal symptoms that can
originate from totally different causes. The most helpful way to start thinking
about all of this is in terms of the external area (vulva) versus the internal
If you experience an occasional and temporary rash and/or itchiness, it could be something as simple as contact dermatitis. Something in your personal habits may have changed, such as your soap, for instance, causing an allergic reaction. If that might be the case, go back to your prior routine to see if it clears up.
If rash or itchiness lasts more than a couple of days — and especially if it’s painful — you could have an infection or worse. For instance, dysplasia can be a pre-cursor to skin cancer of the vulva that often presents with only a chronic itchy spot. I see a lot of women who let this go for months or years without getting it checked out, and then it advances to a stage requiring removal of a large portion of skin. Earlier treatment is often far less invasive. That’s why it’s so important to see your physician or gynecologist right away.
Bad odor, unusual discharge, and pain are reasons to see your physician. These symptoms could be caused by an easily treated yeast infection. On the other hand, they could signal a sexually transmitted infection (STI). The tough part is that yeast infections and STIs share the same symptoms, and your physician is the only one who can sort it out.
A word about STI testing and herpes: any time you get a new intimate partner, you should both be tested for STIs, but even a clean bill of health does not always cover genital herpes. Testing for herpes is tricky, and not typically performed, because there are two types. Type 1 can cause cold sores or genital lesions, but type 2 only causes genital lesions. If you test positive for type 1, it may just be a cold sore that’s nothing to worry about. In addition, many people who carry either type never develop genital lesions and could have no idea that they’re carrying the virus. So it’s important to be clear with your physician about exactly what you and your partner should be tested for.
I’ve spoken to women who won’t enter into relationships because they have symptoms that aren’t being addressed. This is a huge emotional burden for women who have chronic issues that no one talks about.
If you have any concerns, I encourage you to please see your gynecologist. If you don’t have one, start with your family physician. He or she can perform initial tests and make a referral or recommendation from there. And finally, I specialize in vulvovaginal conditions and am more than happy to consult with you.
Chemen Neal, MD, specializes in obstetrics and gynecology. She is a guest columnist and located at University Obstetricians – Gynecologists Coleman Center, 550 N. University Boulevard, Suite 2041, in Indianapolis. She can be reached by calling the office at 317.944.8231.