What Causes Vaginal Itching During Pregnancy?

Vaginal itching during pregnancy is commonly related to hormonal changes or a yeast infection. Medication and a sexually transmitted infection (STI) are other possible causes. Talk to your provider since some conditions need medical treatment to reduce the risk of pregnancy complications.

Causes of Vaginal Itching During Pregnancy

There are several reasons you might experience vaginal itching during pregnancy. Most causes do not require aggressive treatment, but some may need medication. Eight possible causes are:

• Vaginal yeast infections, also known as vaginal thrush or vaginal candidiasis, are caused by the fungus Candida albicans. These infections are particularly common during the second trimester. While uncomfortable, they pose little risk to your fetus.
• Sexually transmitted infections, such as herpes, chlamydia, gonorrhea, and trichomoniasis, can lead to vaginal itchiness. Treating these infections is crucial as they can be passed to your fetus and cause serious complications.
• Bacterial vaginosis is a bacterial infection that occurs when the healthy bacteria in your vagina become imbalanced and overgrow, causing irritation and itching. This infection can raise the risk for premature birth, low birth weight, and breathing problems in the fetus.
• Group B strep infection is a common type of bacteria carried by 10% to 30% of pregnant people. During labor, group B strep can be transmitted 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 both you and your baby.
• Hormonal changes during pregnancy can make your skin more sensitive, leading to dryness, cracking, rash, and itching.
• Breastfeeding, as well as preparing for it, lowers estrogen levels and can lead to vaginal dryness and itchiness.
• Medications, such as certain antihistamines and antidepressants, can also cause vaginal dryness and itchiness.
• Pubic hair can grow long and wiry during pregnancy, causing itchiness when it rubs against the skin, especially if you wear tight underwear or pants.

How to Soothe the Itch

Various treatments are available for 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

Some topical medications, like Vagisil cream, don’t contain antifungal agents but aim to reduce itching using 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, especially 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.

Prevention Tips

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.