Persistent Vaginal Discharge: Causes and Solutions

Infection and secretion issues?

Hello, Doctor: (This message is a bit long; thank you very much for your patience in reading it.) I have not engaged in penetrative sexual intercourse.
Since the end of October 2017, I have noticed that my discharge has turned yellow and thick, sometimes resembling semi-melted cheese, without any odor.
After consulting with a gynecologist, I was prescribed oral medication, but there was no improvement.
This led to a prolonged series of visits and treatment with suppositories.
I have tried both antifungal and antibacterial treatments, but almost every time I use a suppository, the discharge issue returns within a day or two.
I have consulted both small clinics and large hospitals, and to find the right treatment, I have had my discharge tested.
Each doctor has given different opinions; some say it's a yeast infection, others say it's bacterial, some suggest not to worry and just rest, while others insist on continuous treatment.
I have taken various antibiotics and used different types of suppositories, which provided slight improvement, but the discharge remains yellow and thick, though it is no longer as solid as before.
Occasionally, I experience some itching and pain, but there is no odor.
I feel very lost...
Some doctors have told me that if I have a yeast infection, I should avoid taking antibiotics.
Since this inflammatory condition has persisted for over six months, I have been very disciplined with my lifestyle and diet, taking probiotics and even trying traditional Chinese medicine, and I have not engaged in sexual activity during this time.
I even went to a clinic without health insurance where a doctor examined my discharge under a microscope.
That doctor said it was a yeast infection combined with E.
coli, and that injections, suppositories, and oral medication would resolve it.
However, after enduring several antibiotic injections and taking many medications, I am still not better...
I am very worried that this issue is significantly affecting my confidence and mood, and I am unsure what is wrong with my body.
I would like to ask: 1.
Can someone who has not engaged in sexual activity still have such a severe and persistent infection? It seems many people recover in just a week of medication.
It is frustrating that I have already had my discharge examined under a microscope and followed the doctor's prescriptions, yet I have not been able to achieve a cure.
2.
With my vagina being in a constant state of inflammation for six months, could this affect fertility? Could it lead to an infection in the uterus or ovaries? If I start having sexual activity in the future, will it worsen (will I be stuck in this situation forever and unable to have sexual intercourse)? I apologize for this silly question, but I am very worried...
3.
Given that my treatment has not been effective or has led to recurrent issues, should I continue using suppositories (which I have been using almost continuously outside of my menstrual period) along with improving my lifestyle, or should I stop long-term medication to avoid harming the mucosa and focus solely on lifestyle adjustments? 4.
I am very concerned about this issue...
I am unsure how serious it is, but it greatly affects my mood.
Would relaxing help improve my immune response and aid in healing? Thank you, Doctor.
🙏

L, 20~29 year old female. Ask Date: 2018/06/28

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the amount of vaginal discharge typically varies among individuals and changes throughout the menstrual cycle.
For instance, after menstruation, the discharge is usually minimal and gradually increases.
During ovulation, the discharge becomes more abundant, characterized by a clear, stretchy, and viscous consistency with no odor.
After ovulation, the discharge decreases again but becomes thicker.
Just before menstruation, the discharge increases once more, often appearing slightly yellow or blood-tinged and may have a faint fishy odor.
Normal vaginal discharge has several sources:
1.
A light milky white, slightly acidic mucus, commonly referred to as leukorrhea, which is mildly acidic and odorless (secreted by the normal vaginal flora, particularly Lactobacillus).
2.
Clear, egg-white-like mucus (secreted by glands in the cervix, endometrium, and vaginal mucosa).
3.
Mucus secreted by the Bartholin's glands located just inside the vaginal opening, which serves a lubricating function.
These secretions are normally minimal and continuously flow from the vagina.
The primary functions of these secretions are:
1.
To maintain a slightly acidic environment in the vagina that inhibits the growth of harmful bacteria.
2.
To help clear sloughed epithelial cells from the cervix and vaginal mucosa.
3.
To provide lubrication during sexual intercourse.
You should consult a physician if you experience any of the following changes in vaginal discharge:
1.
An abnormal increase in volume that causes discomfort or requires the use of panty liners.
2.
Changes in color or consistency of the discharge.
3.
An unpleasant odor, as normal vaginal discharge is typically odorless; a foul smell usually indicates a disruption in the vaginal environment and potential pathogen growth.
4.
Accompanying symptoms such as itching or burning in the vulva or vagina, lower abdominal pain, which may indicate vaginitis or pelvic inflammatory disease.
Common types of vaginitis can be categorized by their causes:
1.
Candidiasis: Primarily caused by Candida albicans, characterized by a large amount of white, milk-like or cottage cheese-like discharge, with burning and itching in the vagina and vulva; some may experience frequent urination or painful urination.
2.
Bacterial vaginosis: Usually a mixed infection, presenting with yellow discharge and an unpleasant odor, often associated with Gardnerella vaginalis, characterized by a fishy smell.
3.
Trichomoniasis: Caused by Trichomonas vaginalis, resulting in yellow-green, frothy discharge, with significant itching in the vulva and pain during intercourse.
4.
Atrophic vaginitis: Caused by a lack of hormones following oophorectomy or menopause, also known as atrophic vaginitis.
The cause of each infection may vary, and a clinical evaluation along with laboratory tests is necessary for an accurate diagnosis; it cannot be diagnosed and treated based solely on description.
Generally, infections do not affect fertility.
If symptoms persist, it is advisable to consult with your treating physician for a detailed discussion.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2018/06/28

More Info

Understanding persistent vaginal discharge can be a complex issue, particularly when it involves symptoms that have persisted for an extended period. Based on your detailed description, it seems that you have been dealing with a challenging situation regarding your vaginal health. Let's address your concerns systematically.

1. Infection Without Sexual Activity: It is indeed possible to experience vaginal infections without engaging in sexual intercourse. The vagina is home to a variety of microorganisms, and an imbalance in these can lead to infections such as bacterial vaginosis or yeast infections (caused by Candida species). Factors such as hormonal changes, antibiotic use, and even stress can disrupt this balance, leading to symptoms like the yellow, thick discharge you described. The fact that you have not had sexual intercourse does not exempt you from these infections; they can occur due to other factors, including hygiene practices, clothing choices, and even diet.

2. Impact on Fertility: Chronic inflammation in the vaginal area can potentially lead to complications if left untreated. While it is less common for a vaginal infection to ascend to the uterus or ovaries, it is not impossible. Persistent infections can lead to conditions such as pelvic inflammatory disease (PID), which can affect fertility. However, the mere presence of a vaginal infection does not automatically mean that fertility will be compromised. It is crucial to seek a thorough evaluation from a healthcare provider who can assess your specific situation and recommend appropriate treatment.

3. Long-term Use of Medications: The ongoing use of antifungal or antibacterial medications without improvement can lead to resistance or further irritation of the vaginal mucosa. It is essential to communicate with your healthcare provider about the lack of improvement and discuss the possibility of alternative treatments or diagnostic tests. Sometimes, a more comprehensive approach that includes lifestyle changes, dietary adjustments, and possibly probiotics can be beneficial. It is also important to avoid self-medicating or using over-the-counter treatments without professional guidance, as this can complicate the situation further.

4. Emotional Impact and Stress Management: The psychological toll of dealing with a chronic health issue can be significant. Stress can indeed affect your immune system, potentially making it harder for your body to fight off infections. Engaging in stress-reducing activities, such as mindfulness, yoga, or other relaxation techniques, can be beneficial. It is also important to maintain open communication with your healthcare provider about your emotional well-being, as they may be able to provide resources or referrals to mental health professionals if needed.

In conclusion, it is crucial to continue seeking medical advice and possibly consider a second opinion if you feel your concerns are not being adequately addressed. A thorough evaluation, including cultures and possibly imaging studies, may be necessary to pinpoint the exact cause of your symptoms. Remember, you are not alone in this, and many women face similar challenges. With the right approach and support, it is possible to find relief and regain your confidence.

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