photo by Helga_Weber

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,

Okay, so I have a very embarrassing question for you and wanted to check with you before I go see a health provider. This past weekend, I went away with a guy I have just gotten into a relationship with. He is my second sexual partner and has been checked for STDs recently, as have I.  This weekend, we had sex fairly often, and we also used a vibrator that, unbeknownst to him, was not meant to go inside me. Even though I pulled it out, I have been feeling a lot of discomfort since we got back.

I have a lot of whitish discharge and it has a terrible odor, not to mention the fact that I am very sore. Could this be a case of irritation due to the “foreign object” or possibly a case of BV? If it is just irritation, then I would prefer not to pay for a medical visit, but if it’s BV, my understanding is that I should get antibiotics. Any ideas would be appreciated.

— Saddle Sore

Dear S.S.,

You should be seen by a health care provider. Whenever a woman has an irritation of the vagina and an abnormal discharge — vaginitis or vulvovaginitis — she should see her health care provider and try to get a definitive diagnosis. Because the discharge you describe has a strong, unpleasant odor, three possible causes of vaginitis come to mind.

The first possible cause is what you suspected — bacterial vaginosis (BV). It is a condition caused by several bacteria, including gardnerella vaginalis. (BV used to be called “nonspecific vaginitis.”) Usually there is a heavy vaginal discharge. It is grayish and frothy and has an unpleasant, “fishy” odor. Most women have at least one incident of BV in their lives.

BV is sometimes caused or made worse by sexual contact, which can disrupt the balance of normal bacteria that protect the vagina. Certain body fluids, especially semen, may be more disruptive for some women. Germs on a dildo or vibrator might also have the same effect.

Diagnosis is made by examination of the vagina and vaginal discharge. Various creams and gels, as well as oral medication, can be used to treat BV.

There is a second possible cause of the irritation and discharge — a foreign body or object left in the vagina. If the vibrator or sex toy has moving parts that could fall off, it is possible something did fall off, and it is still in your vagina. The health care provider will closely inspect your vagina to make sure this is not the case. If it is the case, the object will be removed, your vagina cleansed with a cleansing solution, and you may also need antibiotics, depending upon analysis of the discharge.

Another possibility is trichomoniasis. It is a sexually transmitted infection caused by the protozoan trichomonas. “Trich” is one of the most common vaginal infections. More than seven million people get it every year. It is spread by exchanging fluids through mutual masturbation, if fluids from one partner are passed to the genitals of the other, sharing sex toys, and vaginal intercourse.

Many women have no symptoms. When symptoms do appear, they usually include a frothy, often musty smelling discharge, itching in and around the vagina, spotty bleeding in the discharge, and possibly an urge to urinate more often than usual. Men rarely have symptoms and are rarely tested for it.

Diagnosis is made by examination of the vagina and vaginal discharge. Both partners can be successfully treated for “trich” with oral medication. You may become infected again if your partner isn’t treated. If you have more than one sex partner, each partner (and their partners) should be treated, too. Use condoms and avoid sharing certain fluids — semen, vaginal lubrication or discharge, and menstrual flow — with your partner(s) during treatment.

It is very important to see a health care provider. Vaginitis isn’t often a major health problem. But sometimes it can be serious. It can also increase the risk for HIV infection, for example. And there’s always the chance that your discomfort and discharge are being caused by another, more potentially dangerous infection like gonorrhea and chlamydia, which can have symptoms like vaginitis. Your health care provider can find the cause of your problem and offer the correct treatment.

Best wishes for successful treatment and for continuing good sexual health,

Vanessa
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.