Why does itching appear before menstruation and what to do?

Perhaps most women can complain of varying degrees of discomfort before the start of a new monthly cycle. In some, it is manifested by increased irritability and fatigue, in others - abdominal pain and intestinal disorders. Less common are complaints of itching before menstruation: discomfort sometimes occurs in the vulva, or even throughout the body. Such a symptom is alarming: what is it - a norm or a disease?

Can there be itching before menstruation?

In some cases, the female body tries to indicate the existence of a particular problem with uncharacteristic symptoms. For example, itching may appear before menstruation - inside the vagina, or on the external genitalia. Indeed, this happens, and this symptom cannot be ignored.

There can be many reasons for this phenomenon: we will talk about this later. One thing is clear, it is necessary to visit a doctor. Often women think: if there are no other symptoms, then a slight itching before menstruation can be considered a variant of the norm, or one of the manifestations of allergies or traces of stress. Is it normal for itching before period?

If an unpleasant symptom occurs systematically and does not disappear within three or four cycles, then appropriate conclusions must be drawn and still visit a doctor. After all, the causes of the problem are far from always harmless or do not require treatment, but they can aggravate the situation and greatly harm health. Well, if the unpleasant itchy sensations disappeared by themselves, just as they appeared. If this does not happen, then you need to look for the original cause of the problem.

Causes of the itching before menstruation

From the foregoing, it becomes clear that there are many reasons for the appearance of itching before menstruation, and all of them must be considered before making a diagnosis.

• Thrush, or candidiasis, is a fungal infection that primarily manifests itself as itching, as well as the appearance of characteristic cheesy vaginal discharge. Such itching can disturb, both before menstruation, and during and after sexual intercourse. [1]
• Hormonal imbalance is a disorder that many women simply do not think about. In fact, the hormonal influence can be quite strong and is manifested by a wide variety of symptoms, including itching. In the second phase of the monthly cycle, there is often an excess of estrogens against the background of low progesterone production. This causes fluid retention in the tissues, the appearance of edema, potassium deficiency, a disorder of water and electrolyte metabolism. After the normalization of the hormonal balance, all these symptoms disappear.
• Inflammatory processes in the genital area - for example, colpitis, vaginitis, cervicitis. Such diseases can be accompanied not only by itching, but also by whites - liquid vaginal discharge. [2], [3]
• Sexual infections, sexually transmitted diseases - in particular, we are talking about gonorrhea, trichomoniasis, genital herpes.  [4].  [5]. [6]
• Allergic processes are a common cause of itching before menstruation. Allergies can be caused by pads, hygiene and detergents, tampons, and even underwear.
• Insufficient hygiene of the genitals, perineal area.
• Somatic diseases (cardiac pathologies, kidney diseases, respiratory diseases, injuries).
• Nervous breakdowns, stressful and depressive conditions, neuroses.

Risk factors

There are many known causes of itching before menstruation - both harmless and pathological, caused by any disease. However, some people experience itching for the same cause, while others do not. Why it happens? The fact is that certain risk factors play a significant role, which largely affect the intensification of unpleasant symptoms. The most common factors are:

• weak immunity, hypothermia, malnutrition, beriberi;
• improper hygiene care (insufficient or, conversely, excessive), too dry and sensitive skin;
• the presence of bad habits (smoking, drinking alcohol or drugs), prolonged or improper treatment with certain medications (chaotic medication without indications, with a violation of dosage, etc. Is especially dangerous);
• the use of insufficient daily volume of liquid, dehydration;
• exposure to chemical agents;
• prone to allergies, wearing synthetic underwear;
• frequent or deep stress, depression, nervous breakdowns;
• periods of strong hormonal fluctuations (recent abortions, taking hormonal drugs, age after 45 years, etc.);
• overweight, endocrine diseases;
• heredity.

Pathogenesis

There cannot be a single pathogenetic mechanism by which itching appears before menstruation, because there can be many reasons for this problem. Most often, the change in hormonal levels is “to blame” for the problem: about a week before the onset of menstruation, the ratio of estrogens and progesterone in the body changes. At the same time, it is the imbalance of the hormones of the female genital area that regulates the monthly cycle.

The situation is aggravated by the lack of certain vitamins - for example, retinol, pyridoxine, as well as magnesium, calcium and zinc.

The opinions of experts about the pathogenesis differ. For example, the probability of a violation of the water-electrolyte balance or the production of prostaglandins, as well as the hyperadrenocortical mechanism of development, is considered.

As can be seen from practice, itching before menstruation is more likely to bother women with weight instability. In other words, the risk group includes both patients with obvious overweight and those who constantly follow this or that diet, either lose weight sharply or recover sharply.

Symptoms

Often, women believe that itching before menstruation can only mean pathology if it is accompanied by a rash or peeling of the skin. But this is not entirely true: often itching occurs without additional symptoms, or is accompanied by other signs that are most often not associated with each other.

• Itching of the labia before menstruation, associated with hormonal imbalance, can additionally manifest other symptoms. For example, periodic failures of the monthly cycle, scant (or vice versa, heavy) bleeding, discomfort during intercourse, dry mucous membranes, pronounced PMS, and in some cases, the inability to become pregnant are characteristic.
• Itching in the vagina before menstruation is most often associated with an inflammatory process, or with diseases that are sexually transmitted. For example, trichomoniasis is characterized by redness on the labia and groin, swelling of the genitals. With gonorrhea, there is a yellowish or pinkish-yellow discharge, as well as itching and even pain. With genital herpes, a small rash appears around the anus, inguinal lymph nodes increase.
• Itching in the perineum before menstruation can be caused by a fusion of two disease processes: allergies and disorders of the autonomic nervous system. Itching becomes the key pathological symptom - pronounced, interfering with normal living, working and even sleeping. The skin of the perineum eventually becomes dry, inflamed, rough, and sometimes areas of hyperpigmentation appear.
• Itching of the skin of the body before menstruation, redness and peeling, a violation of the general condition can be observed with some dermatological problems that tend to exacerbate on certain days of the cycle, when hormonal changes and a natural drop in immunity occur. In any case, this is a reason to contact a specialist.
• Itching in the anus before menstruation can be triggered by problems such as helminthic invasions, proctitis, hemorrhoids. It is also often associated with non-compliance with personal hygiene rules. Additional symptoms of helminthic lesions can be frequent indigestion, anemia, emaciation, the appearance of circles under the eyes.
• Itching and discharge before menstruation in most cases are caused by colpitis - inflammation of the tissues of the vagina. Colpitis can be caused by various infectious agents, including fungal flora, and genital infections. The main symptoms, in addition to itching, are abundant mucous or purulent discharge, swelling, discomfort during sexual intercourse, pain in the lower abdomen.
• Before menstruation, itching and white discharge with a foreign odor is a symptom indicating the presence of inflammation. The inflammatory process can be limited to the vaginal cavity, or localized in the uterus, appendages. Allocations can be not only white, but also greenish, cloudy, yellowish. The smell is "rotten fish", sour, or putrid.
• Itching and brown discharge before menstruation is sometimes a concern with endometriosis. This disease is also characterized by diverse pains (lower, upper abdomen), the appearance of blood clots during menstruation, frequent inflammatory processes, pronounced PMS, and in some cases infertility.
• Itching before menstruation without discharge and odor often indicates an allergic reaction that develops, for example, when using hygiene products (pads, tampons, intimate gels, etc.). Additional signs are a slight swelling of the genital organs, redness of the mucous membranes, the appearance of rashes like urticaria.
• Itching and burning before menstruation often indicate a violation of the rules of personal hygiene. It can be either insufficient hygiene of the genital organs, or excessive. So, on the eve of menstruation, many women begin to diligently observe hygiene rules, wash themselves several times a day. Washing with too hot water, as well as douching and irrigation with infusions or decoctions, or medicinal antiseptic solutions, has a special load. As a result, the skin becomes dry and hypersensitive, itching appears.
• Severe itching before menstruation, as a sign of vaginal dysbacteriosis, may be accompanied by painful sensations during intercourse, cutting and pain in the genital area, strong or light spotting. If left untreated, vaginitis, cystitis often develops, and dysbacteriosis becomes chronic.
• Before menstruation, curdled discharge and itching are a sure sign of an exacerbation of fungal pathology. Curdled discharge usually has a sour smell, and itching bothers not only before the onset of menstruation, but also after sexual intercourse. Additionally, the general condition may worsen, headaches may appear.
• Before menstruation, burning in the urethra appears due to chronic urethritis or cystitis. Diseases are accompanied by pain and pain when passing urine, redness at the exit of the urethra, the presence of pus or blood in the urine, and discomfort in the lower abdomen.

Depending on the predominance of certain symptoms, the doctor prescribes appropriate diagnostic measures, and only after that makes a final diagnosis and prescribes treatment.

Diagnostics of the itching before menstruation

The basic criterion for diagnosing itching before menstruation is regular cyclicity, the frequency of this symptom, its connection with menstruation (disappearance at the end of the bleeding period).

The doctor must take into account all additional symptoms, clarify the nature of menstruation. An important diagnostic link can be a woman's keeping a kind of diary, where she must track her condition for several cycles, noting any changes and symptoms associated with itching and menstruation.

Laboratory tests must necessarily include a study of the hormonal background, namely, the level of estradiol, prolactin and progesterone. Other tests are prescribed depending on the presence of other complaints and symptoms. These can be general clinical studies (blood, urine), allergy tests, blood sugar determination.

Instrumental diagnostics is carried out as part of an additional examination. It may include:

• evaluation of ovarian function;
• electroencephalogram;
• X-ray of the skull, Turkish saddle.

If necessary, it is recommended to consult a neurologist, dermatovenereologist, endocrinologist, infectious disease specialist.

Differential diagnosis

Differential diagnosis is carried out:

• with dermatological itching (atopic dermatitis, psoriasis, dermatoinfections);
• with systemic itching (with liver diseases, chronic renal failure, blood diseases);
• with neurogenic itching (disorders of the peripheral and central nervous system);
• with psychogenic itching.

For example, hormonally caused dryness of the skin and mucous membranes, cholestasis, iron deficiency anemia, age-related changes can also cause limited itchy sensations.

If it is impossible to establish the cause of itching before menstruation by diagnostic means, then the presence of an idiopathic disorder is indicated.

Treatment of the itching before menstruation

Women who regularly have itching associated with the onset of menstruation are advised to lead a healthy lifestyle, give up bad habits, normalize work and rest, and prevent stress. In the second phase of the cycle, you should follow a diet that limits the intake of carbohydrates and salt. Particular emphasis should be placed on a healthy full-fledged night's rest, regular walks in the fresh air. Physical activity will also bring benefits - in particular, cycling, swimming, yoga, aerobics.

As a drug treatment, depending on the underlying disease, the doctor may suggest:

• taking oral contraceptives or progesterone drugs;
• taking antiestrogen (Tamoxifen) or antigonadotropins (Goserelin);
• homeopathic remedies (Cyclodinone, Remens);
• sedatives (valerian extract, motherwort tincture), tranquilizers (Phenibut);
• diuretics (Furosemide);
• analgesics (Ibuprofen, Nimesil);
• vitamins;
• antihistamines (Cetirizine, Loratadine);
• psychotherapy.

Medications that a doctor may prescribe

• Ketoconazole is a systemic antifungal drug that is usually prescribed at 200-400 mg per day. The duration of therapy may be different, depending on the extent of the fungal infection. Ketoconazole is not used in case of hypersensitivity to the drug. Possible side effects when taken can be abdominal pain, nausea, headaches, sleep disturbances.
• Novo-Passit is a sedative and anxiolytic drug that effectively calms, relieves mental stress, and relaxes smooth muscles. Novo-passit is successfully used to eliminate increased neuromuscular excitability, as well as for dermatosis, which is accompanied by itching. The solution is taken 5 ml three times a day (sometimes the dose is increased to 10 ml). Side effects are a feeling of fatigue, dizziness, digestive disorders, muscle weakness. If digestive disorders occur, the remedy should be taken with food.
• Cetirizine is a systemic antihistamine, which is taken 10 mg at a time, during dinner. The indication is a different type of itching, including idiopathic. Generally, cetirizine does not cause drowsiness when taken at the recommended doses. Headaches, dry mouth are rarely noted.
• Remens - refers to complex homeopathic remedies, which are successfully used to eliminate PMS, hormone-induced itching before menstruation, and also as part of complex therapy for inflammatory processes in the genital area. The standard course of treatment is 3 months. Remens is taken 10 drops three times a day (unless otherwise prescribed by the doctor). Side effects are practically not found: the exception is hypersensitivity to the composition of the drug.
• Phenibut is a drug that can act on neurogenic itching. It relieves nervous tension, normalizes sleep, improves the functional state of the brain. Phenibut is taken before meals, 250-500 mg three times a day, for 14-21 days. In rare cases, at the very beginning of treatment, side symptoms such as headache, dizziness, and nausea may disturb.

Vitamins

An additional intake of vitamins can relieve itching before menstruation, because many processes in the body are inextricably linked with what and in what quantities a person eats. Women who are concerned about discomfort in this period should increase the percentage of foods rich in zinc, calcium, and B vitamins in their diet.

With the approach of a new menstrual cycle, the female body begins to lack potassium and magnesium, which directly affect the state of the vascular network. The source of these minerals are bananas, herbs, nuts, seeds, apricots, bran. If the need arises, you can take pharmaceutical preparations - for example, Magne B ₆, Magnikum, Asparkam, Panangin.

In addition to minerals, before menstruation there is an additional need for tocopherol, or vitamin E. This vitamin is present in nuts, cereals, vegetable oils, as well as in pharmaceutical preparations - for example, Aevit.

To ensure the full effect, you need to supplement the diet with iron, ascorbic acid and vitamin B ₁₂, calcium.

Physiotherapy treatment

Physiotherapy can be prescribed in combination with drug treatment and psychotherapy, which allows you to reduce the dosage of medications while maintaining the maximum therapeutic effect. Physical procedures normalize the functionality of the central nervous system and the autonomic nervous system, stabilize the hormonal background and the psycho-emotional state of the patient.

• The method of transcranial electroanalgesia involves the impact of pulsed currents, which has a calming and analgesic effect, stabilizes the nervous system.
• Electrosleep - affects the brain with the help of low-frequency pulsed currents, which reduces the excitability of the nervous system, improves hormonal pituitary function.
• The galvanization method involves the use of direct electric current, which has a calming effect and reduces the excitability of the brain.
• Medical electrophoresis with sedatives on the collar area has a calming and tonic effect.
• Acupuncture, reflexology affects the bioactive zones, providing an antidepressant, analgesic effect.
• The use of a contrast or circular shower eliminates the effects of stress, improves the general state of immunity, relieves tension, irritability, and normalizes sleep.
• Coniferous, iodine-bromine, radon baths have a calming effect, normalize the functionality of the reproductive organs, anesthetize, and stabilize the hormonal background.
• Therapeutic massage reduces the excitability of the nervous system, has a relaxing effect, and optimizes metabolic processes.

Alternative Treatment

Alternative medicine, which offers a wide arsenal of recipes, will also help overcome itching before menstruation. You can get to know them right now:

1. Dandelion root extract. To prepare it, brew 1 tbsp. L. Dried root 200 ml of boiling water, keep under the lid for about half an hour, filter. Further, the drug is taken 100 ml twice a day before meals. Treatment should begin approximately 10 days before the expected first day of a new monthly cycle.
2. Infusion from the fruits of red rowan. Washed with 2 tbsp. L. Fruits, pour 500 ml of boiling water and insist under the lid until completely cooled. Next, the infusion is filtered and drunk during the day a little.
3. Fennel seed infusion. Take 1 tbsp. L. Seeds, pour boiling water (0.5 l), keep under the lid for 20 minutes. Taken warm during the day.
4. A decoction of Ivan-tea. Plant in the amount of 1 tbsp. L. Pour 500 ml of water, place on a small fire, bring to a boil and boil for 2 minutes, then remove from heat, cover with a lid and leave for an hour to infuse. After that, the agent is filtered and drunk before meals, 100 ml each.

Herbal treatment

You can supplement traditional treatment by taking various useful herbal preparations. You can cook them from such plants:

1. Juniper fruits, yarrow herb, licorice root.
2. Hawthorn flowers, cudweed grass, chamomile flowers, motherwort grass.

These herbs are taken in equal amounts. Next, take 2 tbsp. L. Mixture, pour 500 ml of boiling water and infuse in a thermos for half an hour. The infusion is cooled, filtered and taken little by little throughout the day, regardless of the time of the meal.

Some women manage to soothe itching before menstruation with lemon balm tea. Take 2 tbsp. L. Dry leaves of lemon balm, pour 250 ml of boiling water, keep under the lid for an hour. Drink this tea twice a day, between meals.

In addition, an infusion of cornflower flowers can also be useful. Pour 1 tbsp. L. Flowers 250 ml of boiling water, insist under the lid for half an hour. Next, the infusion is filtered and divided into three portions: for morning, afternoon and evening intake.

Homeopathy

Homeopathy can offer many remedies for getting rid of itching before menstruation. The choice of the drug is entirely the work of a specialist, since the appointment is carried out taking into account the constitutional characteristics of the woman. Reception of the selected remedy in high potency begins the day before the onset of discomfort.

The drugs of choice may be:

• Pulsatilla is used for itching on the background of scanty and irregular periods, with chilliness, swelling and a tendency to tearfulness.
• Sepia is suitable if itching in the genitals is accompanied by a constant feeling of fatigue, nausea, tachycardia, migraine, burning pains.
• Lachesis is prescribed for patients prone to irritability, talkativeness, inexplicable anxiety.
• Graphite is suitable for eliminating itching in patients who are prone to fullness, owners of dry and rough skin. Itching they appear before the meager menstruation, characterized by discomfort in the vagina and / or anus.
• Conium will help with significant endocrine insufficiency, as well as in cases where itching before menstruation is accompanied by engorgement of the mammary glands.
• Nux vomica can be used by strong-willed, masculine patients.
• Causticum is suitable in cases of itching in the urethra, as well as cystitis and urinary incontinence.

Complications and consequences

Lack of treatment, or incorrect treatment tactics for itching before menstruation, can lead to the development of serious complications. Such complications can be divided into two groups:

1. Close consequences in the form of external infectious processes, chronic fungal infections, intimate problems.
2. Long-term consequences in the form of urinary infections (cystitis, urethritis, nephritis, inflammation of the reproductive organs), infertility.

These pathologies can manifest themselves in complicated and chronic forms of itching, which is relatively rare in medicine.

Prevention

Preventive measures to prevent itching before menstruation should always be comprehensive. At the same time, experts immediately indicate a whole list of ways that can not only prevent the problem, but also reduce the manifestations of an existing itch.

• Hormonal preparations.

They are taken only as directed by a gynecologist, and never on their own. This applies to both hormone replacement therapy and oral contraceptives.

• Sedative drugs.

Such funds are recommended to be taken shortly before the start, as well as during menstruation. Valerian or motherwort tinctures, viburnum bark, peony rhizome, mint tea are best suited.

• Elimination of bad habits.

Itching before menstruation often worries those women who have one or more addictions - for example, they smoke, drink alcohol, or drink a lot of strong coffee during the day. Therefore, such habits should be abandoned as soon as possible.

• Proper nutrition.

Eating only healthy food is the foundation of good health. It is recommended to severely limit or completely exclude such foods as weaknesses, pastries, soda, excessively fatty and spicy dishes from the diet.

• Physical activity.

A physically active life significantly affects the health of women - of course, in a positive aspect. Walking, sports training, outdoor games, swimming, bike rides - all this not only improves metabolic processes, but also activates the production of serotonin and endorphin - substances known to many as “hormones of joy”. Among other things, an active life reduces cravings for unhealthy foods.

• Timely and complete rest.

Throughout the cycle, including before menstruation, we must not forget about quality rest. And this is not only a healthy night's sleep: you can take a course of massage procedures, take a relaxing bath, take a leisurely walk in the park. It would seem that nothing complicated. But in such a simple way, many problems with the nervous system can be prevented, including itching before menstruation.

• The development of stress resistance.

In moments of conflict situations, it is important to be able to competently get away from stress, or to prevent an unpleasant development of the situation, if possible.

• Timely treatment of diseases.

So that itching before menstruation never bothers, it is important to contact doctors in time and treat any diseases - inflammatory or allergic processes, fungal infections, dysbacteriosis, etc.

Forecast

Itching before menstruation is a serious problem that reduces a woman's ability to work and worsens her quality of life. In some cases, the problem can even lead to mental breakdowns. If you find regular signs of itching, you need to visit a doctor and be examined. The doctor will perform a differential diagnosis with similar pathologies, after which he will prescribe the necessary therapeutic measures. But self-medication can significantly aggravate the situation. In the presence of the disease and in the absence of adequate treatment, the problem may progress, and in the future the symptoms will expand. In addition, the course of background pathologies, for example, inflammatory processes in the reproductive apparatus, may worsen.