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MoonDragon's Obgyn Information
PRURITUS VULVAE
(Itchy Vulva)




BASIC INFORMATION


"For Informational Use Only"
For more detailed information contact your health care provider
about options that may be available for your specific situation.


DESCRIPTION

Pruritus Vulvae (Itchy Vulva) is an acute or chronic disorder of the skin around the vulva (the vaginal lips) and anal region of women. Most women have a slight itch from time to time, however, pruritus vulvae means the itch is persistent and causes distress. This disorder is characterized by severe itching. Itch at night may be particularly bad, and disturb your sleep. It is not contagious. It affects female adolescents and adults, especially after menopause, but it can affect a woman at any age. Approximately 1 in 10 women see their health care provider about persistent vulvar itch at some stage in their life. It is quite common and can result in a lot of distress, often for many years. Treatment may only relieve symptoms temporarily.

Pruritus vulvae is not the same condition as vulvodynia. Vulvodynia is defined as a chronic vulvar discomfort or pain, characterized by burning, stinging, irritation or rawness of the female genitalia in cases in which there is no infection or skin disease of the vulva or vagina causing these symptoms.





FREQUENT SIGNS & SYMPTOMS

  • Intense itching, sensitivity and irritation in the genital area. The skin may be dry.


  • Thin, white vaginal discharge (sometimes).


  • Discomfort during sexual intercourse.





  • CAUSES

  • Stress may increase vaginal itching and make you more susceptible to infections.


  • Skin disease, such as psoriasis, dermatitis, lichen simplex, lichen sclerosus or lichen planus.


  • Systemic disease, such as diabetes mellitus.


  • Any cause of a generalized body itch may include the vulva. For example, a side effect of some medicines, some blood disorders, some thyroid problems.

  • Vaginal atrophy and dryness from less natural vaginal lubrication caused by estrogen deficiency, common after menopause. The vulvar and vaginal skin tends to become thinner and dryer after menopause, which can make it prone to itch.


  • Pregnancy can cause itch due to vulvar engorgement.


  • Chemical irritants - Skin reaction to irritants, such as excessive sweat, toilet tissue, sanitary pads, detergents, fabric softeners, feminine sprays, ointments, creams, soaps, douches, deodorants, powders, perfumes, contraceptive foams and jellies and and some types of fabrics. Irritant contact dermatitis is due to scratching, friction, soap, occlusive underwear or inappropriate chemical-medicinal applications.


  • Systemic allergies, including food allergies.


  • Disorders of the vagina or rectum, such as vaginitis or hemorrhoids. An infection such as threadworm or pinworm (a parasitic infection mainly affecting children), scabies, candida (also called thrush), and some sexually transmitted diseases such as trichomoniasis, or gardnerella.

    Vaginal yeast infections often includes a discharge that is white and curd-like. Vaginal yeast infections can be brought on by antibiotics, birth control pills, pregnancy, menstruation, condom use, sexual intercourse, diabetes, and a weakened immune system.

    Vaginitis symptoms include inflammation, itching, discharge, and odor caused by other infections, including sexually transmitted diseases (STDs). see links above. Vaginitis in girls before puberty is common. If a young girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed.


  • Urinary incontinence.


  • Skin tumor or precancerous or cancerous vulvar conditions such as vulvar intraepithelial neoplasia, extramammary Paget disease, or vulvar cancer (invasive, but rare).


  • In some cases, no cause can be found.




    RISK INCREASES WITH

  • Stress.


  • Days prior to menstruation.


  • Hot, humid weather.


  • Diabetes mellitus.


  • Lack of urinary control.


  • Post-menopause.


  • Use of irritating chemicals and medications.





  • PREVENTIVE MEASURES

  • Wear cotton underpants rather than nylon or other synthetic material. Keep all underwear and outerwear loose and made from natural materials.


  • Avoid contact with irritants listed in Causes.


  • Obtain treatment for underlying disorders.





  • EXPECTED OUTCOME

  • Treatment usually provides relief in 1-2 weeks.





  • POSSIBLE COMPLICATIONS

  • Secondary bacterial infection of the inflamed skin.


  • Chronic course.




  • TREATMENT


    GENERAL MEASURES

    DIAGNOSTIC

  • Diagnostic tests may include laboratory study of vaginal secretions, urine, and blood studies (including hormone levels) and if needed, a biopsy of the vulva (removal of a small amount of tissue for laboratory examination).


  • Physical exam of the affected area. Swab samples may be taken for microscopic examination. A pap smear may be performed.


  • Allergy patch tests may be performed to determine whether any contact allergy to a fragrance, medication, or other material is present.

    TREATMENT

  • Treatment will depend on the underlying cause. For example, anti-fungal cream for thrush, antibiotics for certain infections, steroid cream for various skin conditions, hormone cream or HRT (hormone replacement therapy) if the itch is related to the menopause.


  • Clothing:
    • Wear loose fitting underwear, preferably made from 100% cotton. Avoid nylon or synthetic underwear and pantyhose which tends to block 'fresh air', and cause you to sweat more.


    • Change your underwear daily, If necessary, put a tissue or a thin cotton pad in your underwear to absorb moisture which may be irritating.


    • Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible.


    • Avoid wearing tight fitting clothes, such as cycling shorts or tight leggings. Skirts and dresses are probably better than trousers. Also stockings are probably better than tights. The aim is to allow some air to get to the vulva region and not to allow it to become too sweaty. Consider not wearing any underwear at all.

  • Washing:
    • Wash the genital area with water and unscented soap only once a day. You can wash the area twice daily with lukewarm water only or use a soap-free cleanser instead of conventional soap. Wash your vulva gently. Do not scrub or wash vigorously. Avoid perfumed soaps or bubble bath.


    • Do not put on your underwear until your vulva is fully dry. A hair dryer may be useful to dry properly. Be careful about holding the hairdryer too close. You don't want burns on top of your itching problem.


    • It may be best to wash your hair separately to the rest of your body, as shampoo which runs down your body in a shower may irritate your vulva.


    • After urinating or having a bowel movement, clean the genital area gently with absorbent cotton or antiseptic wipes. Water soaked moist towelettes work well for cleaning after using the toilet. Wipe from front to back (vagina to anus).


    • Avoid feminine hygiene products such as sprays and commercial douches.

  • Don't scratch the itchy area. Scratching will aggravate soreness and irritation and may result in secondary infection, which can keep the itching going for as long as a week before healing. Try to avoid the 'itch-scratch cycle' The itch-scratch cycle is where scratching causes more itching - which causes more scratching - which causes more itching - etc. So, if you scratch, it may make the itch worse. So, apart from any other treatment, try not to scratch if at all possible. Keep your nails cut short. Consider wearing cotton gloves at night to stop scratching in your sleep.


  • Sometimes soaps, perfumes, bubble baths, deodorants, scented creams, the dye in toilet tissue, etc, can sensitize (irritate) the delicate vulval skin. Don't use any of these on your vulva. Use plain, non-colored, unscented toilet tissue.


  • Some people develop a skin sensitivity to a laundry detergent or fabric conditioner. This is uncommon, but it may be worth considering changing to a different brand. Read labels to try to find one that will work for your situation.


  • Do not use condoms that are lubricated with spermicide, which can be 'sensitizing' to some people. Some people have problems with latex allergies as well as a sensitivity toward spermicides. If you are sensitive to the spermicide, consider changing brands or find condoms that do not use spermicide. If you use a latex-rubber contraceptive device such as a condom, diaphragm, or a cervical cap, you may want to consider trying an alternative method of contraception, such as non-latex male and female condoms or other devices if you have latex-rubber sensitivities. See MoonDragon's Contraception Index for more information about contraception methods. However, unless there is a allergy, condoms should be used to avoid catching or spreading sexually transmitted diseases.


  • Avoid overexertion, heat, and excessive sweating.


  • Keep the vulvar area as dry and cool as possible, especially at night time, when itching can be worse. Do not become too hot at night. If you are peri-menopausal and have night sweats, Try to keep as cool as possible using a fan or AC, fewer blankets and 100% cotton sleep wear.


  • Delay sexual activity until your symptoms get better or at least use a lubricant, such as K-Y Lubricating Jelly or a natural herbal based oil during intercourse. Wash genital area after intercourse and dry thoroughly to remove moisture, bodily fluids and perspiration.


  • During menstruation, use tampons rather than sanitary napkins until the disorder heals. Insert tampons with care. If you must use sanitary napkins, change pads frequently. Try to by products that are hypoallergenic, scent-free, and untreated by chemicals.


  • Sit in a bathtub of warm (tepid, not hot) water several times a day to relieve itching. Healing herbs may be added to a sitz bath, if desired.


  • Bland moisturizers (emollients), such as aqueous cream or emulsifying ointment, can ease the itch whatever the cause. You can use these in addition to most other treatments. Use them liberally. You can buy these at pharmacies, or get them on prescription. Do not apply strong steroid creams for more than a few days. Avoid the temptation to try every cream, ointment or salve you may find in a pharmacy since allergic reactions occur quite readily when inflamed skin affects the genital region. If any treatment seems to irritate the condition, discontinue use and consult with your health care provider. Some patients with severe itching are helped by oral antihistamines or sedative tricyclic antidepressant medications, such as amitriptyline or serotonin re-uptake agents, taken at night.


  • Avoid activity that can irritate the genital region, such as riding a bicycle, a motorcycle or moped, or horseback riding.


  • Eat yogurt with live cultures or take lactobacillus acidophilus tablets when using antibiotics. Check with your health care provider or midwife.


  • If you are overweight, try to lose weight.


  • If you are diabetic, keep your blood sugars under good control.


  • If you know that you have a yeast infection because your symptoms are exactly the same as those in the past, try over-the-counter creams or vaginal suppositories. See MoonDragon's Holistic Treatments for Candida-Yeast Infections for more helpful suggestions. Yeast infections are not considered sexually transmitted. However, sometimes men also develop itching and redness following sexual contact. If this is the case or you get recurrent infections for unclear reasons, both you and your partner may require treatment. Talk with your health care provider.


  • For itching related to menopause, your health care provider may consider recommending an estrogen cream or tablets to insert vaginally.


  • Teach children to resist and report any attempted sexual contact by another person. Don't try to remove any foreign object from a child's vagina. Take the child to a health care provider right away for removal and treatment, if needed.




    MEDICATION

  • Treatment for any infectious cause found. Antifungal drugs may be prescribed for yeast infections. Antibiotics may be prescribed for bacterial vaginal infections, including sexually transmitted diseases.


  • Use low-potency, non-prescription steroid cream or ointments. A mild steroid cream such as hydrocortisone, may be advised as it often settles the itch within a few days. This may also help to break any 'itch-scratch cycle' that has developed. You can use a mild steroid cream for 2-3 days every now and then. You should not use steroid cream regularly on the vulva, as it can have a 'thinning' effect on the skin with long term use.


  • More potent steroid creams or lotions to reduce inflammation may be prescribed. These require 24 to 36 hours to provide relief. Note: Steroid creams can make some conditions of the vulva worse. So, you should see your health care provider about persistent vulval itch before using any treatment.


  • Ointments that contain hormones are sometimes recommended.


  • Benzodiazepines or antihistamines at night to ensure rest. An antihistamine medicine at bedtime may help if sleep is affected. They do not have a great effect on the itch, but some antihistamines cause drowsiness, which may help you to sleep. A doctor or pharmacist can advise on which antihistamines are 'sedating'.





  • ACTIVITY

  • Watch your hygiene. Keep your body clean, especially the genital area. Do not re-wear dirty, soiled underwear or clothing. Poor hygiene can make itching worse and may contribute to secondary infections as bacteria and fungus buildup occurs. Stay Clean. Stay dry.


  • Avoid overexertion, heat and excessive sweating.


  • Consider delaying sexual relations until irritation has cleared up.





  • DIET

  • No special diet specific to this problem. Avoid foods to which you may be allergic.

    Whole Foods Diet is important for treating infection as well as building your immune system include:
    • Fresh vegetables and fruits
    • Fish and poultry
    • Flax seed oil
    • Other essential fatty acids, such as olive oil and nuts
    • Plenty of fresh water
    • 1 tablespoon psyllium seed husk fiber and/or 6-8 tablespoons flax seed meal and/or ¼ cup oat bran daily Organically raised foods where possible
    • Whole grains
    • Vitaklenz (List of ingredients below, can be obtained at this link: www.vitaklenz.com)
      • Wormwood - 105 mg
      • Black Walnut - 200 mg
      • Pumpkin Seed - 250 mg
      • Milk Thistle - 105 mg
      • Olive Leaf - 300 mg
      • Pau D'Arco - 150 mg
      • Gentian Root - 180 mg
      • Echinacea - 100 mg
      • Barberry - 80 mg
      • Garlic - 25 mg
      • Thyme Leaf Powder - 25 mg
      • Clove Powder - 25 mg

    Avoid:
    • Alcohol
    • Animal fats
    • Caffeine
    • Dairy products and, for some patients
    • Fast foods
    • Junk foods
    • Hydrogenated oils and margarine
    • Processed foods
    • Sugar
    • Wheat products
    • White flour products






    HOLISTIC TREATMENTS & RECOMMENDATIONS

    Note: These are suggestions that will help with vulvar itching caused infections such as vaginal yeast (candida). Yeast is a natural part of a healthy vaginal environment. It helps prevent growth of infective bacteria. If the yeast grows too much, it is noticeable as a nice-smelling, white, cottage-cheese-like accumulation on your vaginal walls or in your underwear. Yeast over-growth can make your vagina and vulva very irritated, sensitive, sore, and itchy, and can even cause episodes of incontinence.

    You can check the pH of your vagina with litmus paper. A healthy acidic reading would be 4 to 4.5 pH. Yeast over-growth begins at 5.5 and irritation is usually evident when the pH reaches 6 or higher (more alkaline).

  • Suppository Treatment for vaginal yeast infections: Insert Boric Acid suppositories twice a day, in morning and again before bed Repeat for 2-4 weeks depending on severity of infection.


  • External Treatment: Warm sitz baths infused with several drops Tea Tree oil (Melaleuca alternifolia). Vaginal douching with tea infusion of one or both of the following dried herbs:
    • Goldenseal (Hydrastis canadensis)
    • Oregon Grape Root (Mahonia aqjuifolium)

    OTHER NATURAL TREATMENTS

    Boric Acid/Borax: Boric Acid/Borax kills severe or persistent yeast infections.
    Method: Fill 00 capsules with Boric Acid to use as vaginal suppositories. Insert 1 to 2 capsules filled with Boric Acid high into your vagina, by the cervix, every night for a week to 2 weeks. Caution: Boric Acid may cause large amounts of vaginal discharge, superficial burning and discomfort for the first few days. Discontinue use if the burning is severe.

    Cranberries: Cranberries are often used in treating urinary tract infections as they are a rich source of Vitamin C, contain substances that inhibit bacteria from clinging to the walls of the urinary tract, lower the pH of your urine helping combat yeast infections.

    Garlic: Garlic contains natural anti-fungal substances that kill off yeast and should be added to the diet. It may also be used internally.
    Method: Wrap an unpeeled clove of garlic in gauze or cheesecloth tying the ends with unwaxed dental floss, leaving a bit of string dangling to pull it out afterward. Insert it high into the vagina, on or behind the cervix, before going to bed every night for 5 to 10 days. Leave it in for several hours at a time or overnight. Use nightly until after symptoms cease. Note: Care should be taken not to cut the clove of garlic as the juice may sting and cause irritation. If you peel the clove, do it very carefully. Garlic will make your breath and sweat smell or garlic if you use this remedy. Garlic capsules may be used instead. Garlic may not work on stubborn infections. Occasionally people are allergic to garlic.

    Hydrogen Peroxide: Hydrogen Peroxide is produced naturally by bacteria in your vagina and kills yeast. If you wish to increase Hydrogen Peroxide:
    Method: Mix 1 teaspoon of ordinary 3% hydrogen peroxide from your market or pharmacy with 1 cup of water and use as a douche once a day until after symptoms cease.

    Acidic Rinse or Douche: A rinse/douche can be made using 4 tablespoons apple cider vinegar in a quart of water and use it in a sitz bath or as a vaginal douche once or twice daily. Results should be evident in 3 days; continue for 10 days. You can alternate apple cider vinegar with acidophilus every other day for a week. White vinegar (acetic acid) can be used, 1 tablespoon in a quart of water. Sitz or douche as above. Lemon juice can be used same as white vinegar. Lactic acid (Lactinex powder) as directed. See boric acid above.

    Potassium Sorbate: Potassium Sorbate is a potent fungicide usually used in preserving foods and brewing beer to stop the growth of the yeast at the correct time.
    Method: Make a 3% solution by adding 8 gm (about 1 tablespoon) potassium sorbate to a cup of water. Dip a cotton tampon in the solution, inserting it at bedtime and removing it in the morning. Continue treatment for a few days until after the symptoms are relieved.

    To relieve vulva itching:
    Method: Make a paste of Slippery Elm powder and a little water and apply as needed. Soak a cotton pad in Aloe vera juice and apply as needed. Note: Slippery Elm or Aloe vera will only relieve itching not kill yeast. Combine with an anti-fungal treatment.

    Apply Calendula and Urtica ointment to vulva 4 times a day, or bathe vulva with Thuja solution, 10 drops of mother tincture to 250 ml (1/2 pint) boiled cooled water.

    Tea Tree Oil: Tea Tree Oil is widely used for yeast infections.
    Method: Soak a tampon with a lubricant, such as KY jelly or Olive Oil, and add a few drops of pure Tea Tree Oil and insert into the vagina. Caution: Tea Tree oil can sting if it comes in contact with the vulva.

    Vitaklenz: The double action of the powerful Vitaklenz formula assists in the elimination of parasites as well as Candida and Yeast infestations. Vitaklenz is the result of thousands of years of accumulated knowledge from traditional medicines around the world that have successfully treated parasites and yeast infestations in humans. The 12 active herbal ingredients in Vitaklenz are well known for their anti-parasitic, anti-candida and cleansing effects on the human system.

    Yogurt: Yogurt contains Lactobacillus acidophilus, a bacterium found in healthy vaginas, which kills yeast by producing hydrogen peroxide.
    Method: Apply directly to the vulva and into the vagina 1-2 times a day until after symptoms clear up. Use plain, unsweetened yogurt. Make sure it says that it contains "active" or "live" cultures on the label or make your own yogurt. Eat a cup of plain yogurt daily. 1-2 tablespoons / 15-30 ml of plain yogurt in the vagina every day or two (use your imagination and be creative about getting the yogurt in the vagina, such as using a reusable vaginal applicator that comes with some vaginal medications, contraceptive foams and jellies, or vaginal lubricants). A yogurt sitz bath is helpful. Use 16 ounces or 125 ml yogurt in 2 quarts of warm water.

    Nettle Infusion: Drink at least 2 cups of nettle tea (strong tea) daily to help keep vulva region from itching, burning and keep yeast free.

    Vulvar rinsing after urination: It is important to keep the vulvar region clean. This is especially important if you have strong urine that can cause inflammation and itchiness. After urination, the vagina should be thoroughly washed with plain cold water. Another option, if you have problems with yeast infections is to keep a quart jar next to your toilet and use 1-2 tablespoons of apple cider vinegar to a quart of warm water. After urination, pour vinegar-water over the vulvar and anal region as a rinse. The vinegar will keep the area slightly acidic, which will help to inhibit bacteria and fungal growth. In case of severe pruritus, it is advisable to wash the vulva with neem leaves decoction and apply green light charged coconut oil (coconut oil that has been exposed to green colored light or placed in the sunlight with solar rays going through a green colored glass for 25 to 30 minutes. This will help reduce infections.

    HOMEOPATHIC REMEDIES
    Dryness of vagina, Pruritus vulvae

    Specific remedies to be taken 4 times daily for up to 14 days:
    • Sulphur 6c: Vulva itches, crotch very sweaty and smelly, matters made worse by heat and washing.
    • Caladium 6c: Increased desire for sex, creeping sensation in vulva which wears off during daytime naps but gets worse at night or when moving around.
    • Carbo veg. 6c: Labia visibly swollen, local veins distended.
    • Rhus tox. 6c: Localized itching, skin very red, itching relieved by heat.
    • Conium 6c: Itching aggravated by suppressed desire for sex or by frequent sex.
    • Calcarea 6c: Itchiness worse immediately before and after period, general sweatiness and chilliness, especially if woman is overweight.
    • Radium brom. 6c: Itchiness soothed by hot baths and by moving around out of doors, most uncomfortable first thing in morning.

    TRADITIONAL CHINESE MEDICINE (TCM)

    INTERIOR
    • Blood Heat Producing Wind - summer time, after hot showers, ameliorated by cold: Zhi Yang Xi Feng Yang
    • Blood Deficiency - elderly, dry seasons (fall/winter), dry/pale skin with flaking: Dang Gui Yin Zi
    • Wind Damp Invasion - late summer, younger people easily effected, fluid discharged: Quan Chong Fang
    • Strong Wind - spring - neck area with thick dry skin (top part of body): Wu Shi Qu Feng Tang
    • Wind Cold - winter - yang deficiency - front of body around stomach channel. Agg. By cold: Gui Zhi Ma Huang Ge Ban Tang
    • Damp Heat - lower jiao area and perineum, aggravated at night: Long Dan Xie Gan Tang

    EXTERNAL
    • Ku Shen Tang

    TCM Herbs Recommended by Hsin Kuang Herbal Store & Clinic:

  • Cortex Dictamni Radicis (Dittany Bark, Fraxinella): Source: Bark of Dictamnus dasycarpus Turcz., family Rutaceae. Indication: Clear away heat, expe; wind and deprive dampness: For carbuncle and prurigo of dampness-heat type, scabies and tinea. Pharmacological Actions: (a). Inhibiting the growth of pathogenic fungi. (b). Its infusion lowers vaccine-induced fever in rabbits. (c). Dictamnine, one of its active components, increases the myocardial tone of frogs.


  • Cortex Phellodendri (Phellodendron Bark): Source: Bark of Phellodendron chinense Schneid. or P. amurense Rupr., family Rutaceae. Indication: (a). Clear away heat and deprive dampness from middle-jiao: For diarrhea, dysentery, jaundice, leucorrhagia, stranguria, edema of lower limbs, prurigo, etc. of dampness-heat type. (b). Purge the asthenic fire and clear away toxic materials: For skin infection, furunclosis complicated by septicemia, burn, and seasonal febrile diseases. (c). Purge the kidney-fire and reduce asthenia-heat: For syndrome of fire-hyperactivity and yin-deficiency manifested as hectic fever, night sweat, emission and red-dry tongue. Pharmacological Actions: Berberine is the main active component with an action similar to Rhizoma Coptidis. (a). Possessing broad-spectrum antibacterial and antiprotozoal effect. (b). Intravenous injection or oral administration of berberine exerts a hypotensive effect on experimental animals. (c). Small dosage of berberine enhances the action of acetylcholine on animals' hearts in vitro, while large dosage counteracts it. (d). Relaxing the smooth muscles of blood vessels and stimilating those of uterus, urinary bladder, bronchus and gastrointestines. (e). Promoting bile secretion. (f). Berbertine inhibits the cellular growth of ascitic cancer and lymphoma.


  • Fructus Cnidii (Common Cnidium Fruit): Source: Fruit of Cnidium monnieri (L.) Cuss., family Umbelliferae. Indication: (a). Warm the kidney and strengthen yang: For deficiency of kidney-yang manifested as impotence, sterility, soreness of the waist and knees, enuresis and frequent micturition. (b). Deprive dampness and relieve itching (external use): For leucorrhagia with pruritus vulvae, eczema of scrotum, tinea, scabies, etc. Now it is prepared as vaginal suppository for trichomonas vaginitis. Pharmacological Actions: (a). its alcoholic extract exerts a gonadotropic effect, i.e., prolong estruation, increase the weight of ovary and uterus in female mice and that of prostate, seminal vesicle and musculi levator ani in male mice. (b). Relieving cyclophosphamide-induced leukopenia in mice. (c). Inhibiting the growth of trichophyta in vitro.


  • Borneolum Syntheticum (Borneol Flakes, Bingpian): Source: The resin of Dryobalanops aromatica Gaertn. f., family Dipterocarpaceae. Indication: (a). Wake the patient from unconsciousness: For coma of sthenic type, especially that of heat origin. (b). Clear away heat, alleviate pain, prevent putrefaction and relieve swelling: For sorethroat, aphthae, toothache, otopyorrhea and cervical erosion; also indicated for skin infection. (c). Remove nebula to improve visual acuity: For conjunctivitis, blepharitis and external oculopathy. Pharmacological Actions: (a). Inhibiting the growth of Staphylococcus aureus, Streptococcus hemolyticus and Diplococcus pneumoniae in vitro, the minimunm inhibitory concentration (MIC) being 0.5%. (b). Local use as analgesic, owing to its action on the sensory nerves.


  • Radix Sophorae Flavescentis (Flavescent sophora root): Source: Root of Sophora flavescens Ait., family Leguminosae. Indication: (a). Clear away heat and deprive dampness from middle-jiao: For diarrhea, dysentery, jaundice and leucorrhagia of dampness-heat type. Recently, also used for trichomoniasis intesrinalis, lambliasis, trichomonas or mycotic vaginitis (chiefly for local use). (b). Expel wind and kill parasite: For pririgo of wind-heat or dampness-heat type, scabies, pyoderma, leprosy, etc. (c). Eliminate phlrgm and relieve dyspnea: For cough and dyspnea. (d). Calm the mind: For insomnia, palpitation, insanity, etc. Recently, used for neurasthenia, manic psychosis and arrhythmia. (e). Clear away heat and promote diuresis: For stranguria of heat type and edema. Pharmacological Actions: (a). Matrine and oxymatrine counter the arrhythmia induced by chloroform-adrenaline or aconitine, and its injection slows heart rate and weakens myocardial contractility in experimental animals. (b). Inhibitory on the contraction of sensitized guinea-pig intestine and release of allergic medium in vitro. (c). Anti asthmatic and expectorant. (d). Bacteriostatic, antiamebic and trichomonacidal. (e). Matrine 30mg/kg and oxymatrine 100mg/kg show therapeutic effect on X-ray induced leukopenia in rabbits. (f). Inhibitory on sarcoma180 in mice.


  • Herba Schizonepetae (Fineleaf Schizonepeta, Jing Jie): Source: The branch and leaf with inflorescence of Schizonepeta tenuifolia (Benth.) Briq. and S. multifida (L.) briq., family Labiatae. Indication: (a). Expel wind-evil and induce sweating to expel the exogenous evils from the body surface: For common cold of wind-cold type, also for common cold of wind-heat type when used with drugs of acrid flavor and cool nature. (b). Promote skin eruption and alleviate itching: For the incomplete eruption during measles, and urticaria. (c). Expel exogenous evils to relieve skin infection: For early stage of skin infection with fever and chilliness. (d). Soothe the throat: For sorethroat and hoarseness with superficies-syndrome. (e). Its carbonized preparation may be used for stopping bleeding: For epistaxis, hemafecia, metrorrhagia. Pharmacological Actions: (a). Mild antipyretic effect. (b). Oral use of its decoction can promote the secretion of sweat glands and improve cutaneous blood circulation.


  • Radix Ledebouriellae (Ledebouriella Root, Fangfeng): Source: The root of Ledebouriellae divaricata (Turcz. Hiroe, family Umbelliferae. Indication: (a). Expel wind and induce sweating to expel the exogenous evils from the body surface: For common cold of wind-cold or wind-heat type, for headache and body aching, also for urticaria and eczema. (b). Expel dampness and alleviate pain: For arthralgia of wind-cold-dampness type, headache and migraine. (c). Expel wind and relieve spasm; For tetanus. (d). Clear away toxic material: For chronic arsenism and mercurialism. Pharmacological Actions: (a). Antipyretic: Oral use of decoction and alcoholic infusion (2.0 g/kg) can lower vaccine-induced fever in rabbits. (b). Analgesic: Oral use of alcoholic infusion (21.18 g/kg) and subcutaneous injection (42.36 g/kg) can alleviate pain.


  • Radix Polygoni Multiflori (Fleeceflower Root, He Shou Wu): Source: Root tuber of polygonum multiflorum Thunb., family Polygonaceae. That prepared by drying is known as crude sample, and that prepared by steaming with the juice of black soya beans as prepared sample. Indication: (a). Invigorate the liver and kidney, benefit essence and blood: For insufficiency of essence and blood manifested as baldness, backache with weakness of the knee joint, immovability of extremities, hemiplegia and paraplegia; for blood-deficiency syndrome manifested as sallow complexion , palpitation, dizziness, tinnitus, numbness of the extremities, insomnia, dreaminess sleepiness, somnambulism, epilepsy, urticaria and dermatoxerasia; for hypofunction of liver and kidney with emission or leucorrhagia. Recently, also used for hypercholesterinemia and atherosclerosis. (b). Relax the bowels (crude herb): For constipation of asthenia-syndrome. (c). Clear away toxic material (curde herb): For scrofula, carbuncle, etc. In addition, the prepared herb is used for chronic malaria with deficiency of vital energy and blood. Pharmacological Actions: (a). The prepared sample can promote lymphocyte transformation. (b). Reducing serum cholesterol, and relieving atherosclerosis. (c). The crude sample is a purgative.

  • Fructus Kochiae (Kochia Fruit, Broom Cypress Fruit): Source: Fruit of Kochia scoparia (L.) Schrad., family Chenopodiaceae. Indication: (a). Clear away heat and promote diuresis: Forstranguria of heat type and leucorrhagia. (b). Kill parasite, expel wind and alleviate itching: For skin lesion of dampness type, urticaria, scabies and vaginal pruritus with discharge. Recently also used for erythma multiforme, pityriasis rosea, mycotic vaginitis, etc. Pharmacological Actions: Inhibiting the growth of various dermatomyces in vitro.



    NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...


  • You or a family member has symptoms of pruritus vulvae (itchy vulva).


  • You have pelvic or lower abdominal pain or fever. These may be signs of other severe infection or problems and needs immediate attention by your health care provider.


  • If you have increased thirst or appetite, unexplained weight loss, frequent urination, or fatigue - these may be signs of diabetes. See your health care provider right away.


  • You have unusual vaginal bleeding, swelling, or discharge.


  • Your partner also has symptoms or you think you may have a sexually transmitted disease.


  • You have burning with urination or other urinary symptoms - you may have a urinary tract infection.


  • You have blisters or ulcers on your vagina or vulva.


  • Symptoms don't improve or worsen in one to two weeks, despite treatment.


  • Scratching leads to skin infection.


  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.





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