Physical
- introitus – hymen, congenital anomaly, infection, episiotomy repair, neoplastic, atrophy / dystrophy
- vaginitis
- cervicitis
- endometriosis
- pelvic inflammatory disease
- uterine retroversion with prolapse, paracervical varices
- urethritis / cystitis
- urethral caruncle / diverticulum
Psycho-physiological (more common)
- vaginismus – psychological or secondary to pain
- inadequate lubrication
- inadequate vaginal elevation
Pruritus vulvae
- dermatoses
- dystrophies
- infection
- premalignant / malignant disease
- poor hygiene
- general medical disease – diabetes mellitus, blood dyscrasias, liver or renal impairment
- psychological
Management of pruritus vulvae
- remove potential cause
- improve general hygiene
- avoid vulval irritants
- reduce urge to scratch – topical steroids, topical testosterone, etretinate (retinoid)
- psychic soothing
