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Itching, burning, pain, infections?

Itching, burning, pain, infections? You are not alone.

Alex Scranton
Director of Science
and Research

Here’s the deal: vulvovaginitis (or vaginitis) symptoms are really common.

If you are experiencing vulvar or vaginal inflammation — pain, itching, burning, irritation or infections – you are not alone. You may not be talking about your symptoms – in fact, many others are keeping quiet about them as well. This silence is a problem. As a result this health issue is not getting the attention it rightly deserves. Research on vaginal symptoms and their causes is scant, at best. While we have been able to identify some risk factors, for the most part we really don’t know what is causing most of the itching, burning and infections of the vulva and vagina. What’s worse, the few treatments available, are truly inadequate — often only successful for the short term – and way too many people have recurring symptoms month after month.

Check out these numbers – which give a picture of how grim the situation is:

A 2019 snapshot survey of over 1,500 women in Boston found that more than a third reported they were currently experiencing one or more moderate to severe symptoms such as vulvar or vaginal itching, burning, discharge, dryness and/or pain.[1] Over a lifetime it is estimated that at least 75% of women in the U.S. will experience episodes of vaginitis at some point.[2]

While to some this may seem like a minor discomfort or inconvenience, vaginal symptoms — especially those which involve disrupted vaginal skin or an unhealthy imbalance of vaginal bacteria — can increase the risk of much more serious conditions. For example, studies have shown that vaginitis and abnormal vaginal bacteria are associated with a significantly higher risk of pre-term birth and miscarriage.[3] Similarly, a disrupted balance of vaginal bacteria can reduce the chances of successful in vitro fertilization (IVF).[4] Bacterial vaginosis is well-known to increase risks of contracting sexually-transmitted diseases such as HIV,[5] chlamydia and Gonorrhea.[6] Preliminary research indicates that disrupted vaginal bacteria may significantly increase the risk of cervical cancer.[7]

How are most people handling their symptoms? Most commonly, people are self-treating their symptoms with over-the-counter products – at least initially. Douches, washes, anti-itch creams and over-the-counter yeast infection medications are widely used in hopes of quickly and quietly resolving these problems. Seeking professional medical care often comes much later, (if at all) when other options have repeatedly failed.

An important question on our minds is…how frequently are vulvar and vaginal symptoms caused or exacerbated by the intimate care products people use on their bodies? Could the chemicals in these products be causing adverse reactions in sensitive vulvar and vaginal tissue? Might these chemicals be upsetting the beneficial balance of vaginal bacteria? Could the creams, washes and wipes people are using in hopes of lessening their symptoms, actually be worsening the problem?

There is some evidence to support these concerns:

  • A 2018 survey conducted in Canada found that people who reported using any vaginal or genital hygiene products were three times as likely as those who did not to report adverse vaginal symptoms.[8]
  • Another study tested a store-bought “feminine” moisturizer, lubricant and spermicide and found that all three products effectively killed lactobacillus, a particularly important type of beneficial vaginal bacteria.[9]
  • Numerous studies have found higher rates of abnormal vaginal bacteria and higher rates of bacterial vaginosis in people who douche regularly.[10]
  • A study of women in Los Angeles found that those who reported intravaginal use of petroleum jelly had more than twice the risk of bacterial vaginosis.[11]
  • Associations with product use can also be made among populations that experience disproportionately higher rates of vulvar and vaginal symptoms. For example, Black women have both higher rates of bacterial vaginosis and more frequently report using douche and other intimate care products than white women.[12] Similarly overweight and obese women are also at greater risk of bacterial vaginosis, and also more commonly report use of vaginal products than women who weigh less.[13]

This research is far from complete, however. None of these studies represents a smoking gun which tells us that intimate care product use is causing these harms. But they add to the body of evidence that supports a valid reason for concern – and they justify the dire need for more investigation.

What can you do to help change the situation?

Voice your frustration! Talk about your symptoms with others – and express your dissatisfaction with the treatments (or lack thereof) that are available to you. (You will find many others who are right there with you in your situation.)

Question your use of intimate care products. Do you notice a change in symptoms if you do not use them or switch brands? Could they be making your symptoms worse instead of better?

Question your healthcare. Are you getting the healthcare you deserve? Are you being heard? As studies show, Black women’s health is being disproportionally impacted by exposures to intimate care products — organizations like Black Women’s Health Imperative (BWHI) and Black Mamas Matter Alliance offer invaluable resources and support centered on the health and well-being of Black women and girls.

Ask hard questions of manufacturers of intimate care products. Ask what they are doing to assure your safety and health. Do they know if their customers report higher rates of symptoms? Do they know what effect their product has on beneficial vaginal bacteria?

Let go of shame or embarrassment. Vaginal symptoms are incredibly common, experienced by the vast majority of us – and not a sign of personal failings or bad choices.

Join Women’s Voices for the Earth to raise your voice with others to demand a safer and healthier world.

——————-

[1] Watson LJ, James KE, Hatoum Moeller IJ, Mitchell CM. Vulvovaginal Discomfort Is Common in Both Premenopausal and Postmenopausal Women. J Low Genit Tract Dis. 2019;23(2):164-169. doi:10.1097/LGT.0000000000000460

[2] Lanis A, Talib HJ, Dodson N. Prepubertal and Adolescent Vulvovaginitis: What to Do When a Girl Reports Vaginal Discharge. Pediatr Ann. 2020;49(4):e170-e175. doi:10.3928/19382359-20200317-01

[3] Donders GG, Van Calsteren K, Bellen G, et al. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG. 2009;116(10):1315-1324. doi:10.1111/j.1471-0528.2009.02237.x

[4] Kong Y, Liu Z, Shang Q, et al. The Disordered Vaginal Microbiota Is a Potential Indicator for a Higher Failure of in vitro Fertilization. Front Med (Lausanne). 2020;7:217. Published 2020 Jun 24. doi:10.3389/fmed.2020.00217

[5] Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008;22(12):1493-1501. doi:10.1097/QAD.0b013e3283021a37

[6] Wiesenfeld HC, Hillier SL, Krohn MA, Landers DV, Sweet RL. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin Infect Dis. 2003;36(5):663-668. doi:10.1086/367658

[7] Mitra A, MacIntyre DA, Marchesi JR, Lee YS, Bennett PR, Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next?. Microbiome. 2016;4(1):58. Published 2016 Nov 1. doi:10.1186/s40168-016-0203-0

[8] Crann SE, Cunningham S, Albert A, Money DM, O’Doherty KC. Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey. BMC Womens Health. 2018;18(1):52. Published 2018 Mar 23. doi:10.1186/s12905-018-0543-y

[9] Fashemi B, Delaney ML, Onderdonk AB,  and Fichorova RN. (2013)  Effects of feminine hygiene products on the vaginal mucosal biome.  Microbial Ecology in Health and Disease.  Vol. 24. 19703. 2013.

[10] Cottrell, B. H. (2010). An updated review of evidence to discourage douching. The American Journal of Maternal Child Nursing. Vol. 35, No.2, pp:102-107. March/April 2010.

[11] Brown JM, Hess KL, Brown S, Murphy C, Waldman AL, Hezareh M. Intravaginal practices and risk of bacterial vaginosis and candidiasis infection among a cohort of women in the United States. Obstet Gynecol. 2013;121(4):773-780. doi:10.1097/AOG.0b013e31828786f8
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[12] Koumans EH, Sternberg M, Bruce C, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007;34(11):864-869. doi:10.1097/OLQ.0b013e318074e565
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[13] Brookheart RT, Lewis WG, Peipert JF, Lewis AL, Allsworth JE. Association between obesity and bacterial vaginosis as assessed by Nugent score. Am J Obstet Gynecol. 2019;220(5):476.e1-476.e11. doi:10.1016/j.ajog.2019.01.229

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