Differential Diagnosis for Vaginal Itching and Burning in a Postmenopausal Woman
Single Most Likely Diagnosis
- Vulvovaginal Atrophy (VVA): This condition, also known as genitourinary syndrome of menopause (GSM), is the most common cause of vaginal itching and burning in postmenopausal women. It occurs due to the decrease in estrogen levels, leading to thinning, drying, and inflammation of the vaginal walls.
Other Likely Diagnoses
- Vaginal Infections: Such as bacterial vaginosis, candidiasis (yeast infection), and trichomoniasis. These infections can cause itching, burning, and abnormal discharge.
- Irritants or Allergens: Exposure to soaps, detergents, douches, or spermicides can irritate the vaginal area and cause itching and burning.
- Lichen Sclerosus: A chronic skin condition that can cause thinning and patchy skin in the genital area, leading to itching and discomfort.
Do Not Miss Diagnoses
- Vulvar Cancer: Although rare, vulvar cancer can present with itching and burning in the vulvar area. Early detection is crucial for effective treatment.
- Lichen Planus: An autoimmune condition that can affect the skin and mucous membranes, including the vagina, causing itching, burning, and pain.
- Herpes Simplex Virus (HSV): Genital herpes can cause itching, burning, and painful blisters in the genital area.
Rare Diagnoses
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by vaginal inflammation, itching, and burning, often accompanied by a yellowish discharge.
- Vaginal Dermatoses: Such as psoriasis, eczema, or contact dermatitis, which can affect the vaginal area and cause itching and burning.
- Neurological Disorders: Certain conditions like vulvodynia or neuropathic pain can cause chronic itching and burning sensations in the vaginal area without any visible signs of infection or inflammation.