Vaginal Discharge: Causes, Symptoms, and When to Seek Help

Vaginal discharge (white/light yellow, cottage cheese-like, acidic, slightly salty, without itching or odor symptoms)?

Hello Doctor: I have a sexually transmitted infection that started at the end of June.
The initial symptoms included itching, burning in the genital area, and a fishy odor from the discharge.
At that time, Dr.
A prescribed an oral medication for trichomoniasis (not an antibiotic, it was a round pink tablet) and a topical ointment.
Later, due to persistent issues, I consulted another doctor, Dr.
B, who diagnosed me with a candidal infection.
During this period, I had my menstrual cycle and used sanitary pads for too long, which caused friction and numerous wounds in the labia and above the urethral opening (the wounds were increasing in size and were red, swollen, and painful).
After examining the area under a microscope, Dr.
B prescribed oral antibiotics, the round pink tablet, an anti-itch cream (Fucidin), and a topical anti-inflammatory and analgesic ointment (Neomycin).
Subsequently, the wounds and symptoms in the genital area improved significantly, but the discharge remained white/light yellow, cheese-like, sour, salty, and without itching or odor.
Concerned about the potential negative effects of excessive antibiotic use, I returned to Dr.
A.
After an internal examination, Dr.
A diagnosed a candidal infection and prescribed Neomycin ointment and another topical cream (Fucidin).
A bacterial culture was also performed, revealing two less commonly seen bacteria, for which specific oral antibiotics were prescribed.
After that, the friction wounds in the vagina improved, but I still occasionally experience burning and redness.
To this day, the discharge remains white/light yellow, cheese-like, and sour.
Is this considered healthy, or is there still an underlying infection that needs further monitoring? Additionally, I have recently experienced friction wounds affecting the urethral opening, causing pain during urination, but there is no persistent pain or bleeding.
However, I do notice some strands of discharge on the toilet (not sure if it's leukorrhea).
Could this indicate a urinary tract infection?

Xingxing, 20~29 year old female. Ask Date: 2017/11/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have a sexually transmitted infection that started at the end of June.
The initial symptoms included itching, burning in the genital area, and a fishy discharge.
At that time, Dr.
A prescribed oral medication for trichomoniasis (a non-antibiotic, round pink pill) and a topical ointment.
In the middle stage, since the original doctor was unable to resolve the issue, I consulted another physician, Dr.
B, who diagnosed me with a yeast infection.
During this period, due to my menstrual cycle, I used sanitary pads for an extended time, which caused friction and numerous wounds in the inner labia and above the urethral opening, leading to increasing redness, swelling, and burning pain.
After Dr.
B performed a microscopic examination, he prescribed oral antibiotics, the round pink pill, as well as an anti-itch cream (Hydrocortisone) and Neomycin ointment (for inflammation and pain relief).
Subsequently, the wounds and symptoms in the genital area improved significantly, but the discharge remained white/light yellow, cheese-like, sour, salty, and without itching or odor.
Concerned about the potential negative effects of excessive antibiotic use, I returned to Dr.
A, who, after an internal examination, diagnosed a yeast infection.
He prescribed Neomycin ointment and another topical cream, and also performed a bacterial culture, which revealed two less commonly seen bacteria.
He prescribed specific oral antibiotics targeting these two bacteria.
After that, the friction wounds in the vagina improved, but sometimes there is still a burning and swelling sensation.
Even now, the discharge continues to be white/light yellow, cheese-like, and sour.
Is this considered healthy, or is there still an infection that requires further monitoring?
Additionally, recently, the friction wounds have affected the urethral opening, causing pain during urination, but there is no persistent pain or bleeding.
However, I notice some strands of discharge on the toilet (not sure if it's normal).
Does this indicate a urinary tract infection?
Answer: Yes, this does indicate a urinary tract infection.

Reply Date: 2017/11/19

More Info

Understanding vaginal discharge and its associated symptoms can be quite complex, especially when there are multiple factors at play, such as infections and irritation. Based on your description, it seems you have been experiencing a series of vaginal health issues, including itching, pain, and abnormal discharge, which have led to multiple consultations with different healthcare providers.
Firstly, it’s important to understand that vaginal discharge can vary in color, consistency, and odor based on a variety of factors, including hormonal changes, infections, and overall health. Normal discharge is typically clear or white and does not have a strong odor. However, changes in discharge can indicate an underlying issue, such as a yeast infection, bacterial vaginosis, or sexually transmitted infections (STIs).

In your case, the initial symptoms of itching, burning, and foul-smelling discharge suggest a possible case of bacterial vaginosis or a trichomoniasis infection, which is often treated with specific antibiotics. The subsequent diagnosis of a yeast infection (candidiasis) aligns with the symptoms of white, cheese-like discharge, which is common in such infections. The presence of irritation and wounds in the vaginal area, especially after prolonged use of sanitary pads, indicates that friction and moisture may have exacerbated the situation, leading to further discomfort and potential secondary infections.

The medications prescribed by your healthcare providers, including oral antibiotics and topical treatments, are standard approaches to managing these types of infections. However, it is crucial to complete the full course of any prescribed medication to ensure that the infection is fully treated. Overuse of antibiotics can lead to imbalances in the vaginal flora, potentially resulting in recurrent infections, which seems to be a concern for you.

Regarding your current symptoms of persistent discharge that is white or light yellow, cheese-like, and has a sour smell, it is essential to follow up with your healthcare provider. While some improvement in irritation and pain is a positive sign, the ongoing abnormal discharge may indicate that the infection has not fully resolved or that there is another underlying issue that needs to be addressed.
As for the pain during urination, especially if it is localized to the urethral area, it could suggest irritation or inflammation of the urethra, possibly due to the friction from the vaginal irritation or an infection. It is not uncommon for infections in the vaginal area to lead to urinary symptoms, as the anatomy of the female urinary and reproductive systems is closely related. If you notice any changes in urination, such as increased pain, burning, or blood in the urine, it is crucial to seek medical attention promptly, as these could be signs of a urinary tract infection (UTI).

In summary, while some of your symptoms have improved, the persistent abnormal discharge and occasional pain during urination warrant further evaluation. It is advisable to return to your healthcare provider for a thorough examination, including possibly repeating cultures or tests to identify any remaining infections. Additionally, maintaining good vaginal hygiene, avoiding irritants, and ensuring proper moisture management can help prevent future issues. Always communicate openly with your healthcare provider about your symptoms and concerns to ensure you receive the most appropriate care.

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