Recurrent Vaginal Infections: Symptoms, Diagnosis, and Treatment

Recurrent vaginitis

Hello Doctor: Last November, I experienced an increase in yellow-green vaginal discharge and itching in the vulva.
I visited a gynecologist who performed an internal examination (without instruments) and diagnosed me with a Candida infection.
I took antibiotics for the first time but had an allergic reaction, so I switched to another type and took it for about five days, which significantly alleviated my symptoms, and the doctor discontinued the medication.
However, the discharge situation has been recurrent, and I still have yellow-green discharge resembling mucus.
I consulted a Traditional Chinese Medicine doctor who did not perform an internal examination since I have not had sexual intercourse with a male.
The doctor mentioned that my symptoms were mild (not very itchy, and no pain when touching the vulva) and advised me to use iodine sitz baths, but after trying this for one to two months, I have not noticed significant improvement, and I still have discharge.
I would like to ask: 1.
Given the atypical symptoms of Candida, and since I have not had male sexual experience, can I still have a vaginal discharge test to determine the type of infection? 2.
Since my symptoms do not seem severe, doctors are often reluctant to prescribe antibiotics or conduct tests.
How can I communicate this effectively? 3.
Although I have not had male sexual experience, I have used my fingers for vaginal masturbation.
Is it possible to contract trichomoniasis or other vaginitis? Thank you, Doctor.

Liu Xiaojie, 10~19 year old female. Ask Date: 2021/08/22

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
"Vaginal infections" can cause abnormal discharge, perineal itching, unpleasant odor, burning sensation during urination, frequent urination, and bleeding.
In more severe cases, it may lead to abdominal pain or fever.
"Treatment methods" vary depending on the symptoms and require proper health education.
It is recommended to visit an outpatient clinic for examination and evaluation by a specialist in obstetrics and gynecology.
2.
It is advised to switch to another physician.

Reply Date: 2021/08/22

More Info

Understanding recurrent vaginal infections can be quite complex, especially when symptoms persist despite treatment. Based on your description, it seems you have been experiencing a range of symptoms including increased vaginal discharge, itching, and discomfort, which have led to multiple consultations and treatments. Let's break down your concerns and provide some clarity on the situation.

1. Diagnosis of Vaginal Infections: You mentioned that your initial diagnosis was a yeast infection (candidiasis), which is common and can cause yellow-green discharge along with itching. However, recurrent symptoms can sometimes indicate other infections, such as bacterial vaginosis or trichomoniasis, especially if the discharge is persistent and changes in character. Even without sexual intercourse, it is possible to contract infections through other means, including the use of contaminated objects or fingers. A vaginal swab or wet mount examination can help identify the specific type of infection, including the presence of yeast, bacteria, or parasites. It is advisable to request a comprehensive examination, including a Pap smear if appropriate, to rule out any underlying issues.

2. Communication with Healthcare Providers: It can be frustrating when symptoms are dismissed or not taken seriously. When discussing your symptoms with your healthcare provider, it is essential to be clear and assertive about your concerns. Explain the persistence of your symptoms and how they affect your quality of life. You can request specific tests, such as a vaginal culture or a test for sexually transmitted infections (STIs), even if you have not had penetrative intercourse. If your current provider is unwilling to perform these tests, consider seeking a second opinion from another gynecologist or a specialist in infectious diseases.

3. Risk of Other Infections: While your lack of sexual experience may reduce the likelihood of certain STIs, it does not eliminate the risk of infections like trichomoniasis, which can be transmitted through non-penetrative sexual activity or shared personal items. Additionally, bacterial vaginosis can occur due to an imbalance of normal vaginal flora, which can be influenced by various factors, including hygiene practices, hormonal changes, and even stress.
In terms of treatment, if you are experiencing recurrent infections, it may be beneficial to explore long-term management strategies. This could include:
- Probiotics: Some studies suggest that probiotics may help restore the natural balance of bacteria in the vagina, potentially reducing the frequency of infections.

- Antifungal or Antibiotic Therapy: If a specific infection is identified, targeted treatment is crucial. In cases of recurrent yeast infections, a longer course of antifungal medication may be necessary.

- Lifestyle Modifications: Maintaining good hygiene, wearing breathable cotton underwear, and avoiding irritants (like scented soaps or douches) can help prevent future infections.

In conclusion, recurrent vaginal infections can be a sign of an underlying issue that requires thorough investigation. It is crucial to advocate for your health by seeking appropriate testing and treatment. If your symptoms persist, do not hesitate to pursue further medical advice until you find a resolution. Your health and comfort are paramount, and you deserve effective care.

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