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

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Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® 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,

Planned Parenthood


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

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13 Comments on "Dear Dr. Vanessa: Help, Something's Off Down There!"

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5 years 9 months ago

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!

5 years 10 months ago

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…

Madamoiselle L
5 years 10 months ago

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.

5 years 10 months ago

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!

5 years 10 months ago

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