What are some causes of feminine itching? I'm 53 years old, I haven't had a period in five years and I have no infections that I am aware of.

--M.D.

Yeast and bacterial infections are very common in postmenopausal women who are not on estrogen replacement. Although you say you have no infections you are aware of, it is impossible to rule out infection with certainty without an examination; therefore, you should see your gynecologist for a complete evaluation.

There are several reasons other than infection for genital itching. Sensitivity to soaps or detergents is one; it is best to wash the genitals with plain warm water, and avoid scented toilet papers and sanitary pads. Menopause in and of itself can contribute to itching. The lack of estrogen that occurs after menopause leads to thin, dry, sensitive vaginal tissues.

Other noninfectious causes of vaginal itching are more ominous. With vulvar dysplasia (abnormal cells) or cancer, itching may be the first -- and many times only -- symptom. In some cases, the skin may be white or red, or have a different texture than the rest of the vulvar skin. If an abnormal-appearing area is noted during an exam, the doctor may take a small biopsy (sample of tissue) in the office. Laser treatment is sometimes used to eliminate dysplasia, but for cancer, the abnormal area must be cut out surgically. In early cancers, this is a simple procedure that is usually curative, but in later-stage disease, the surgery is extensive and is usually done by a subspecialist called a gynecologic oncologist.

I suggest you make an appointment to see your gynecologist., Most likely this itching is from a benign, but annoying, cause that can be easily treated. In a postmenopausal woman with genital itching, however, abnormalities such as dysplasia or cancer must always be ruled out.