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"Vulvar itching, what could be wrong?"
I went to the doctor for very heavy and thick greenish yellow discharge and vulvular irritation including itching and burning. She did a std panel and treated me for chlamydia and gonorrhea because she thought that's what was wrong. My labs came back and I was clean of chlamydia gonorrhea and trichomoniasis along with yeast (which I was also treated for). She said it must just be bv although it typically does not cause the irritation. She treated me with 7 day antibiotic of flagyl and it did nothing and I feel my "issue" is getting worse. What could be wrong? She doesn't seem to have a clue
The most common causes of vulvar itching are infections, specifically a yeast infection (candida), trichomonas and occasionally BV, though as you mention BV typically does not cause itching. STDs such as gonorrhea and chlamydia are also possible though typically present with discharge rather than itching. Other possible causes of vaginal itching and discharge include a retained foreign body (such as a tampon, toilet paper, or even a piece of condom), inflammatory skin conditions such as lichen sclerosis, irritation from productions such as spermicides, gels, douches, or laundry detergent, other skin conditions such as a fungal infection or psoriasis, or irritation due to vaginal atrophy if you are past menopause. Less common would be a fistula (a tract) from the colon to the vagina. The most important first step in figuring out what is wrong is a pelvic exam with a prep of the vaginal secretions. If your doctor hasn't done this yet you need to go back to her and have this done, which will also make sure that there isn't anything retained in your vagina. If you have already had a pelvic exam and it was not revealing, the next person to see would be a gynecologist who can examine you for any of the other causes I listed. If you develop fevers, shaking chills, or unable to eat or drink, or otherwise feel sick you should go to the doctor even sooner to make sure you don't have a systemic infection.
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