### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Had Mirena inserted in October, developed an itchy dry flaky patch on my labia...it doesn t spread, doesn t go away, and I have tried anti fungal cream, hydrocortisone, steroid cream...steroid cream reduces it but never goes completely away. What is this?

### output:

Hello, Thank you so much for your question. Itchy on labia can be from vaginal discharge from IRENA IUD. Vaginal discharge is abnormal when it occurs with the following symptoms: Itching of the vagina or the area around vagina, redness, pain, or swelling around the vagina, discharge that is foamy, greenish-yellow, or has blood in it, discharge that smells bad, pain when urinating or having sex, pain in the lower part of the belly, fever. Different conditions can cause abnormal vaginal discharge. The most common causes are: An infection in the vagina, cervix or uterus, a reaction to something in the vagina that a woman forgot to take out, such as a tampon or condom, a reaction to a soap or other product that was in the vagina, changes in the body that occur after menopause. You should not treat abnormal vaginal discharge by yourself. Treating yourself can cause your symptoms to get worse. If you have abnormal vaginal discharge, see a doctor so that he or she can figure out the cause. Your doctor will talk with you and do an exam. He or she will also take a sample of your vaginal discharge, and do lab tests on the sample to look for an infection. The treatment will depend on the cause of the abnormal vaginal discharge. For example, different vaginal infections are treated with different medicines. If you have a vaginal infection, your doctor will want to figure out what type of infection you have so that he or she can treat it with the right medicine. If it caused by certain types of infections, your sex partner will also need to see a doctor for treatment. Sometimes you can help prevent abnormal vaginal discharge by using warm water and unscented non-soap cleanser to wash your vulva (the vulva is the area of skin around the outside of the vagina), taking baths in plain warm water, and not using scented bath products, not using sprays or powders on your vagina, not douching (douching is when a woman puts a liquid inside her vagina to rinse it out, not wiping with baby wipes or scented toiler paper after you use the restroom. Hope I have answered your question. Let me know if I can assist you further. Best regards,