[28F] Experiencing vaginal discharge with foul smell and cramping

Patient Description

A 28-year-old female presents with a thick, white vaginal discharge accompanied by a foul smell and cramping, which has been ongoing for 3 weeks. The discharge is sometimes enough to soak through her underwear. The patient also reports occasional itching but no burning sensation. Additionally, she experiences cramping and pressure in the abdomen when sitting down. She has noticed vaginal bleeding a few times outside of her normal menstrual cycle and pain during sexual intercourse. The patient's boyfriend had a new sexual partner and did not use protection. There is no history of similar symptoms, fever, severe abdominal pain, nausea, vomiting, or pelvic inflammatory disease.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing one of the following conditions:

  • Bacterial Vaginosis (BV): This is a common vaginal infection in women of reproductive age. It occurs when the balance of bacteria in the vagina is disrupted. Symptoms include a foul-smelling, white or gray vaginal discharge, and sometimes itching.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Sexually Transmitted Infection (STI): Given the recent sexual history of your partner, it's possible that you may have contracted an STI such as Chlamydia or Gonorrhea. These infections can cause abnormal vaginal discharge and pelvic pain.

    • Treatment usually involves antibiotics. It's important to get tested and treated to prevent complications.
  • Yeast Infection: This is a common fungal infection that can cause thick, white discharge and itching. However, it usually doesn't cause a foul smell.

    • Treatment typically involves antifungal medication, which can be over-the-counter or prescribed by a doctor.

What you can do

Given your symptoms, it's important to see a healthcare provider for a formal diagnosis. They may perform a pelvic exam or order tests to determine the cause of your symptoms. In the meantime, here are some general suggestions:

  1. Avoid douching or using scented feminine hygiene products, as these can disrupt the natural balance of bacteria in the vagina.
  2. Wear cotton underwear and avoid tight-fitting pants to allow your vagina to breathe and stay dry.
  3. Avoid sexual intercourse until you have been evaluated by a healthcare provider.

What you should look out for

Please seek immediate medical attention if:

  • Your symptoms worsen or do not improve within a few days.
  • You develop a fever, severe abdominal pain, or other new symptoms.
  • You have difficulty or pain urinating.

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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9 mo ago


People Also Ask


What are the common symptoms of bacterial vaginosis (BV)?

Common symptoms of bacterial vaginosis include a thin, white or gray vaginal discharge with a strong fishy odor, especially after intercourse, and sometimes itching or irritation.


How can sexually transmitted infections (STIs) affect vaginal health?

STIs can cause a range of symptoms affecting vaginal health, including abnormal discharge, pelvic pain, bleeding between periods, and pain during intercourse. They can lead to serious complications if untreated.


What are the differences between a yeast infection and bacterial vaginosis?

A yeast infection typically causes thick, white discharge resembling cottage cheese, intense itching, and irritation, but usually no odor. Bacterial vaginosis, on the other hand, often results in a thin, grayish discharge with a strong odor and mild itching.


When should I see a doctor for abnormal vaginal discharge?

You should see a doctor if you experience abnormal vaginal discharge that is persistent, has a strong odor, is accompanied by itching or irritation, or if you have other symptoms like pelvic pain or bleeding between periods.


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