[19F] With vaginal irritation and discharge

Patient Description

A 19-year-old female presents with vaginal irritation both internally and externally, accompanied by a water-like milky white discharge without odor. The discharge is significant enough to soak through a panty liner and has persisted for about a month. The patient reports a burning sensation during urination, rated as moderate, and experiences itching, redness, swelling, and pain in the vaginal area, with itching being the most prominent symptom. Symptoms improve when Dr. Bronner's soap is discontinued, but irritation recurs around the menstrual cycle. The patient has not been tested for sexually transmitted infections since the onset of symptoms and denies any fever, chills, sores, blisters, or unusual bumps in the genital area. The menstrual cycle is regular, and there are no known pre-existing conditions, allergies, or current medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Yeast Infection (Candidiasis): This is a common fungal infection that can cause vaginal irritation, itching, redness, and a thick, white discharge. However, your discharge is described as water-like, which is less typical for a yeast infection.

    • Treatment usually involves antifungal medications, which can be over-the-counter or prescribed by a doctor.
  2. Bacterial Vaginosis (BV): This condition occurs due to an imbalance of bacteria in the vagina and can cause discharge and irritation. The discharge is often described as thin and grayish, but it can vary.

    • Treatment typically involves antibiotics prescribed by a healthcare provider.
  3. Contact Dermatitis: Since you mentioned improvement after stopping Dr. Bronner's soap, it's possible that your symptoms are due to an allergic reaction or irritation from a product.

    • Treatment involves avoiding the irritant and using soothing creams or ointments as recommended by a healthcare provider.
  4. Sexually Transmitted Infections (STIs): Some STIs can cause similar symptoms, especially if there has been a change in sexual partners and unprotected intercourse.

    • Testing and treatment by a healthcare provider are important for STIs.

What you can do

  1. Avoid Irritants: Since stopping the use of Dr. Bronner's soap helped, continue to avoid it and any other new products that might be causing irritation.

  2. Maintain Good Hygiene: Use mild, unscented soaps and wear breathable cotton underwear to reduce irritation.

  3. Stay Hydrated: Drinking plenty of water can help with the burning sensation during urination.

  4. Track Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.

  5. Consult a Healthcare Provider: It's important to see a doctor for a proper diagnosis and treatment, especially since the symptoms have persisted for a month.

What you should look out for

  • Seek Medical Attention If:
    • Symptoms worsen or do not improve with self-care measures.
    • You develop new symptoms such as fever, chills, or unusual sores.
    • You experience severe pain or discomfort.

Remember, while I can provide information, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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1 mo ago


People Also Ask


What are the common symptoms of a yeast infection?

Common symptoms of a yeast infection include itching, redness, swelling, and a thick, white discharge that resembles cottage cheese. There may also be a burning sensation during urination or intercourse.


How can bacterial vaginosis be distinguished from other vaginal infections?

Bacterial vaginosis often presents with a thin, grayish discharge and a fishy odor, especially after intercourse. Unlike yeast infections, BV does not typically cause significant itching or redness.


What is contact dermatitis and how can it affect the vaginal area?

Contact dermatitis is an allergic reaction or irritation caused by contact with certain substances, such as soaps or detergents. In the vaginal area, it can cause itching, redness, swelling, and discomfort.


Why is it important to get tested for sexually transmitted infections if experiencing vaginal irritation?

Testing for sexually transmitted infections is important because some STIs can cause symptoms similar to other vaginal infections, and untreated STIs can lead to serious health complications. Early detection and treatment are crucial.


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