[23F] With persistent smelly yellow discharge and dyspareunia

Patient Description

A 23-year-old female presents with a persistent smelly yellow discharge occurring daily for several months, though not present during sleep. The patient reports pain, rated 3 out of 10, at the onset of intercourse but denies itching during intercourse. There have been no changes in the menstrual cycle since becoming sexually active, and the patient has had only one sexual partner. The patient has not been tested for sexually transmitted infections. There is no history of pelvic trauma or recent changes in personal hygiene products. The patient is currently taking doxycycline for acne and occasionally uses ibuprofen and Tylenol for dental pain. There are no known allergies or chronic illnesses.

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Arora's Assessment

What might be happening

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

  • Bacterial Vaginosis (BV): This is a common vaginal infection caused by an imbalance of bacteria in the vagina. It often results in a fishy-smelling discharge that can be yellow or gray. BV can cause discomfort during intercourse and may be accompanied by itching.

    • Treatment typically involves antibiotics prescribed by a healthcare provider.
  • Sexually Transmitted Infections (STIs): Infections such as trichomoniasis or chlamydia can cause yellow discharge with an unusual odor and discomfort during intercourse.

    • Testing and treatment by a healthcare provider are essential, as these infections are typically treated with antibiotics.
  • Yeast Infection: Although yeast infections usually cause white, thick discharge, they can sometimes present differently. They often cause itching and irritation.

    • Over-the-counter antifungal treatments are available, but a healthcare provider can confirm the diagnosis.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor or visit a clinic to get a proper diagnosis and treatment. They may perform tests to determine the exact cause of your symptoms.

  2. Maintain Good Hygiene: Use mild, unscented soaps and avoid douching, which can disrupt the natural balance of bacteria in your vagina.

  3. Track Your Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can help in identifying patterns or triggers.

  4. Avoid Irritants: Consider avoiding scented products, such as tampons or pads, that might irritate the vaginal area.

What you should look out for

Seek medical attention if you experience:

  • An increase in pain or discomfort
  • Fever or chills
  • Any new or worsening symptoms

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

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2 d ago


People Also Ask


What are the common symptoms of bacterial vaginosis?

Common symptoms of bacterial vaginosis include a fishy-smelling discharge that may be yellow or gray, discomfort during intercourse, and sometimes itching. It is caused by an imbalance of bacteria in the vagina.


Can sexually transmitted infections cause unusual vaginal discharge?

Yes, sexually transmitted infections such as trichomoniasis or chlamydia can cause unusual vaginal discharge that may be yellow and have an unusual odor. They can also cause discomfort during intercourse.


How can I differentiate between a yeast infection and other vaginal infections?

Yeast infections typically cause a thick, white discharge and intense itching, whereas bacterial vaginosis often results in a fishy-smelling discharge. A healthcare provider can perform tests to accurately diagnose the type of infection.


What steps should I take if I suspect I have a vaginal infection?

If you suspect a vaginal infection, consult a healthcare provider for a proper diagnosis and treatment. Avoid using scented products, maintain good hygiene, and track your symptoms to help your healthcare provider identify the cause.

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