Green Discharge: When to See a Gynecologist or Urologist

The discharge is green?

Hello, Dr.
Tsao! I would like to ask about green discharge, especially when I hold my urine.
Additionally, I experience itching, lower back pain during urination, and an unusual odor in the genital area (I can't describe the smell, but it's not fishy—more like a faint damp smell).
These symptoms have been present for quite some time (about six months).
I would like to know if I should see a urologist or continue with gynecology.
I previously visited a gynecologist, but the doctor suggested an internal examination, which I am hesitant to undergo.
I have not engaged in sexual intercourse, so I was prescribed medication (antibiotics and ointment), which helped, but after a while, the issues returned.
Thank you for your assistance!

Wei, 10~19 year old female. Ask Date: 2017/01/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, green discharge is likely a sign of inflammation.
If you are experiencing any discomfort, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2017/01/14

More Info

Green discharge can be a concerning symptom for many women, and it often raises questions about potential infections or underlying health issues. Based on the symptoms you've described—green discharge, itching, discomfort during urination, lower back pain, and an unusual odor—it's essential to consider a few key points regarding gynecological and urological health.

Firstly, green discharge is not typical and can indicate an infection. The most common causes of green discharge include bacterial vaginosis, trichomoniasis (a sexually transmitted infection), or a mixed infection involving yeast and bacteria. Given that you have experienced these symptoms for an extended period (approximately six months), it is crucial to seek further medical evaluation.

The presence of itching and discomfort during urination suggests that there may be an inflammatory process occurring, which could be due to a urinary tract infection (UTI) or a vaginal infection. UTIs can cause symptoms such as a burning sensation during urination, frequent urges to urinate, and lower abdominal or back pain. The fact that you have a faint odor accompanying your discharge may also indicate an infection, as infections often produce distinct smells due to the presence of bacteria or other pathogens.

In your case, since you have already consulted a gynecologist and received antibiotics and topical treatments, but the symptoms have recurred, it may be beneficial to consider a few options:
1. Follow-Up with a Gynecologist: If you are comfortable, returning to a gynecologist for a thorough examination, including a pelvic exam, may provide more insights. A gynecologist can perform tests to identify the specific type of infection and recommend appropriate treatments. If you are hesitant about an internal examination, discuss your concerns with the doctor; they may be able to provide reassurance or alternative examination methods.

2. Consult a Urologist: Given your symptoms of lower back pain and discomfort during urination, it may also be wise to consult a urologist. Urologists specialize in urinary tract issues and can evaluate whether there is an underlying urological condition contributing to your symptoms. They may perform tests such as urinalysis or imaging studies to assess your urinary tract health.

3. Consider Lifestyle Factors: While seeking medical advice, consider any lifestyle factors that may contribute to your symptoms. Wearing breathable underwear, avoiding irritants (such as scented soaps or hygiene products), and maintaining good hygiene can help reduce the risk of infections. Additionally, staying hydrated can help flush out bacteria from the urinary tract.

4. Explore Other Conditions: If infections are ruled out, other conditions such as vulvodynia (chronic pain in the vulvar area) or interstitial cystitis (a chronic condition causing bladder pressure and pain) may need to be considered. These conditions can cause similar symptoms and may require different management strategies.

In conclusion, while green discharge can indicate an infection, the combination of your symptoms suggests that a thorough evaluation is necessary. Whether you choose to see a gynecologist or a urologist, it is important to communicate all your symptoms clearly and express any concerns you have about examinations. Persistent symptoms should not be ignored, and seeking further medical advice is a proactive step towards understanding and resolving your health issues.

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