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Unpleasant odour in the private areas

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White discharge coming from the vagina

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Question
I frequently suffer from vaginal yeast infections, which I find very difficult to control. This rather limits the frequency of sex with my long-term partner. Usually when we do have sex, it's very painful for me and feels very 'tight'.

Sometimes after sex, the entrance to my vagina swells and feels very tender. This can take a couple of days to heal. I would be grateful if you could give me an indication as to whether or not this is normal.

I'm living in a foreign country and my command of the local language is not great. This is why I haven't been to see a doctor yet.

Answer
You say that this is due to vaginal yeast infections, so I presume that you are talking about thrush.

I wonder whether you have had tests for this, and if so what treatments you have had. Treatment with oral tablets/capsules is very effective so that usually the symptoms are relieved for a time, even if they come back again later.

In some patients with recurrent thrush, they can be given a supply of these tablets to take whenever the problem recurs. You don't say whether the symptoms are worse in relation to any particular time of your period, but this is often a feature of vaginal thrush.

If you have not had any diagnostic tests for thrush, then of course the diagnosis must be in doubt. Because thrush is common, it is tempting to ascribe all vaginal itching, soreness, discharge or other problems to this, when it might have another cause, such as bacterial vaginosis or trichomonas vaginalis, which need quite different treatments.

Also, sometimes other things can irritate the vagina, such as being allergic to dyes in clothes, biological washing powders, vaginal deodorants and douches, or bath additives, so it is worth thinking about these.

You don't mention the pill, so if you are using condoms or some other barrier method and/or spermicide, then it is possible that the rubber or chemicals impregnating them could be causing a form of allergic reaction.

Pain during intercourse suggests vaginal inflammation and dryness. This can occur if you have some sort of chronic infection or inflammation. To some extent this may be alleviated with adequate lubrication, such as by using KY jelly. The soreness around the entrance to the vagina could be helped by a hydrocortisone cream.

But these are only interim measures. What you really need is to get to the bottom of why you are having these persistent symptoms.

If implementing any of the suggestions I have made does not help, then I think you are going to have to have some further tests and investigations done to sort out this distressing problem.

Yours sincerely

Dr Keith Barnard, GP

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