What's going on with vaginal itching and leucorrhea?

Vaginal itching and tofu-like leucorrhea are usually typical manifestations of vulvovaginal candidiasis.

1. Vulvovaginal candidiasis

Vulvovaginal candidiasis is a common gynecological infection caused by the overgrowth of Candida. Typical symptoms are severe itching, burning pain of the vulva and white curd-like or tofu-like leucorrhea. Common triggers of the disease include long-term antibiotic use, pregnancy, poorly controlled diabetes, or low immunity. The diagnosis requires a gynecological examination combined with routine leucorrhea testing. Antifungal drugs such as clotrimazole vaginal tablets, miconazole nitrate suppositories, or fluconazole capsules can be used for treatment. At the same time, the vulva must be kept dry and clean, and tight-fitting chemical fiber underwear must be avoided.

2. Bacterial vaginosis

Although bacterial vaginosis is characterized by thin gray-white leucorrhea, some patients may be complicated by Candida infection and develop tofu-like discharge. Typical symptoms include leucorrhea with a fishy smell and vaginal pH greater than 4.5. Metronidazole vaginal gel or clindamycin phosphate vaginal cream should be used for treatment. Sexual life should be prohibited during the treatment, and lactobacillus preparations should be supplemented to restore the vaginal microecological balance.

3. Trichomonal vaginitis

Trichomonas vaginitis usually presents as yellow-green foamy leucorrhea, but abnormal discharge may occur in mixed infections. Most patients have vulvar burning sensation and dyspareunia, and active trichomonas can be seen on microscopic examination of leucorrhea. Oral metronidazole tablets are the first choice for treatment, and sexual partners need to be treated simultaneously. During treatment, you should avoid ingesting alcohol, change sterile underwear every day, and all towels and bathware need to be boiled and sterilized.

4. Allergic vulvitis

Contact with items such as sanitary napkins, detergents or condoms may trigger allergic reactions, leading to vulvar itching and changes in the nature of discharge. It manifests as sudden itching, redness and swelling, and the leucorrhea may be abnormal due to secondary infection. Suspected allergenic products need to be stopped immediately, and the vulva should be washed with warm water. In severe cases, hydrocortisone ointment can be used for a short period of time, and loratadine tablets can be taken orally for anti-allergic treatment if necessary.

5. Diabetes related vulvitis

Uncontrolled diabetic patients are prone to intractable vulvar itching and recurrent vaginal infections due to stimulation of urine sugar and reduced immunity. Typical manifestations include vulvar skin thickening and pigmentation, and leucorrhea may take on a variety of abnormal shapes. In addition to antifungal treatment, the key is to control blood sugar levels. It is recommended to test fasting blood sugar and glycated hemoglobin, and pay special attention to daily cleaning and moisturizing care of the vulva.

When the above symptoms occur, you should avoid scratching or washing the vagina by yourself, choose pure cotton breathable underwear and change it daily. Reduce the intake of high-sugar foods and supplement yogurt with probiotics in moderation. All drug treatments must be completed under the guidance of a gynecologist. After completing the prescribed course of treatment, it is recommended to review the leucorrhea routine. If symptoms recur or are accompanied by fever or pelvic pain, complicated infections or other gynecological diseases need to be ruled out promptly.