[21F] Experiencing unusual vaginal discharge

Patient Description

A 21-year-old female presents with a significant increase in vaginal discharge that is sometimes greenish in color but mostly milky white with a thicker consistency. She reports slight itching and a slight sour odor, which is more noticeable during her menstrual cycle. The patient has experienced similar symptoms in the past. She denies any new sexual partners, use of protection, pain or discomfort during urination or intercourse, fever, lower abdominal pain, redness, or swelling in the vaginal area. The patient has an IUD and has been taking sertraline (50mg) and amitriptyline (75mg) for approximately 10 years, and omeprazole for a couple of weeks. She has a known allergy to amoxicillin, which causes hives. No other symptoms or medical history were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the most likely cause of your symptoms is a vaginal infection. The most common types of vaginal infections are:

  • Bacterial Vaginosis (BV): This is an overgrowth of normal bacteria in the vagina. Symptoms can include a milky white or gray discharge, a fishy odor (especially after sex or during your period), and sometimes itching or burning. Treatment usually involves antibiotics.

  • Yeast Infection: This is an overgrowth of a fungus called Candida, which is normally present in the vagina. Symptoms can include a thick, white, cottage cheese-like discharge, itching, redness, and swelling. Treatment usually involves antifungal medication.

  • Trichomoniasis: This is a sexually transmitted infection caused by a parasite. Symptoms can include a frothy, yellow-green vaginal discharge with a strong odor, discomfort during sex and urination, and irritation and itching. Treatment usually involves antibiotics.

What you can do

You should make an appointment with a healthcare provider for an evaluation. They can perform tests to determine the cause of your symptoms and prescribe the appropriate treatment. In the meantime, here are some things you can do to help alleviate your symptoms:

  • Avoid douching, as this can disrupt the balance of bacteria in your vagina and make your symptoms worse.
  • Wear cotton underwear and loose-fitting clothing to help keep your genital area dry and prevent irritation.
  • Avoid sexual intercourse until your symptoms have resolved to prevent further irritation and possible transmission of an infection to your partner.

What you should look out for

You should seek immediate medical attention if:

  • Your symptoms worsen or do not improve within a few days of starting treatment.
  • You develop new symptoms, such as pelvic pain, fever, or chills.
  • You have abdominal pain or a fever higher than 100.4°F (38°C).

Please remember that while I strive to provide accurate information, I am not a doctor. You should consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of bacterial vaginosis?

Common symptoms of bacterial vaginosis include a milky white or gray discharge, a fishy odor (especially noticeable after sex or during menstruation), and sometimes itching or burning.


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

A yeast infection typically causes a thick, white, cottage cheese-like discharge, itching, redness, and swelling, while bacterial vaginosis usually results in a milky white or gray discharge with a fishy odor. A healthcare provider can perform tests to accurately diagnose the condition.


Can an IUD affect vaginal discharge or cause infections?

An IUD can sometimes cause changes in vaginal discharge, but it is not typically associated with causing infections. However, if you experience unusual symptoms, it's important to consult with a healthcare provider.


What are the potential side effects of long-term use of sertraline and amitriptyline?

Long-term use of sertraline and amitriptyline can have side effects such as weight gain, dry mouth, drowsiness, and changes in mood or behavior. It's important to discuss any concerns with your healthcare provider.


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