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Dear Dr. Vanessa: Help, Something’s Off Down There!

Thu, Jan 21, 2010

Advice, What's Up Doc?

photo by striatic

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood¬ģ Federation of America, will be answering your questions here. To ask her your own question, click here.

Dear Dr. Vanessa,

For nearly 5 months I have had a sour tasting vaginal discharge.¬† It is the consistency of paste and is always in my underwear.¬† It is destroying my sex life!¬† My BF wants BJ’s in the middle of sex and when I do it I feel like I am going to throw up from the sour taste.¬† (BTW, he never goes down so he has no idea other than he has seen the paste on his penis.)¬† It is horrible.¬† I have seen 2 gyno’s, been treated 3 times with cream for yeast infection, twice with pills for YI and once for a bacterial infection (with cream).¬† Nothing works!¬† I have looked endlessly for a solution on the internet:¬† all I come across is women with the same stupid problem and NO CONCRETE ANSWERS!!¬† It is so frustrating as there appears to be no end in sight for this.¬† I eat right, exercise, use condoms and drink plenty of water.¬† What is the deal?¬† Please help.¬† Thank you.

–Cootie Coochie

Dear C.C.,

Don’t lose hope.  The first step is to find a clinician who is willing to take the time to listen to you and perform a series of tests to figure out what is going on.  Ask the gynecologists you’ve already seen for a referral to someone who specializes in vaginal infections.  If you cannot get a referral from them, make an appointment with the Planned Parenthood health center nearest you by calling 1-800-230-PLAN.
Stress to the next clinician you talk with that you really need someone who will work with you over the long term because it may take some time to figure out the right diagnosis and treatment.  Give the clinician all the details you gave me when asking your question.

Prior to your visit, do not douche, use any feminine hygiene products, or take any medications to try to rid yourself of the discharge.  The clinician will examine it under a microscope and check its pH to determine how acidic it is.  From these examinations, the clinician should be able to tell you right away if you have yeast or trichomonas, if bacterial vaginosis is likely, and if there are healthy levels of normal bacteria in your vagina, such as lactobacilli.

The clinician may also take cultures to send to a lab.  It may take about a week to get the results.  The cultures may help with making a diagnosis and determining an effective treatment.  For example, clinicians can use the results of the culture to tell if you have a strain of yeast that is not killed by commonly used medications.

If you have an infection, your clinician will determine whether you have a persistent infection that has never been adequately treated or a recurrent infection that gets cured with treatment but then returns after you become infected again.  The cultures will be really helpful in identifying the proper medication to treat persistent infections.  If you have a recurrent infection, your clinician will help you figure out why your infection keeps coming back.  Some possible reasons include a partner with an infection, products that change the normal mix of organisms in your vagina, changes in vaginal pH caused by semen, or an illness that makes you prone to certain infections (for example, diabetics are prone to yeast infections).

Be aware that this might not be an infection.  For example, bubble baths, perfumes, soaps, laundry detergents, and feminine hygiene products can cause inflammation and change vaginal discharge.

With time, treatment, and follow-up visits, you and your clinician can get to the bottom of the problem.

Best wishes for finding a solution and for continuing good sexual health,

Vanessa
Planned Parenthood

dr_vanessa_cullins

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood¬ģ Federation of America.

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13 Responses to “Dear Dr. Vanessa: Help, Something’s Off Down There!”

  1. Doug Says:

    I know this is about discharge, but boy that guy sounds like a winner.

  2. Dannie Says:

    My thoughts as well, Doug. My thoughts as well.

  3. Spes Says:

    Agreed, Doug and Dannie. He sounds like a real stand up kind of guy.

  4. Johnny Says:

    Why, because he doesn’t want creamy sour discharge in his mouth? She says it makes her want to puke too.

    This woman is writing in because she has a bona fide problem with her vagina. I don’t think this case warrants a harsh judgement against the guy for not going down.

  5. Spes Says:

    Johnny, I cannot speak for Doug or Dannie, but you are mistaken in your assumption for my distaste of the boyfriend. I get the impression that he is inattentive and insensitive, at least in bedroom play, which is typically indicative of a general trend. Just as women have the right to not give head if they don’t like, so do men. But also if you want someone going downtown on you, you have to be willing to reciprocate. Fair’s fair.

  6. johnny Says:

    Fair enough… I guess I missed that “he wants blowjobs in the middle” part…

  7. Doug Says:

    Spes said what I would have said. Granted most of it is her fault for putting up with it, it still seems he has a lack of empathy or a sense of reciprocation. It’s his perogative to not go down there, but then he shouldn’t expect mid-intercourse oral performed on himself. And to have “no idea” that the sour smelling, milky white paste on his member has a bad taste is a little far fetched, he could at least not request it. Then again, she does it…..

  8. Dannie Says:

    If she truly isn’t interested in receiving oral, doesn’t feel she is missing out, and is not giving him head out of a sense of pure obligation, then sure–that’s between the two of them, and it’s really not our place to judge. We don’t really have all of the story (as Doug said, this is about vaginal discharge); they could have ironed this out a long time ago in their relationship. Still. If it were me…not my kinda guy. Just sayin’.

  9. Dannie Says:

    And, I must add, wow. What a turn in focus from the original point of her letter..

  10. Lizi Says:

    I do not have the same problem as the writer, but I definetly am in the same boat as her. Ive been to many gynos and GPs, but no solutions. Its becoming very expensive!

  11. Madamoiselle L Says:

    If the OP can’t get a GYN to diagnose and treat her, would a dental dam (or just some plastic wrap) help? That would “shield” any stuff that he might perceive as “not nice.” (Plain store bought Plastic wrap will make a nice workable dental dam. Place it over your pubes and let him go at it. “Clean” and safe.)

    Also, if he won’t put it in his mouth, he shouldn’t expect her to, either.

  12. JD Says:

    I had a somewhat similar problem – recurrent yeast infections, couldn’t figure out why… Turns out I am sensitive to glycerine in many lubes (and lubricated condoms). Switched to unlubricated condoms and glycerine free lube and the problem cleared right up. Not that this is her problem, but it’s something to think about…

  13. ss Says:

    In addition to the test for various infections, you may want to consider: Using a lube without glycerin OR parabens. Most people know glycerin lube can cause yeast infections in those prone to them, but parabens are also a big irritant for some people. Astroglide makes a glycerin and paraben free version. You may be reacting to the condoms themselves. You should consider seeing a naturopath. Chronic health issues like this are often the result of an imbalance which could be corrected through diet/supplements, and most Western doctors avoid this route. Also, put laundry that contains underwear on an extra rinse cycle, and don’t use Tide, it bothers a lot of people!


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