Vaginal Itching During Pregnancy: Causes, Treatments, and Prevention Tips

Vaginal itching during pregnancy is a common concern and can be linked to hormonal changes, increased discharge, or infections like yeast or bacterial vaginosis. While mild discomfort is common, persistent irritation, redness, swelling, or unusual discharge could signal an underlying issue that needs medical attention. In fact, up to 13% of pregnant women experience vulvovaginal candidiasis (yeast infection), a frequent cause of itching, during their pregnancy [5]. In this guide, we’ll explore what causes genital itching during pregnancy, how to treat it safely, and ways to prevent discomfort throughout each trimester.

What is Vaginal Itching and Why Does it Occur in Pregnancy?

Vaginal itching, or pruritus vulvae, refers to irritation or discomfort in the vaginal or vulvar area. It is a common issue experienced by most women at some point in their lives, caused by various factors such as harsh soaps, allergic reactions, fungal infections, or skin conditions like eczema [4].

During pregnancy, this itching can become more frequent and pronounced due to significant hormonal fluctuations, increased vaginal discharge, shifts in vaginal pH levels, or heightened sensitivity in the genital area. The rise in estrogen and progesterone levels, in particular, can alter the vaginal environment, making it more susceptible to certain infections and irritation [2]. While usually harmless, persistent or severe itching during gestation could indicate an underlying infection and must be evaluated by a healthcare provider.

What Causes Vulvovaginal Itching During Pregnancy?

The following conditions are the most common clinical causes for itching in the vaginal area during pregnancy:

1. Bacterial Vaginosis (BV)

It is an infection of the vagina caused by an overgrowth of certain bacteria, disrupting the normal balance of the vaginal microbiome [1]. BV is characterized by a thin, greyish-white discharge and a distinct ‘fishy’ odor that often becomes more noticeable after sexual intercourse. BV can damage the vulvar skin, leading to an itchy sensation. If left untreated, bacterial vaginosis during pregnancy may increase the risk of complications such as preterm birth, low birth weight, and late miscarriage, making timely medical care crucial [1].

2. Vulvovaginal Candidiasis (Yeast Infection)

Yeast infections are one of the most frequent causes of vaginal itching during pregnancy, with prevalence rates as high as 13% [5]. In pregnancy, hormonal changes, particularly the elevated levels of estrogen, stimulate the growth of Candida species (a type of fungus) in the vagina [5]. This overgrowth, called Vulvovaginal Candidiasis, causes intense itching, burning, and a thick, white, ‘cottage-cheese-like’ discharge. While highly annoying and uncomfortable for the mother, a yeast infection generally poses little to no risk to the baby [5].

3. Trichomoniasis

Trichomoniasis is a common sexually transmitted disease (STD) caused by a parasitic protozoan [2]. When symptoms are present, they typically include itching in the vaginal area, painful urination, and a frothy, foul-smelling, greenish-yellow discharge. This infection requires prompt medical treatment under a healthcare provider’s supervision during pregnancy to prevent potential complications such as premature rupture of membranes and preterm delivery [2].

4. Hormonal and pH Changes

When a woman is pregnant, the overall chemical balance of the vagina may shift. The normal acidic pH (around 3.5–4.5) often becomes slightly less acidic, which can sometimes cause burning or a low-level irritation, especially if no infection is present [3]. Itching caused solely by these normal physiological shifts typically happens throughout pregnancy and may be mild.

5. Increased Vaginal Discharge (Leukorrhea)

Pregnancy often leads to a natural increase in vaginal discharge, known as leukorrhea, due to increased blood flow to the area and elevated estrogen levels. This thin, milky-white discharge, while normal, can cause local irritation or contribute to a moist environment favorable for the growth of yeast or bacteria [3].

6. Urinary Tract Infection (UTI)

Urinary Tract Infections are one of the most common types of infections that happen to pregnant women. Even though itching in the vaginal area is not a primary sign of a UTI, the two conditions can sometimes occur concurrently. Additionally, a severe UTI can complicate a pregnancy, making screening and treatment essential [6].

Effective Management and Treatments for Vaginal Itching in Pregnancy

If home remedies do not help, or if symptoms are severe and accompanied by unusual discharge or odor, it is essential to consult your obstetrician or gynecologist for proper diagnosis and guidance. The treatment will depend entirely on the underlying cause.

Home Care and Lifestyle Changes

These non-pharmacological methods can help alleviate general irritation and prevent recurrence:

• Wear loose, comfortable clothes. Avoid tight jeans and leggings to promote airflow and let the genital area breathe.
• Opt for clean, white cotton underwear. Cotton is breathable and moisture-wicking, helping to keep the area dry. Avoid synthetic or dark-colored underwear.
• Maintain gentle hygiene. Clean the area with plain warm water or an unscented, mild, pH-balanced vaginal wash once daily. Avoid douching or using harsh, perfumed soaps, which disrupt the natural pH.
• Reduce sugar intake. A high-sugar diet may fuel the growth of Candida and other organisms; reducing intake can help prevent yeast overgrowth.
• Stay Hydrated. Drink lots of water to support overall physiological balance.
• Apply a cold compress (wrapped in a clean cloth) to the external area for immediate, temporary relief from intense itching.
• Avoid scratching! Scratching will only worsen the problem, damage the skin, and increase the risk of secondary infection.
• Avoid wearing underwear to sleep (if comfortable) to allow maximum air exposure.

Medical Treatments (Prescription Only)

• For Fungal Infections (Yeast): If your healthcare provider diagnoses a yeast infection, they will prescribe topical antifungals (creams or suppositories, such as clotrimazole or miconazole) for 3 to 7 days, as these are generally considered the safest first-line treatment during pregnancy. Oral medications are often avoided or used with caution [5].
• For Bacterial Infections (BV) or Trichomoniasis: These conditions require prescription antibiotics, such as oral or vaginal metronidazole, which are considered safe for use during certain stages of pregnancy when indicated, to prevent serious complications [1], [2].
• Always avoid self-medicating and follow your medical professional’s advice. Over-the-counter creams should only be used after a confirmed diagnosis by your doctor.

How to Prevent Vaginal Itching During Pregnancy?

Preventing genital itching centers on maintaining a healthy, balanced vulvovaginal environment:

• Maintain Proper Personal Hygiene: Use gentle, unscented soaps and never douche, as this disrupts the natural protective pH balance [4].
• Wear Breathable Clothing: Consistently opt for 100% cotton underwear and loose-fitting outer garments to keep the area dry and reduce irritation.
• Stay Hydrated and Mind Your Diet: Adequate hydration is key. Discuss dietary changes, such as incorporating unsweetened, live-culture yogurt or high-quality probiotic supplements, with your doctor. While some studies suggest benefits for promoting healthy bacteria and improving vaginal health, the evidence is limited and specific recommendations should come from your provider [7].
• Practice Safe Sexual Health: Use barrier methods (condoms) to prevent sexually transmitted infections, which are a cause of itching and carry risks in pregnancy [2].

When Should I Be Worried About Vaginal Itching?

It’s essential to differentiate between normal physiological changes and potential infections during pregnancy. While some degree of mild, intermittent itching can be normal due to increased blood flow and hormonal fluctuations, you should contact your healthcare provider immediately if you experience:

• Severe, debilitating, or persistent itching that disrupts your daily activities or affects sleep.
• Itching accompanied by unusual discharge: This includes a frothy, greenish-yellow discharge (Trichomoniasis), a thin, fishy-smelling gray discharge (BV), or a thick, cottage-cheese-like discharge (Yeast) [1], [2], [5].
• Pain, burning, swelling, or severe redness of the vulva.
• Pain during urination or sexual intercourse.

Seeking timely medical advice ensures proper diagnosis and treatment, safeguarding both maternal and fetal health.

Takeaway

While mild vaginal itching during pregnancy is often a normal part of the physiological changes, recurring or severe symptoms should not be ignored. The key to safe management is accurate diagnosis. Always speak to your healthcare provider before trying new remedies or medications, including over-the-counter products. Maintaining meticulous, gentle hygiene and choosing the right clothing are the simplest, most effective steps to keeping discomfort at bay.

Expert Quote:

“Vaginal itching is uncomfortable and can disrupt one’s daily routine. While some amount of vulvovaginal itching is common during pregnancy, it is paramount to get it evaluated by your obstetrician or gynecologist before trying any home remedies or over-the-counter medications to relieve it, as treatment depends entirely on identifying the correct underlying cause.”

Dr. Mandeep Chadha

Frequently Asked Questions (FAQs)

Is Vaginal Itching Common During Pregnancy?

Yes, mild to moderate vulvar itching during pregnancy is common. Hormonal changes and increased vaginal discharge (leukorrhea) can cause this discomfort. It is a frequent complaint, especially in the later trimesters, but it’s usually not serious unless an infection is present.

Are There Safe Treatment Options for Vaginal Itching During Pregnancy?

Yes, there are safe treatment options. Home remedies for general irritation include using unscented, mild soap, wearing breathable cotton underwear, and staying dry. For infections like yeast or BV, your doctor will prescribe pregnancy-safe treatments, such as topical antifungal creams or specific antibiotics, respectively [1], [5]. Always check with your doctor before using any medication or over-the-counter cream.

When Should I Be Concerned About Vaginal Itching During Pregnancy?

You should be concerned if the itching is severe, persistent (lasting more than a few days), or accompanied by other symptoms like unusual discharge, a foul odor, or pain. These could be signs of an infection (like yeast, BV, or trichomoniasis) or other medical conditions. Consult your doctor to determine the cause and receive the right treatment.

At what month does itching start in pregnancy?

Vaginal itching can start at any time during pregnancy, but it is often more common in the second and third trimesters. This is due to the peak hormonal changes and the resulting increase in vaginal discharge that occurs as pregnancy progresses.

How can I get quick relief from vaginal itching at home?

To alleviate vaginal itching immediately at home, try a clean, cold compress (wrapped in a cloth) applied to the external area. Also, avoid scented soaps, douches, or any harsh products, and wear loose, breathable cotton underwear. Keeping the area clean, cool, and dry is crucial. If the itching persists or is severe, consult a doctor to rule out infections or other underlying causes.

References

[1] Kenfack-Zanguim, J., Kenmoe, S., Bowo-Ngandji, A., Kenfack-Momo, R., Thierry Ebogo-Belobo, J., Kengne-Ndé, C., Serge Mbaga, D., Zeuko’o Menkem, E., Lontuo Fogang, R., Tchatchouang, S., Laure Ndzie Ondigui, J., Irma Kame-Ngasse, G., Nina Magoudjou-Pekam, J., Roussel Takuissu, G., Nkie Esemu, S., Nantcho Clavela, N., Barriere Fodjo, A., Ndip, L., Bigoga, J., & Esemu, L. F. (2023). Systematic review and meta-analysis of maternal and fetal outcomes among pregnant women with bacterial vaginosis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 289, 9–18. https://doi.org/10.1016/j.ejogrb.2023.08.013

[2] Van Gerwen, O. T., Opsteen, S. A., Graves, K. J., & Muzny, C. A. (2023). Trichomoniasis. Infectious Disease Clinics of North America, 37(2), 245–265. https://doi.org/10.1016/j.idc.2023.02.001

[3] Marangoni, A., Laghi, L., Zagonari, S., Patuelli, G., Zhu, C., Foschi, C., Morselli, S., Pedna, M. F., & Sambri, V. (2021). New insights into vaginal environment during pregnancy. Frontiers in Molecular Biosciences, 8, 656844. https://doi.org/10.3389/fmolb.2021.656844

[4] Patient.info. (n.d.). Itchy Vulva (Pruritus Vulvae). Retrieved from https://patient.info/womens-health/vulval-problems-leaflet/itchy-vulva-pruritus-vulvae

[5] Disha, T., & Haque, F. (2022). Prevalence and Risk Factors of Vulvovaginal Candidosis during Pregnancy: A Review. Infectious Diseases in Obstetrics and Gynecology, 2022, 1–14. https://doi.org/10.1155/2022/6195712

[6] Ansaldi, Y., & de Tejada Weber, B. M. (2023). Urinary tract infections in pregnancy. Clinical Microbiology and Infection, 29(10), 1249-1253. https://doi.org/10.1016/j.cmi.2022.09.020

[7] Wu, L. Y., Hsu, C. Y., Huang, T. T., Yu, M. H., Chen, M. C., & Chen, H. H. (2024). The Role of Probiotics in Women’s Health: An Update Narrative Review. Taiwanese Journal of Obstetrics & Gynecology, 63(1), 29–36. https://doi.org/10.1016/j.tjog.2023.09.018