[28F] With persistent vaginal discharge and unpleasant odor

Patient Description

A 28-year-old female presents with a persistent thin, runny vaginal discharge that soaks through pads and has an unpleasant odor, though not fishy. The discharge has been present for several months, with no prior similar episodes. The patient reports irregular menstrual cycles, having experienced two periods in one month for a few months, but they have since returned to regularity. The patient experiences occasional pelvic pain but no consistent pattern. There is a history of significant stress, but no new sexual partners, antibiotic use, or changes in diet or personal hygiene products. The patient has not traveled recently. There was one episode of burning during urination, but no itching or unusual bleeding between periods. The patient has not found any effective measures to reduce the odor. No known allergies or chronic conditions were reported.

Arora's Assessment

What might be happening

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

Bacterial Vaginosis (BV): This is a common condition caused by an imbalance of bacteria in the vagina. It often results in a thin, gray, white, or green discharge with a strong, unpleasant odor. BV is not sexually transmitted, but sexual activity can increase the risk. Stress and hormonal changes, such as those from irregular menstrual cycles, can also contribute to BV.
- Treatment typically involves antibiotics prescribed by a healthcare provider. It's important to complete the full course of treatment even if symptoms improve.
Trichomoniasis: This is a sexually transmitted infection (STI) that can cause a greenish discharge with a strong odor. It often comes with itching or irritation, which you haven't experienced, but it's still worth considering.
- Treatment involves a specific antibiotic, usually metronidazole or tinidazole, which is effective in clearing the infection.
Other Vaginal Infections: While less likely given your symptoms, other infections such as yeast infections or sexually transmitted infections could also cause changes in discharge and odor.
- Treatment would depend on the specific infection and would require a healthcare provider's diagnosis.

What you can do

Consult a Healthcare Provider: It's important to see a doctor or gynecologist for a proper diagnosis and treatment plan. They may perform tests to determine the exact cause of your symptoms.
Maintain Good Hygiene: While it's important to keep the vaginal area clean, avoid douching or using scented products, as these can disrupt the natural balance of bacteria.
Manage Stress: Since stress can impact your symptoms, consider stress-reduction techniques such as exercise, meditation, or talking to a mental health professional.
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.

What you should look out for

Worsening Symptoms: If your symptoms worsen or you develop new symptoms such as itching, burning, or pain, seek medical attention promptly.
Fever or Pelvic Pain: If you experience a fever or significant pelvic pain, these could be signs of a more serious infection and should be evaluated by a healthcare provider.
Persistent Symptoms: If your symptoms persist despite treatment, follow up with your healthcare provider for further evaluation.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

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