Women's Health Community

Dear An: Your symptoms (burning/itching/irritation/no foul odor) more suggest a candida ("yeast") infection than bacterial vaginosis (BV). In terms of the vaginal pH reading, yeast tends to be either normal or acidic, while BV creates an alkaline pH. On actual pH paper yeast would measure 4.0-4.7 while BV would read 5.0-5.5.

It is hard to know what an at home BV treatment would do as BV cure is best achieved with a prescription (eg metronidazole or clindamycin). Perhaps the at home treatment reduced the symptoms of whatever you have but did not cure the situation.

A sample of your discharge really needs to be viewed under a microscope by your GYN or clinic. That can help establish the most "for sure" diagnosis (eg yeast, BV, or even an overgrowth of the beneficial hydrogen peroxide producing lactobacilli [the good vaginal bacteria>). A GYN can also do screenings for sexual infections such as chlamydia or gonorrhea if indicated.

If the symptoms are intolerable you can surely choose to see urgent care. Yet a GYN type clinic has the most expertise (in my biased view).

Yours,
Jane

PS You have raised some excellent questions about OTC diagnosis and treatments for vaginal symptoms. I'm thinking about doing a blog on your topic soon. Thanks for your comments.

Update: so the night before I was able to get to the Gyno I had heavy bleeding as if I was having my period for about an hour. Then as quickly as the symptom came they disappeared. I was able to see the gyno in the morning. He said I was still really inflamed. He thought I had a yeast and bv. I asked about stds and he said he didn't see any signs of an std. He tested me for bv/ yeast and by my request tested me for stds. The result of the yeast and bv came back negative. I'm still waiting on results for the std. The nurse who called with results again told me that the doctor doesn't believe I have an std but vaginitis cause my an allergic reaction. Although comforting to hear from a doctor I dont have symptoms of std I'm still nervous. I havent used anything different down there except for a tampon. Can you develop an allergy to tampons?

Dear An: Thanks for your feedback. It's interesting that "official" tests by the GYN were negative for both yeast and bacterial vaginosis (BV). It was certainly reasonable for you to request STD screenings. If they all come back negative you can cross those off your list of possible causes as well.

Yes, one can develop an inflammation reaction to products used in the vagina. Some common examples would be lubricants, condoms, vaginal washes or vaginal cosmetics, or a new brand of tampon.

By way of overview, a normal discharge is made up from exfoliated vaginal skin cells, bacteria, and secretions from the cervix and vaginal walls. While as many as 30 types of bacteria can be found in normal vaginal discharge, about 95% of a healthy vaginal bacteria population consists of lactobacilli. There are several subtypes of lactobacilli, but the most important type produces hydrogen peroxide. Just like hydrogen peroxide is used to clean cuts and scrapes on the surface of external skin, the hydrogen peroxide produced by the lactobacilli helps decrease the numbers of undesirable bacteria such as E. Coli. A healthy vaginal pH is relatively acidic (pH 3.8-4.5). An acidic pH also discourages undesirable bacteria.

Any change in the balance of "normal" bacteria can change the vaginal ecosystem. Discharge characteristics can vary over a menstrual month depending upon hormones, changes in pH, brief overgrowths of different species of normal vaginal bacteria, and exposure to semen or menstrual flow.

If all your screenings return as negative is it reasonable to do a "watch & wait" to see if the symptoms resolve on their own without further treatment. Sometimes even over the counter treatments can contain ingredients which increase irritation. If symptoms persist or escalate go back to your GYN when the symptoms are the worst for another test.

Yours,
Jane