Vaginal Infections: Symptoms, Diagnosis, and Treatment

Vaginal trichomoniasis infection?

Doctor, I have been experiencing yellow-green discharge for quite some time now, which has an odor.
The discharge is abundant, and I also experience pain during intercourse, often feeling as if my vaginal opening is being stretched.
Sometimes, there is bleeding, and I frequently have itching around the vaginal area.
I always use condoms and have never gone without one.
However, my sitting habits are not very normal.
I visited a gynecologist who only asked if I had had intercourse and when my last menstrual period was (which was in mid-June).
When I mentioned the yellow-green discharge, she examined me and prescribed a vaginal suppository, stating that I had an infection.
I asked if it was trichomoniasis, and she said no, just inflammation, but she did not conduct any tests—just a visual examination.
After researching online, I found that the clinic has poor reviews, with claims that they prioritize profit, and there are even reports of missed pregnancies by the doctors there.
She only instructed me to use the suppository before bed and asked if I experienced itching.
When I confirmed that I did, she prescribed me a medication for an additional fee of $100 and asked me to return in three days.
I asked the nurse how long it would take to improve, and she said it would take some time.
I inquired if I absolutely had to use the suppository, and she insisted that I must.
Should I consider switching to another clinic? Is it really just simple inflammation? I also mentioned using feminine hygiene spray, and she said that it was not advisable.
Is that true? I am very anxious and would appreciate your help, thank you!

Xiao Li, 20~29 year old female. Ask Date: 2015/07/05

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the physician may sometimes diagnose and treat based on the patient's clinical symptoms and medical history.
It is recommended that you finish the prescribed medication first.
If your symptoms do not improve, please consult your physician for relevant tests (such as microscopy, bacterial culture, blood tests, etc.) for further evaluation.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2015/07/05

More Info

Understanding vaginal infections is crucial for maintaining reproductive health, and your symptoms suggest that you may be experiencing a significant infection that requires thorough evaluation and treatment. Based on your description, you are dealing with yellow-green discharge, an unpleasant odor, pain during intercourse, a sensation of pressure at the vaginal opening, occasional bleeding, and itching. These symptoms can be indicative of several types of vaginal infections, including bacterial vaginosis, trichomoniasis, or a yeast infection, among others.

Symptoms and Diagnosis
1. Bacterial Vaginosis (BV): This is characterized by a fishy odor, especially after sexual intercourse, and a thin, grayish-white discharge. It is caused by an imbalance of the normal bacteria in the vagina.

2. Trichomoniasis: This sexually transmitted infection (STI) often presents with yellow-green discharge, a foul smell, and can cause itching and irritation. Pain during intercourse is also common.

3. Yeast Infection: Typically presents with thick, white, cottage cheese-like discharge, intense itching, and irritation. However, it can sometimes cause unusual discharge and discomfort.

4. Cervicitis or Vaginitis: Inflammation of the cervix or vagina can lead to similar symptoms, including discharge, pain, and bleeding.

Given that you have a persistent yellow-green discharge with a foul odor, it is essential to get a proper diagnosis. The fact that your previous visit did not involve any laboratory tests or a thorough examination raises concerns about the adequacy of the care you received.

Importance of Laboratory Testing
A proper diagnosis often requires laboratory tests, such as:
- Microscopic Examination: A sample of the discharge can be examined under a microscope to identify the presence of bacteria, yeast, or parasites.

- Culture Tests: These can help identify specific pathogens causing the infection.

- pH Testing: The vaginal pH can help differentiate between bacterial vaginosis and yeast infections.

Treatment Options
Treatment will depend on the specific diagnosis:
- Bacterial Vaginosis: Typically treated with antibiotics such as metronidazole or clindamycin.

- Trichomoniasis: Treated with metronidazole or tinidazole, which is effective against the parasite.

- Yeast Infections: Treated with antifungal medications, either topical or oral.

Follow-Up Care
If your symptoms persist or worsen despite treatment, or if you continue to experience pain and discomfort, it is advisable to seek a second opinion from another healthcare provider. A thorough examination and appropriate testing are crucial for effective treatment.

Regarding Personal Care Products
As for the use of feminine hygiene products, such as sprays or douches, many healthcare providers recommend avoiding them as they can disrupt the natural balance of bacteria in the vagina and lead to irritation or infections. It’s best to maintain vaginal health through gentle cleansing with water and avoiding irritants.

Conclusion
In summary, your symptoms warrant further investigation to rule out serious infections and ensure appropriate treatment. If you feel uncomfortable with the care you received, it is entirely reasonable to seek a second opinion. A healthcare provider specializing in gynecology can offer a comprehensive evaluation and tailored treatment plan. Remember, your health is paramount, and you deserve thorough and respectful care.

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