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Have red and itchy vagina. What is the normal length of menstrual bleeding?

Mar 2013
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Practicing since : 1998
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My periods go for longer than 5 days It starts with spotting for 3-4 days and normal bleeding for 4-5 days. Is it ok? And every time when its get over I get deliberate Itching sensation in my vaginal area and since last month the whole area has got some red marks also.
Posted Thu, 28 Feb 2013 in Menstruation and Miscarriage
Answered by Dr. Aarti Abraham 17 minutes later
Thanks for writing to us with your health query.
Every woman has a unique menstrual pattern, and a length of menstrual bleeding for upto 8 days is normal.
You should be worried if the flow is excessive , or with clots, or excessive cramping.
Also, what you are experiencing is called pre menstrual spotting.
If this has been your pattern ever since you attained menarchae ( your periods began ), you need not worry, however if this pre menstrual spotting is a recent development, it requires further evaluation.
The commonest reason is low levels of progesterone in the luteal ( post ovulatory phase ), which leads to incomplete shedding of the lining of the uterus. It could be age related, due to stress, anxiety etc, thyroid hormone disorders , increased prolactin levels, or due to polycystic ovarian disease.
Certain hormonal medications ( commonly birth control pills ) are the reason for such pre menstrual spotting.
Pelvic infections, ovarian or uterine tumours etc. also could cause such spotting.
A condition called endometriosis also might present in this way.
In order to confirm the diagnosis, please consult a gynecologist, go for an indepth evaluation, and a pelvic ultrasound scan also.

As for the itching and red marks in the vaginal area, you are suffering from vulvovaginitis.
Vulvovaginitis refers to inflammation of both the vagina and vulva (the external female genitals). These conditions can result from an infection caused by organisms such as bacteria, yeast or viruses. In addition, irritations from chemicals in creams, sprays, or even clothing that are in contact with this area can result in vaginitis. In some cases, vaginitis results from organisms that are passed between sexual partners and from vaginal dryness and lack of estrogen.

The six most common types of vaginitis are:

Candida or "yeast" vaginitis
Bacterial vaginosis
Trichomoniasis vaginitis (a sexually transmitted infection)
Chlamydia vaginitis
Viral vaginitis
Non-infectious vaginitis
Atrophic vaginitis

Each of these vaginal infections can have different symptoms, or no symptoms at all. In fact, diagnosis can even be tricky for an experienced clinician. Sometimes more than one type of vaginitis can be present at the same time.

Yeast infections produce a thick, white vaginal discharge with the consistency of cottage cheese. Although the discharge can be somewhat watery, it is odorless. Yeast infections usually cause the vagina and the vulva to be very itchy and red, even before the onset of discharge.

Bacterial vaginosis (BV) actually is the most common vaginal infection in women of reproductive age. Bacterial vaginosis often will cause a vaginal discharge. The discharge usually is thin and milky, and is described as having a "fishy" odor. This odor may become more noticeable after intercourse.

Redness or itching of the vagina are not common symptoms of bacterial vaginosis. Some women with BV have no symptoms at all, and the vaginitis is only discovered during a routine gynecologic exam. Bacterial vaginosis is caused by a combination of several bacteria. These bacteria seem to overgrow in much the same way as do candida when the vaginal pH balance is upset.

Trichomoniasis - When this organism infects the vagina, it can cause a frothy, greenish-yellow discharge. Often this discharge will have a foul smell. Women with trichomonal vaginitis may complain of itching and soreness of the vagina and vulva, as well as burning during urination. In addition, there can be discomfort in the lower abdomen and vaginal pain with intercourse. These symptoms may be worse after the menstrual period. Many women, however, do not develop any symptoms. It is important to understand that this type of vaginitis can be transmitted through sexual intercourse. For treatment to be effective, the sexual partner must be treated at the same time as the patient.

Chlamydia — Is the most common sexually transmitted infection (STI). Unfortunately, most women with chlamydia infection do not have symptoms, making diagnosis difficult. A vaginal discharge is sometimes present with this infection but not always. More often, a woman might experience light bleeding, especially after intercourse, and she may have pain in the lower abdomen and pelvis. Chlamydial vaginitis is most common in young women (18 to 35 years) who have multiple sexual partners. Routine chlamydia screening is done annually for sexually active females age 15-26 years and older if you have multiple sexual partners.

Viral vaginitis — Viruses are a common cause of vaginitis. One form caused by the herpes simplex virus (HSV) is often just called "herpes" infection. These infections also are spread by sexual contact. The primary symptom of herpes vaginitis is pain associated with lesions or "sores." These sores usually are visible on the vulva or the vagina but occasionally are inside the vagina and can only be seen during a gynecologic exam.

Another source of viral vaginal infection is the human papillomavirus (HPV). HPV, sometime referred to as genital warts, also can be transmitted by sexual intercourse. This virus can cause painful warts to grow in the vagina, rectum, vulva or groin. These warts usually are white to gray in color, but they may be pink or purple. However, visible warts are not always present, and the virus may only be detected when a Pap smear is abnormal. Outbreaks of HPV often are associated with stress or emotional distress.

Occasionally, a woman can have itching, burning and even a vaginal discharge without having an infection. The most common cause is an allergic reaction or irritation from vaginal sprays, douches or spermicidal products. The skin around the vagina also can be sensitive to perfumed soaps, lotions, sexual lubricants detergents, and fabric softeners.

Atrophic vaginitis, or vulvovaginal atrophy, is another non-infectious form of vaginitis that results from a decrease in hormones. The vagina becomes dry or "atrophic." The woman may notice pain (especially with sexual intercourse), vaginal itching and burning, or symptoms of urinary urgency and frequency.

Because different types of vaginitis have different causes, the treatment needs to be specific to the type of vaginitis present. I would urge you to have a thorough check up by a gynecologist, and additional testing/swabs of the local area as indicated.

Meanwhile ;

If you recently changed your soap or laundry detergent or have added a fabric softener, you might consider stopping the new product to see if the symptoms remain. The same instruction would apply to a new vaginal spray, douche, sanitary napkin or tampon. Avoid garments that hold in heat and moisture. The wearing of nylon panties, pantyhose without a cotton panel and tight spandex or jeans can lead to yeast infections. Good menstrual hygiene also is important. Do not use vaginal sprays or heavily perfumed soaps for cleansing this area. Likewise, repeated douching may cause irritation or, more importantly, may hide a vaginal infection.

Safe sexual practices can help prevent the passing of diseases between partners. The use of condoms is particularly important.

I hope the information has helped you.
Please feel free to ask for further clarifications.
take care.
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