[18F] With persistent vaginal itching and white milky discharge

Question

Help!!

Patient Description

An 18-year-old female presents with persistent vaginal itching and varying amounts of white, milky discharge for the past 4 days. The itching is rated as a 3 out of 10 in severity and has not been relieved by any measures. There is no unusual odor associated with the discharge. The patient reports no recent changes in hygiene products, sexual activity, or antibiotic use. She has had similar symptoms in the past. There is associated swelling and redness in the vaginal area, but no pain during urination or sexual intercourse, and no fever or chills. The patient is currently taking Accutane as prescribed.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Yeast Infection (Candidiasis): This is a common fungal infection that can cause itching, white discharge, and redness in the vaginal area. It is often triggered by factors such as antibiotic use, hormonal changes, or a weakened immune system.

    • Treatment: Over-the-counter antifungal creams or suppositories are commonly used. Your doctor may also prescribe oral antifungal medication.
  • Bacterial Vaginosis (BV): This condition occurs when there is an imbalance of the natural bacteria in the vagina. It can cause discharge and itching, although the discharge often has a fishy odor, which you did not report.

    • Treatment: Antibiotics prescribed by a doctor are typically used to treat BV.
  • Sexually Transmitted Infections (STIs): Some STIs, such as chlamydia or gonorrhea, can cause vaginal itching and discharge. Given your recent unprotected sexual activity, this is a possibility.

    • Treatment: STIs are treated with specific antibiotics or antiviral medications, depending on the infection.
  • Contact Dermatitis: This is an allergic reaction to substances such as soaps, lotions, or other products that come into contact with the vaginal area. It can cause itching and redness.

    • Treatment: Identifying and avoiding the irritant is key. Topical corticosteroids may be prescribed to reduce inflammation.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment, here are some steps you can take in the meantime:

  1. Maintain Good Hygiene: Keep the vaginal area clean and dry. Avoid using scented soaps, douches, or other products that may irritate the area.
  2. Wear Breathable Clothing: Opt for cotton underwear and avoid tight-fitting clothes to allow the area to breathe.
  3. Over-the-Counter Treatments: You can try over-the-counter antifungal creams or suppositories if you suspect a yeast infection.
  4. Stay Hydrated: Drink plenty of water to help flush out any potential irritants.
  5. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and get insights. This information can be very helpful for your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Worsening Symptoms: If the itching, discharge, or redness worsens or does not improve with over-the-counter treatments.
  • Fever or Chills: These could indicate a more serious infection.
  • Pain: If you develop pain during urination or sexual intercourse.
  • Unusual Odor: If the discharge develops a strong or unusual odor.

Remember, while this advice can help guide you, it is important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What are the common symptoms of a yeast infection?

Common symptoms of a yeast infection include vaginal itching, white and thick discharge resembling cottage cheese, redness, and swelling in the vaginal area. There is usually no strong odor associated with the discharge.


How can I differentiate between a yeast infection and bacterial vaginosis?

Yeast infections typically cause thick, white discharge and intense itching, while bacterial vaginosis often results in a thin, grayish discharge with a fishy odor. Itching is less common with BV compared to yeast infections.


Can Accutane cause vaginal itching or discharge?

Accutane is not commonly associated with causing vaginal itching or discharge. However, it can cause dryness in various parts of the body, which might contribute to discomfort. It's important to discuss any new symptoms with your healthcare provider.


What are some effective over-the-counter treatments for yeast infections?

Effective over-the-counter treatments for yeast infections include antifungal creams or suppositories such as clotrimazole (Lotrimin), miconazole (Monistat), and tioconazole (Vagistat). These treatments are typically used for a few days to relieve symptoms.


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3 Comments


Arora (Bot)#28060

5 mo ago

Hi Nadia, I see you're experiencing some discomfort. How can I assist you further with your symptoms? Do you have any specific questions or concerns about the assessment or your current condition?

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Leo#3962

5 mo ago

Hey there, if you're not able to see a health provider you can try an over-the-counter antifungal (for example miconazole) vaginal cream from CVS/Walgreen/other pharmacies. Use it for a few days as instructed on the box and if your symptoms don't improve after 3-4 days let me know here.

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Leo#3962

5 mo ago

Note that this will only treat a yeast infection. A bacterial infection is generally treated with oral antibiotics that need to be prescribed.

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