bubble_chart Concept

Pudendal itch refers to the symptom of pruritus in the external genitalia or vaginal skin. It is also known as "vaginal orifice itching" or "pruritus of the vaginal orifice." Patients often experience varying degrees of leukorrheal disease.

bubble_chart Pattern Analysis

1. Dampness-heat︰Itching in the genital area, even unbearable itching, yellowish leukorrhea resembling pus, with a foul odor, restlessness and difficulty sleeping, bitter taste in the mouth with a greasy sensation, chest and hypochondriac oppression, scanty and frequent urination, yellow and greasy tongue coating, and wiry and slippery pulse. This is mostly caused by dampness-heat pouring downward, disturbing the Liver Channel, or unclean bathing leading to infection by pathogens, with worms eroding the vagina, belonging to an excess heat pattern. The manifestations include unbearable itching in the genital area and copious leukorrhea that is yellow like pus. Treatment should aim to clear and drain damp-heat, combined with killing worms. The formula used is Gentian Liver-Draining Decoction augmented with densefruit pittany root-bark and Carpesium Fruit, with external use of Cnidium Fruit powder decoction for steaming and washing.
2. Liver-kidney Yin Deficiency︰Dryness, burning sensation, and itching in the genital area, worsening at night; scant yellowish leukorrhea or blood-tinged discharge; vertigo and tinnitus; soreness in the lower back and weak legs; occasional hot flashes and sweating; red tongue with little coating; wiry-thin or thin-rapid and weak pulse. This condition is often caused by prolonged illness, aging and physical decline, or excessive sexual activity and multiple childbirths, leading to liver-kidney yin deficiency, depletion of essence and blood, malnourishment of the genitalia, and blood dryness producing wind. It belongs to the pattern of deficiency heat. Key diagnostic points include: dryness and burning sensation in the genital area, severe itching at night, scant yellowish leukorrhea, or blood-tinged discharge. Treatment should focus on nourishing yin and reducing fire, as well as moistening dryness and dispersing wind. The recommended formula is Anemarrhena, Phellodendron, and Rehmannia Pill with the addition of Chinese Angelica and densefruit pittany root-bark. For hot flashes and sweating, add Epimedium Herb and Common Curculigo Rhizome.

In the differentiation of pudendal itch, the first step is to clearly distinguish between deficiency and excess. Generally speaking, in cases of excess pattern, there is often a large amount of leukorrheal discharge, which may be yellow or white in color, and the pudendal itch is more severe. This condition is commonly seen in young and middle-aged women. In cases of deficiency pattern, the leukorrheal discharge is usually scant, yellow or red in color, accompanied by dryness and burning heat in the genital area, and is more frequently observed in postmenopausal women.

Pudendal itch and leukorrheal disease often occur simultaneously or sequentially, hence this condition is frequently discussed and treated in conjunction with leukorrheal disease.

bubble_chart Documentation

1. Yizong Jinjian Gynecology Essentials．External Genitalia Disorders: "Women's pudendal itch is mostly caused by dampness-heat generating worms. In severe cases, it may lead to limb fatigue and dribbling urination. It is advisable to take Peripatetic Powder and Gentian Liver-Draining Decoction. Externally, grind Peach Kernel into a paste, mix it with Realgar powder, slice chicken liver, and apply the medicine to the affected area. The worms, upon smelling the liver, will burrow into it to feed. Once the liver is removed, the disease will be cured."
2. 《Gynecological Disease Rhymes》: "Itching at the vaginal orifice is caused by liver wind. Boil three qian of Stiff Silkworm and drink the decoction. Take three doses continuously, and the disease will be cured forever. For long-lasting itching and pain at the vaginal orifice, I have a remedy that will bring immediate relief. Use two liang each of raw and cooked Peony Root, and the condition will be alleviated after taking it."