Managing Irregular Periods and Persistent Vaginal Infections

Irregular menstruation and vaginal infection/inflammation?

Hello doctor, my menstrual period does not come on its own unless I receive hormonal injections, and this has been the case for many cycles.
I have consulted numerous obstetricians and gynecologists, but there has been no improvement.
I also have issues with trichomoniasis and inflammation, and I am unsure how to resolve them.
I have tried topical medications, oral medications, and suppositories, but nothing has been effective.
Sometimes my underwear has a yellow-green discharge, and at other times it resembles cottage cheese.
I experience occasional itching and sharp pain.
What should I do to treat and resolve these issues?

KK, 20~29 year old female. Ask Date: 2021/06/01

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
The menstrual cycle can be affected by various physical and mental conditions.
If the menstrual period is consistently irregular, it is recommended to visit a gynecologist for an examination to rule out gynecological issues such as polycystic ovary syndrome.
2.
Vaginal infections can cause abnormal discharge, itching, fever, bleeding, and lower abdominal pain, which are among the most common symptoms in women.
The causes are numerous, and treatment should be accompanied by comprehensive health education.
It is advisable to have an evaluation by a gynecologist in an outpatient setting.

Reply Date: 2021/06/01

More Info

Managing irregular periods and persistent vaginal infections can be quite challenging, and it’s important to approach this issue with a comprehensive understanding of both the menstrual cycle and the potential causes of vaginal infections.
Irregular periods can be caused by a variety of factors, including hormonal imbalances, stress, significant weight changes, polycystic ovary syndrome (PCOS), thyroid disorders, and other underlying health conditions. If you find that your menstrual cycle does not regulate itself without the use of hormonal treatments like progesterone injections, it may indicate an underlying hormonal imbalance that needs to be addressed. Consulting with a healthcare provider who specializes in reproductive health can help identify the root cause of your irregular periods. They may recommend blood tests to check hormone levels, imaging studies like an ultrasound to evaluate the ovaries and uterus, or lifestyle modifications to help regulate your cycle.

On the other hand, persistent vaginal infections, particularly those characterized by yellow-green discharge or a cottage cheese-like consistency, may suggest a few different conditions. The symptoms you describe could be indicative of a yeast infection (often presenting with thick, white discharge) or bacterial vaginosis (which may present with a fishy odor and a yellow-green discharge). Trichomoniasis, a sexually transmitted infection caused by a parasite, can also cause similar symptoms.
If you have already tried various treatments, including topical medications, oral antifungals, and vaginal suppositories, and have not seen improvement, it may be time to revisit your healthcare provider. They can perform a thorough examination and possibly conduct tests such as a wet mount or culture to identify the specific pathogen causing your symptoms. This is crucial because the treatment for each type of infection can differ significantly.
In addition to medical treatment, consider the following tips to help manage and potentially reduce the frequency of infections:
1. Maintain Good Hygiene: Keep the vaginal area clean and dry. Avoid using scented soaps, douches, or feminine hygiene sprays, as these can disrupt the natural balance of bacteria and yeast.

2. Wear Breathable Fabrics: Opt for cotton underwear and avoid tight-fitting clothing to reduce moisture buildup, which can promote yeast growth.

3. Dietary Considerations: Some studies suggest that a diet high in sugar can contribute to yeast infections. Consider reducing sugar intake and incorporating probiotics, which may help maintain a healthy balance of vaginal flora.

4. Manage Stress: High stress levels can impact your hormonal balance and immune system, potentially leading to irregular periods and increased susceptibility to infections. Engage in stress-reducing activities such as yoga, meditation, or regular exercise.

5. Regular Check-ups: Regular visits to your healthcare provider can help monitor your reproductive health and catch any issues early.

6. Consider a Specialist: If general gynecological care has not resolved your issues, consider seeing a reproductive endocrinologist or a specialist in infectious diseases for a more targeted approach.

In conclusion, managing irregular periods and persistent vaginal infections requires a multifaceted approach that includes medical evaluation, lifestyle changes, and possibly dietary adjustments. It’s essential to work closely with your healthcare provider to develop a personalized treatment plan that addresses both your menstrual irregularities and recurrent infections effectively.

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