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Women's Health

Vaginal Discharge & Recurring UTI x 9 months

07/14/2011

Question:

After numerous visits to my physician`s office I still have no relief from this vaginal discharge! Most recently the FNP at the office examined me and did a culture of the discharge, which she said looked like yeast, just as the doctor had said 2 months ago. She sent the culture out to determine the strain of yeast. It came back negative for any kind of yeast. So, what is it? I was treated with a prescription yeast medicine prior to the test results and Cipro for another UTI. I have spent nearly $800 (no insurance) on a yeast infection that isn`t a yeast infection, and was laid off from work yesterday. Oh, and my fiance (who I have been in a monogamous relationship with for 1 1/2 years)has no symptoms of anything. Approx 9 months ago I went to my pcp with vaginal discharge and a severe lower backache. I was diagnosed with a kidney infection, yeast infection, and begininnings of BV. The problem seemed to resolve completely for about 4 weeks. Then the BV returned. This happened 3-4 times. I changed soaps and remained clear of all 3 for about 8 weeks. Then I moved to a new home and have had the following symptoms almost continuously for the past 90+ days: -Milky white discharge, consistency of kefir (thick, but still fluid, and not clumpy)no significant malodor -Increased frequency of bowel movements and loose bowels (almost as though this discharge is entering the rectum and infecting the bowel or acting as an enema) -Frequent urination -Frequent UTI`s This cannot be a normal part of getting older. Any ideas I can take to my provider would be welcome. She seems to be stumped, and almost as frustrated as I am. Oh, one more piece of information, I had a hysterectomy 15 years ago.

Answer:

Vaginal discharge is one of the most common reasons for consultation with a gynecologist.  Although it is often assumed to be due to an infection such as yeast or bacterial vaginosis, that is not always the case.  Discharge that is not associated with any pain, odor or itching can even be normal and fluctuate with hormonal changes in a woman's cycle.

Infections with bacteria or yeast can usually be diagnosed with culture or with examination under a microscope.  Herpes can also cause a vaginal infection.  Treatment will depend on the kind of organism causing the infection.  In women who have such infections repeatedly, use of probiotics and avoidance of douching may help prevent an infection from returning.

Other causes of inflammation that can cause discharge include allergic reaction or non-specific inflammation of the vaginal surface.  Any substance that one may react to should be avoided, including any hygiene product with dyes, fragrances or additives.  Hypoallergenic soap may be useful.  Desquamative inflammatory vaginitis is an inflammatory disorder that is poorly understood and may require local use of steroid medication to reduce inflammation.

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Response by:

Jonathan  A Schaffir, MD Jonathan A Schaffir, MD
Clnical Assistant Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University