What Causes Vaginal Itching During Pregnancy?

Vaginal itching during pregnancy is common and often due to hormonal changes that disrupt the pH balance of the vagina. This can lead to itch-inducing vaginal dryness and sweatiness, as well as yeast infections (which usually also cause thick, white, cottage cheese-like discharge).

Certain medications can also cause vaginal dryness and itching. Less commonly, bacteria vaginosis (BV) or an undiagnosed sexually transmitted infection (STI) may be the underlying cause. This is important to consider since these conditions can pose certain health risks to a fetus.

This article explores the causes of vaginal itching during pregnancy. It also explains how vaginal itching can be treated and prevented based on the underlying cause.

What Causes Vaginal Itching During Pregnancy?

There are many reasons you may experience vaginal itching during pregnancy. Most do not call for aggressive treatment, but some do require medication. Eight possible causes include the following:

• Vaginal yeast infections, also known as vaginal thrush or vaginal candidiasis, are caused by a fungus called Candida albicans. These infections are especially common during the second trimester and, while uncomfortable, pose little risk to your fetus.
• Sexually transmitted infections, such as herpes, chlamydia, gonorrhea, and trichomoniasis, can cause vaginal itchiness. Getting these infections treated is important as they can be passed to your fetus and cause potentially serious complications.
• Bacterial vaginosis is a bacterial infection that occurs when the different kinds of healthy bacteria in your vagina get out of balance and grow too much, causing an irritated and itchy vagina. This infection also puts a fetus at a higher risk for premature birth as well as low birth weight and breathing problems.
• Group B strep infection is a common bacteria that 10% to 30% of pregnant people carry. During labor, group B strep can be passed on to the newborn causing serious health issues. Screening for group B strep is usually done after 35 weeks of pregnancy and can be treated to protect you and your baby.
• Hormonal changes during pregnancy can make your skin more sensitive, causing dryness, cracking, rash, and itching.
• Breastfeeding, and preparation for it, decreases estrogen levels and can lead to vaginal dryness and itchiness.
  
• Medications, like certain antihistamines and antidepressants, can also cause vaginal dryness and itchiness.
• Pubic hair can grow long and wiry during pregnancy and cause itchiness as it rubs against the skin, especially if you wear tight underwear or pants.

Vaginal Itching Treatment During Pregnancy

There are various ways to treat vaginal itching depending on the underlying cause. These include home remedies, over-the-counter (OTC) medications, and prescription drugs.

Home Remedies

Home remedies generally do not treat the underlying cause of vaginal itching. They simply relieve the symptoms and may be appropriate if the itching is mild.

Here are some home remedies that can help:

• Apply a cold compress to the vagina, or take cooling baths.
• Take a baking soda bath, mixing 1/4 to 2 cups of baking soda into a tub full of warm (not hot) water.
• Mix baking soda and water to create a paste, and apply it to the itchy skin.
• Apply coconut oil to the itchy skin. Do not put the oil inside your vagina.
  

Over-the-Counter Medications

Over-the-counter antifungal medications that treat mild yeast infections are available. These include creams and ointments that get applied to the skin and suppositories, which get inserted into the vagina.

Antifungal agents commonly used in OTC vaginal preparations include:

• Clotrimazole, found in products like Lotrimin AF and Mycelex
• Miconazole, found in products like Monistat 3, Monistat 7, and Vagistat 3
• Tioconazole, found in products like Vagistat 1
• Terconazole, found in many generic vaginal antifungals

There are also topical medications like Vagisil cream that do not contain an antifungal agent but are designed to reduce itch with topical anesthetics like benzocaine or lidocaine.

These may be good options if your itching is not caused by a yeast infection.

Prescription Medications

The Centers for Disease Control and Prevention (CDC) recommends a seven-day course of a topical antifungal as the most appropriate option for treating a yeast infection during pregnancy. Prescription-strength versions are available if the infection is severe.

However, oral antifungals are not recommended. The Food and Drug Administration (FDA) currently advises against the use of high-dose Diflucan (fluconazole) due to the risk of birth defects. The risk is greatest during the first trimester and at doses greater than 400 milligrams (mg).

Taking a prescription antiviral drug like Zovirax (acyclovir) is imperative if there is an active outbreak of genital herpes during pregnancy. Other STIs, like chlamydia and gonorrhea, require treatment with a prescription antibiotic like ceftriaxone.

Bacterial vaginosis is most commonly treated with the antibiotics Flagyl (metronidazole) or Clidacin (clindamycin).

When Should I Be Worried About Vaginal Itching?

You should see your healthcare provider if you are not responding to treatment for a vaginal infection during pregnancy, particularly if:

• Your symptoms do not improve or get worse after several days of treatment.
• The vaginal infection returns after treatment.
• You develop new symptoms during or after treatment.
• You experience multiple vaginal infections during pregnancy.

Preventing Vaginal Itching

There are certain practices that can reduce the risk of vaginal yeast infections and other causes of vaginal itching:

• Keep your vaginal area clean and dry. Use mild, unscented soap and water, and pat dry with a clean, soft towel.
• Wipe from front to back after a bowel movement to prevent bacteria from entering the vagina.
• Avoid vaginal douches which can disrupt the natural balance of bacteria and fungus in your vagina.
• Use fragrance-free soaps, bath additives, and laundry detergents. Avoid feminine deodorants.
• Avoid hot tubs and extra hot baths which can dry the vaginal skin out.
• Wear light cotton underwear, and change it whenever it becomes wet or sweaty.
• Avoid tight pants or skirts, opting instead for light, loose-fitting clothes.
  

Summary

Vaginal itching during pregnancy can be triggered by changes in hormones, certain medications, and some infections.

Home remedies may relieve vaginal itching. However, if you have an infection or are experiencing severe symptoms, it's best to reach out to your healthcare provider. Vaginal infections may be treated with over-the-counter or prescription medications depending on the specific diagnosis.

To keep your vagina healthy, be sure to practice good hygiene and note anything that may trigger irritation or itchiness.