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Mixed vaginal infection

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Hello, I am a female, 35 years old. I already have had a child that is now 4 years old. I have the tendency to get vaginal yeast infections. The last one was about 15 days ago. It seemed normal to me as I had taken antibiotics for about 20 days due to a sinusitis - I took a travogen vaginal pill and used travogen cream for 3-4 days. I also started getting lactobacillus vaginal pills for about 4-5 days, but then I had my period and i stopped. I was supposed to get a second travogen vaginal pill after my period, that is, a week ago. However the symptoms have changed. I felt itchy on the outside of my genitals for about 2 days, really intense. Then this stopped. In the last 2 days I have really watery vaginal discharge with a fishy smell that is intense after intercourse (i am trying to conceive a second child too). As I have had many yeast infections in my life, I am very familiar with the symptoms. However these are different. I looked it up at the internet and bacterial vaginosis came up. The problem is I am traveling tomorrow morning to a remote island in thailand and I dont have time to visit a doctor... I dont want to leave it untreated and I am afraid of taking antibiotics like metronidazole, because if it is not a bacterial vaginosis but a different yeast infection, the antibiotics will make it worse again... I am thinking of taking lactobacillus vaginal tablets for about 10 days that are good for both situations and then wait and see.. what can you advise me? I really want to conceive a baby and as I have been trying for a long time - and also had an ectopic pregnancy and tube removal in the meantime - having another obstacle to face is really stressful.. any advise welcome..thank you, Tania

Category: OBGYN

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Category: Infertility Specialist
 26 Doctors Online

Hello,
Thanks for your consult at DoctorSpring.com.

Frankly, self treating ANY thing is fraught with risks.

That too, vaginal infections should definitely not be treated even by a doctor without confirming the type of infection.

Without mincing words, I would say that you NEED to have an internal check up - per vaginum and per speculum AND a vaginal swab to determine the type of infection.

The history of antibiotic use and prior history of recurrent yeast infections points towards a candidal ( fungal infection ). However, the fishy smell and the watery discharge are very strongly suggestive of BV ( bacterial vaginosis ).
The two often DO coexist.

You could take the lactobacillus tablets and wait and watch. But , as you mentioned, the itching is quite intense.
If the underlying infection remains untreated, you would not have any symptomatic relief.

As you really do not have time to see a doctor, we must go with the next best option and that is -Do not take prolonged metronidazole course , as it might flare up a probable yeast infection.

These two infections often coexist and I think that is the case here also. Please go for available OTC kits ( for eg. - FAS 3 kit, AFC kit ).

These have just 3 components ( just 3 tablets ) - fluconazole ( anti yeast ), azithromycin ( BV ) and secnidazole ( BV and anerobes ).This would be ideal, as it covers mixed infections, and does not have side effects of prolonged antibiotic therapy.

Meanwhile, please see a doctor as soon as you can to confirm the diagnosis. Get your blood sugars tested also. Use condoms if you are going to be sexually active, till the infection clears. Wash private parts with Baktolin 5-5 soap ( maintains vaginal pH ).
Avoid cleansing / douching / rubbing vigorously. Avoid use of soaps, gels, cleansers, tampons, perfumed or medicated products.
Wear cotton underpants and change them frequently.
Avoid keeping swimsuits on for too long , to avoid dampness.
Eat lots of yoghurt, curd, salads.
You can take oral probiotics also.
All the best.
Please feel free to ask for further clarifications.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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