I'm 20 years old, and I have a terrible itch in the vaginal area. I know it is not chlamydia or something like that because I'm a virgin, and I couldn't have a sexually transmitted disease. What could this be?

M.

There are many problems that can cause vaginal itching. While most are infections, some are due to irritation rather than infection. Such irritation can be caused by substances such as detergents and soaps. Other possible causes of irritation include reactions to tampons or sanitary napkins. Estrogen depletion can also cause vaginal irritation. While this occurs commonly with menopause, there are uncommon circumstances in which a premenopausal woman could be deficient in estrogen.

A much more common cause of vaginitis is infection. While most vaginal infections are sexually transmitted, many are not. Trichomoniasis is one of the most common sexually transmitted diseases. This infection causes a vaginal discharge and intense itching. While trichomoniasis is usually sexually transmitted, it can also be spread in hot tubs or on contaminated towels.

Bacterial vaginosis is a similar syndrome that is usually caused by the bacterium Gardnerella vaginalis. While this syndrome occurs most commonly in sexually active women, it has been described in women who are not. Therefore, this infection is a possibility in your case.

Candida vaginitis, or a vaginal yeast infection, probably has little relationship with sexual activity. In this infection, the woman has itching and sometimes a white, cottage-cheese-like discharge. This infection often occurs after taking a course of antibiotics for another illness. Candida can be a particular problem in women with diabetes and HIV infection. It is not at all uncommon in virgins.

All things considered, the most likely cause of your symptoms is a vaginal yeast infection. There are several over-the-counter treatments for this infection, though to be sure of your diagnosis, you should see your doctor. All the infections I mentioned can be easily treated by prescription medications, and vaginal yeast infections can be cured by a single prescription pill called Diflucan (generic name fluconazole).