It's not exactly easy to scratch an itch down there, which is why it’s so frustrating when it happens (and sometimes it’s like it comes completely out of nowhere, right?). Vaginal itching can be caused by something as simple as your period products—but in other cases, it can actually be a symptom of a more serious issue. This guide will help you figure out exactly what’s making you feel like you have ants in your pants—and what your treatment options are. (That being said, when it comes to your lady parts, it’s always best to play it safe and visit your gynaecologist  for a proper diagnosis.)

Bacteria vaginosis

Bacterial vaginosis (a.k.a. BV) is the most common reason for vaginal itching and is caused by an imbalance in healthy bacteria and a change in vaginal pH. It feels similar to a yeast infection, but in this case, the discharge is more watery and usually has an odor.

Yeast Infection

Like BV, a yeast infection is frequently the result of vaginal pH being out of whack. They can occur at random or following antibiotic use, sex, stress, or a change in diet (and women with diabetes have a higher risk). In addition to itchiness, you may also notice curdled, white, or thick discharge. To avoid recurrent infections, it is recommended that patients take probiotic with a high bacteria count of acidophilus, like Flora-Q, which will help keep yeast in check.

Contact dermatitis

This skin irritation is caused by allergies to certain products. You can get it from anything with perfumes or additives, including condoms and lubricants, and on top of itching, you may also notice redness, swelling, and skin thickening. It can also be the result of shaving. If you know that you’re susceptible to vaginal irritation, use hypoallergenic hygiene products, like shampoo, fabric softeners, and laundry detergents, making sure to avoid chemicals, soaps, and irritating lubricants. Even toilet paper with scents or colors can be troublemakers. Plus, you should definitely avoid shaving if you're sensitive—and never, ever douche. The vagina is self-cleaning, so you don't need to put anything on or in it.

Eczema or psoriasis

Genetic skin disorders like these two can cause redness and itching in the genital region, along with a patchy or rash-like appearance. If you’re diagnosed with either, a mild steroid like hydrocortisone and taking oatmeal baths can help alleviate the discomfort. If you don’t feel relief within a week, ask your doctor about other treatment options.

Sexually Transmitted Disease (STDs)

We shouldn’t have to tell you this again, but unprotected sex can lead to an STD (which is why you always, always need to use protection). And a bunch of them can make your lady parts itch, including chlamydia, herpes, trichomoniasis, and gonorrhea. Crabs, or pubic lice, can also appear in women with hair down there. With any of these, the itching (or tingling sensation) can progress to pain and burning, says Askew. If you experience itching along with any other common STD symptoms like burning while you pee, foul-smelling discharge, sores on your genitals, and pain during sex, you should book it to your gyno to get tested ASAP. If you do test positive for an STD, your doctor will give you either injectable or oral antibiotics, or an antiviral medication in the case of herpes.

Lichen sclerosus

This serious condition and cause of vulvar itching appears as white spots on the skin. While it can come out of nowhere, some medical professionals think hormones or an overactive immune system may have something to do with it. Lichen sclerosus needs to be diagnosed by a gynecologist and treated with prescription medication.

Hormones

Anytime your hormones levels change or fluctuate (like during your period, pregnancy, menopause, or while you're taking birth control), you may experience vaginal itching. Dryness is another indicator that hormones could be to blame for your pain. When it comes to your period, the products you use during that time of the month (like pads and panty liners) often contain fragrances or colors that can add to the discomfort. If this happens to you often, consider trying a menstrual cup or organic cotton products, which may be less irritating. However, it may be difficult to pinpoint if your birth control prescription is what's causing you to itch down there (sometimes the only way to know if this is the culprit is to stop or start hormonal contraception). With any of these hormonal changes, your doctor might prescribe a hormonal cream to apply topically and you can also ask about switching pills if the itch continues to be a persistent problem.