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Suggest Medical Tests To Rule Out Vaginal Infection
Question: I have been suffering from an ongoing vaginal infection that I can't seem to get rid of. It's causing me to be very depressed and frustrated because I'm not getting the care and answers that I need from my gynecologist. This has been going on for almost 5 months. I have intense itching, painful intercourse because I'm so irritated, thin pasty discharge that looks yellowish green but only in the light on a piece of white tissue. Before any cultures were done, my gyn said that it was a yeast infection and give me 2 single dose courses of gynazole, which didn't do anything. Then I was given 2 doses of Diflucan, a week apart. In November, I had a culture done that showed that I had group B strep, which my doctor said that you don't usually treat it unless the woman is pregnant. She gave me clindamycin cream for 7 days just incase. Same issues. A few weeks later I called and she called in Terconazole just incase it was a rare strain of yeast while I was waiting for my appointment to see her next. Still no difference. I finally saw her for another culture in February, and she did a swab for BV and yeast strains. It came back as no yeast found, but for bv, I low levels of atopobium vaginae and bvab, but high levels of megasphaera 1. I was put on metronidazole gel for 14 days, and took a dose of diflucan on the 7th and 14th days as instructed. I felt 100% better during the treatment, but 2-3 days off of it, I started feeling worse than before with intense itching, burning, and discharge again. I've abstained from intercourse since before my treatment. I've been tested for chlamydia and gonorrhea, both of which were negative. The gynecologist's office said that I was tested for trichomoniasis on my first culture in November when they found the group b strep. I'm also on the Nuvaring for almost 3 years. I'm seriously losing my mind over this and I don't even remember what it's like to feel normal again and it's causing me to be very depressed and scared that I won't find a solution. Any help would be greatly appreciated. Thanks.
Brief Answer:
Need to follow suggestive treatment plan.
Detailed Answer:
Hello Dear,
Thanks for writing to us. Followings are my comments:
1) According to your given information, you are mostly suffering from mixed Vaginal Infection repeatedly.
I would suggest to undergo one Pap Smear Test, Repeat Swab CULTURE test of the discharge, DRUG SENSITIVITY TEST, blood sugar and complete blood count.
Additionally, one urine routine examination and culture test will be worthwhile. It will help to determine better drug treatment.
2) Next thing, you have to ELIMINATE or CORRECT some additional predisposing factors like mental stress, lack of sleep, poor eating habits, hormonal imbalance, certain medicines (like hormone pills, antibiotics, steroids etc), weak immune system, Cervicitis, poor genital hygiene etc.
3) EXTERNAL FACTOR: Common side effects of NUVARING are repeated vaginal infections and irritation, vaginal itching or discharge, headache, stomach cramp, nausea, vomiting, bloating etc. It causes change in vaginal flora if used for long term period.
I suggest you to CHANGE or REMOVE Nuvaring and use some other contraceptive method. It will be more worthwhile in your case.
To summarize, you have to modify all these things to get effective result with treatment. You can consult with your GYNECOLOGIST for proper guidance.
TREATMENT: 1) I suggest Vaginal suppository or capsule (combined Clindamycin, Clotrimazole and Tinidazole) like CLINGEN FORTE for 7 days at bed time.
2) Use vaginal moisturizer cream with RepHresh pH gel or VAGISIL cream to avoid repeated infection and maintain vaginal pH. It can be used prior to intimation each time and maintain genital hygiene before & after sex.
3) Wear only clean and cotton underwear. Don't wear any tight fitting cloths or pants to avoid repeated friction/ irritation/ sweating. Take sound sleep properly. Be stress free through regular meditation or yoga.
4) Take healthy diet as you have mentioned with anti oxidant (like Vitamin -E or C, Selenium, Zinc, Lycopene etc) supplements. Drink plenty of water or juice for better systemic circulation. You must avoid salty, sugary or fatty foods.
5) Avoid chemical cosmetics or soaps or scented bath products around genital area. Don't practice unprotected sex till the problem is completely resolved.
Hope, it helps for your information. Good luck and take care.
For future query, you can directly approach me through
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Regards,
Need to follow suggestive treatment plan.
Detailed Answer:
Hello Dear,
Thanks for writing to us. Followings are my comments:
1) According to your given information, you are mostly suffering from mixed Vaginal Infection repeatedly.
I would suggest to undergo one Pap Smear Test, Repeat Swab CULTURE test of the discharge, DRUG SENSITIVITY TEST, blood sugar and complete blood count.
Additionally, one urine routine examination and culture test will be worthwhile. It will help to determine better drug treatment.
2) Next thing, you have to ELIMINATE or CORRECT some additional predisposing factors like mental stress, lack of sleep, poor eating habits, hormonal imbalance, certain medicines (like hormone pills, antibiotics, steroids etc), weak immune system, Cervicitis, poor genital hygiene etc.
3) EXTERNAL FACTOR: Common side effects of NUVARING are repeated vaginal infections and irritation, vaginal itching or discharge, headache, stomach cramp, nausea, vomiting, bloating etc. It causes change in vaginal flora if used for long term period.
I suggest you to CHANGE or REMOVE Nuvaring and use some other contraceptive method. It will be more worthwhile in your case.
To summarize, you have to modify all these things to get effective result with treatment. You can consult with your GYNECOLOGIST for proper guidance.
TREATMENT: 1) I suggest Vaginal suppository or capsule (combined Clindamycin, Clotrimazole and Tinidazole) like CLINGEN FORTE for 7 days at bed time.
2) Use vaginal moisturizer cream with RepHresh pH gel or VAGISIL cream to avoid repeated infection and maintain vaginal pH. It can be used prior to intimation each time and maintain genital hygiene before & after sex.
3) Wear only clean and cotton underwear. Don't wear any tight fitting cloths or pants to avoid repeated friction/ irritation/ sweating. Take sound sleep properly. Be stress free through regular meditation or yoga.
4) Take healthy diet as you have mentioned with anti oxidant (like Vitamin -E or C, Selenium, Zinc, Lycopene etc) supplements. Drink plenty of water or juice for better systemic circulation. You must avoid salty, sugary or fatty foods.
5) Avoid chemical cosmetics or soaps or scented bath products around genital area. Don't practice unprotected sex till the problem is completely resolved.
Hope, it helps for your information. Good luck and take care.
For future query, you can directly approach me through
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Regards,
Above answer was peer-reviewed by :
Dr. Sonia Raina
Is it possible that I can continue using the Nuvaring and my vaginal flora will eventually regulate again? If I ask my doctor to prescribe Clingen Forte, will it eliminate it or regulate my pH to continue using the Nuvaring? I don't have any other birth control options as I haven't been able to tolerate pills, iud, or shot. I absolutely love the Nuvaring and it has worked great for me. Are there any other ways around this? Also, is it possible that it's not the Nuvaring causing the infection? I noticed that all of this started in November following an accidental exposure to bacteria from my anus during intercourse. Would that be a cause? And one last question. Does Clingen Forte or RepHresh gel affect the effectiveness of the Nuvaring at all?
Brief Answer:
Details are given below.
Detailed Answer:
Hello Dear,
Thanks for follow up queries.
1) Yes, you can continue Nuvaring if vaginal infection is controlled. You can change it and wear new one after controlling infection.
2) Yes, your doctor may prescribe same medicine (if she prefers) or composition to control or eliminate infection.
3) You have to use RepHresh pH gel or V-wash solution to regulate pH and prevent recurrent infection.
4) Sub-dermal implant like Nexplanon can be used for 3 yrs to avoid pregnancy. It has highest protection rate.
5) Nuvaring may be associated with recurrent infection as it is external subs to vaginal flora. Infection can be transmitted from anus also but it needs to confirm by culture test only.
6) No, Clingen Forte or RepHresh Gel DOESN'T affect effectiveness of the Nuvaring. You also follow preventive measures along with drug treatment.
Hope, I have clarified all things. Maintain genital hygiene properly.
Regards,
Details are given below.
Detailed Answer:
Hello Dear,
Thanks for follow up queries.
1) Yes, you can continue Nuvaring if vaginal infection is controlled. You can change it and wear new one after controlling infection.
2) Yes, your doctor may prescribe same medicine (if she prefers) or composition to control or eliminate infection.
3) You have to use RepHresh pH gel or V-wash solution to regulate pH and prevent recurrent infection.
4) Sub-dermal implant like Nexplanon can be used for 3 yrs to avoid pregnancy. It has highest protection rate.
5) Nuvaring may be associated with recurrent infection as it is external subs to vaginal flora. Infection can be transmitted from anus also but it needs to confirm by culture test only.
6) No, Clingen Forte or RepHresh Gel DOESN'T affect effectiveness of the Nuvaring. You also follow preventive measures along with drug treatment.
Hope, I have clarified all things. Maintain genital hygiene properly.
Regards,
Above answer was peer-reviewed by :
Dr. Deepak
Thank you for all of the helpful information.
I'm also worried about pid. Can untreated bv turn into bv? And cn I use the RepHresh gel now, even if I think that my BV may have returned? Or do I need to take an antibiotic and then start the gel? Also, with long-term use of the gel with the Nuvaring, would my vaginal flora eventually return to normal, and would I eventually be able to stop using the gel, and just use the Nuvaring by itself with no infection?
Thanks!a
I'm also worried about pid. Can untreated bv turn into bv? And cn I use the RepHresh gel now, even if I think that my BV may have returned? Or do I need to take an antibiotic and then start the gel? Also, with long-term use of the gel with the Nuvaring, would my vaginal flora eventually return to normal, and would I eventually be able to stop using the gel, and just use the Nuvaring by itself with no infection?
Thanks!a
Brief Answer:
RepHresh gel should be used on daily basis.
Detailed Answer:
Hello Dear,
Welcome back again.
1) In my opinion, it could be mixed type vaginal infection (Bacterial vaginosis and or yeast infection). It should be treated with vaginal suppository or soft capsule.
2) You should use RepHresh gel on regular basis to maintain vaginal pH and avoid recurrence of BV and or other infection. One course antibiotic or probiotics should be taken for 7 days as mentioned above.
3) Yes, vaginal-flora returns to normal if you use the gel on daily basis. It will also give extra protection from recurrent infection.
4) It depends on controlling of vaginal infection. I suggest you to use gel as long as you use Nuvaring. It will reduce infection load and recurrence.
Hope, I have answered your queries. Be well and take care.
Regards,
RepHresh gel should be used on daily basis.
Detailed Answer:
Hello Dear,
Welcome back again.
1) In my opinion, it could be mixed type vaginal infection (Bacterial vaginosis and or yeast infection). It should be treated with vaginal suppository or soft capsule.
2) You should use RepHresh gel on regular basis to maintain vaginal pH and avoid recurrence of BV and or other infection. One course antibiotic or probiotics should be taken for 7 days as mentioned above.
3) Yes, vaginal-flora returns to normal if you use the gel on daily basis. It will also give extra protection from recurrent infection.
4) It depends on controlling of vaginal infection. I suggest you to use gel as long as you use Nuvaring. It will reduce infection load and recurrence.
Hope, I have answered your queries. Be well and take care.
Regards,
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Okay my last question. I used the RePhresh gel today and I don't feel much of a difference in itching but I don't see my doctor until the 31st. If I am infected with bv again, do I need to use antibiotics that they may give me first and then RePhresh immediately following it? Could the fact that I used it today without taking antibiotics first be the reason why I don't feel much difference? Or does it normally take a few days of using it? Thanks.
Brief Answer:
Use antibiotic first, then RepHresh gel on different time.
Detailed Answer:
Hello,
Thanks for your input. I know your concern. Followings are my comments:
1) At first, you need to treat Bacterial Vaginosis or mixed type infection with proper antibiotic course. Vaginal suppository or capsule (combined Clindamycin, Clotrimazole and Tinidazole) should be used for 7 days in your case. It will give better relief and need complete prescription from your doctor.
2) If you have appointment on 31st, you can use previous prescribed antibiotic for BV. Additionally, Diflucan (single dose) should be taken once per week. It will control vaginal infection.
3) You should use antibiotic first (to control infection), then use RepHresh gel on different time (to maintain vaginal pH) to get better result. It will take some time to adapt with your vaginal flora and help to reduce vaginal pH, which is increased by current infection.
4) Do protected sex with condom and use water based lubricant (like K-Y jelly) always. Don't use chemical or scented bath products. Follow other advice.
Hope, it will help to clear your confusion. Revert back to me within a week and let me know whether your condition improved or not.
Regards,
Use antibiotic first, then RepHresh gel on different time.
Detailed Answer:
Hello,
Thanks for your input. I know your concern. Followings are my comments:
1) At first, you need to treat Bacterial Vaginosis or mixed type infection with proper antibiotic course. Vaginal suppository or capsule (combined Clindamycin, Clotrimazole and Tinidazole) should be used for 7 days in your case. It will give better relief and need complete prescription from your doctor.
2) If you have appointment on 31st, you can use previous prescribed antibiotic for BV. Additionally, Diflucan (single dose) should be taken once per week. It will control vaginal infection.
3) You should use antibiotic first (to control infection), then use RepHresh gel on different time (to maintain vaginal pH) to get better result. It will take some time to adapt with your vaginal flora and help to reduce vaginal pH, which is increased by current infection.
4) Do protected sex with condom and use water based lubricant (like K-Y jelly) always. Don't use chemical or scented bath products. Follow other advice.
Hope, it will help to clear your confusion. Revert back to me within a week and let me know whether your condition improved or not.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Thanks for all of the helpful information. I saw my regular gynecologist today but I'm getting a second opinion next week. The main reason that I'm writing you now is because my gynecologist said something today that got me very nervous. Despite pharmacists saying that Metrogel doesn't affect the effectiveness of the Nuvaring, my doctor didn't seem too sure about it. I told her what the pharmacists said and she said that they know more about medication than her. I avoided intercourse the entire 14 days that I was on the medication and I didn't engage in intercourse until 12 days after my last dose of Metrogel. I also removed my Nuvaring the day after my last dose and inserted a new one as schedule a week later. I had a very light period which is unusual for me. My questions to you are,
Can Metrogel affect the Nuvaring's effectiveness, and if so, would I be okay having waited to have intercourse 12 days after my last dose?
Can Metrogel affect your period causing it to be lighter than usual?
Can Metrogel affect the hormones in the Nuvaring causing a lighter period, whether or not the effectiveness of the ring was reduced? And if it does cause a lighter period, was I correct in continuing to follow my normal Nuvaring schedule?
Any help would be greatly appreciated, thanks.
Can Metrogel affect the Nuvaring's effectiveness, and if so, would I be okay having waited to have intercourse 12 days after my last dose?
Can Metrogel affect your period causing it to be lighter than usual?
Can Metrogel affect the hormones in the Nuvaring causing a lighter period, whether or not the effectiveness of the ring was reduced? And if it does cause a lighter period, was I correct in continuing to follow my normal Nuvaring schedule?
Any help would be greatly appreciated, thanks.
Brief Answer:
Metrogel will not interact with Nuvaring.
Detailed Answer:
Hello dear,
Welcome back again.
1) In general, metroGel will NOT interact with NuvaRing. Since both are not orally given, there is NO interaction between this birth control and antibiotic.
You can keep using your NuvaRing while using Metrogel. However, you shouldn't involve in sexual intercourse until treatment is completed.
2) Metrogel DOESN'T cause lighter period. It may be due to hormonal imbalance, mental stress or anxiety and pelvic or vaginal infection. Take IRON supplements and healthy diet. Maintain genital hygiene.
3) Effectiveness of Nuvaring will NOT reduce while you are using Metrogel as both are used in different route. Nuvaring may cause hormonal problem for 1-2 cycles and period may be lighter. It will be overcome with the time period.
Hope, it helps for your information. Good luck and take care.
Regards,
Metrogel will not interact with Nuvaring.
Detailed Answer:
Hello dear,
Welcome back again.
1) In general, metroGel will NOT interact with NuvaRing. Since both are not orally given, there is NO interaction between this birth control and antibiotic.
You can keep using your NuvaRing while using Metrogel. However, you shouldn't involve in sexual intercourse until treatment is completed.
2) Metrogel DOESN'T cause lighter period. It may be due to hormonal imbalance, mental stress or anxiety and pelvic or vaginal infection. Take IRON supplements and healthy diet. Maintain genital hygiene.
3) Effectiveness of Nuvaring will NOT reduce while you are using Metrogel as both are used in different route. Nuvaring may cause hormonal problem for 1-2 cycles and period may be lighter. It will be overcome with the time period.
Hope, it helps for your information. Good luck and take care.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
So I should continue on my normal Nuvaring schedule if I'm prescribed Metrogel again, correct? Also, what are the symptoms of Tuberculosis in the vagina? My gynecologist mentioned that it could present similar vaginal symptoms of a repeated infection and other symptoms in the bodybut that it's a very rare condition.
Brief Answer:
First - treat vaginal infection. Evaluate for genital TB.
Detailed Answer:
Hello Dear,
Welcome back again. Followings are my comments:
1) In my opinion, first of all, you should treat vaginal infection by antibiotic (Metrogyl etc) as you have gotten infection repeatedly. After that, you can use Nuvaring for better result.
It will be more worthwhile in your case though there is NO such interaction between them.
2) Symptoms of genital TB include abnormal vaginal discharge, decrease in flow of menstruation, irregular bleeding, infertility, pelvic pain etc. You need to consult with your treating doctor for evaluation.
Hope, it helps for your information. Wish your good health.
Regards,
First - treat vaginal infection. Evaluate for genital TB.
Detailed Answer:
Hello Dear,
Welcome back again. Followings are my comments:
1) In my opinion, first of all, you should treat vaginal infection by antibiotic (Metrogyl etc) as you have gotten infection repeatedly. After that, you can use Nuvaring for better result.
It will be more worthwhile in your case though there is NO such interaction between them.
2) Symptoms of genital TB include abnormal vaginal discharge, decrease in flow of menstruation, irregular bleeding, infertility, pelvic pain etc. You need to consult with your treating doctor for evaluation.
Hope, it helps for your information. Wish your good health.
Regards,
Above answer was peer-reviewed by :
Dr. Sonia Raina
I'm confused because my doctor tested my pH yesterday and it was normal. She also gave me a 21 day prescription for Metrogel and told me that I should get Acidophilus for vaginal suppositories. Can I still have bv if my pH was normal? And if it's normal, would Acidophilus still help?
Brief Answer:
If your pH is normal, then chance of BV is low.
Detailed Answer:
Hello Dear,
Welcome back again.
1) I think your doctor put on Metrogel with Acidophilus vaginal suppository for maintenance or prophylactic therapy for 21 days to avoid recurrent infection.
2) If pH is NORMAL, then you may NOT have chance of BV. However, other diagnostic criteria of BV (beside pH) should be ruled out.
3) Acidophilus is a bacteria that exists naturally in the intestines and the vagina. It helps to maintain an acidic environment in the vagina, which can prevent the growth of harmful bacteria. It has supportive role though pH is Normal.
Hope, I have answered your query. Good luck and take care.
Regards,
If your pH is normal, then chance of BV is low.
Detailed Answer:
Hello Dear,
Welcome back again.
1) I think your doctor put on Metrogel with Acidophilus vaginal suppository for maintenance or prophylactic therapy for 21 days to avoid recurrent infection.
2) If pH is NORMAL, then you may NOT have chance of BV. However, other diagnostic criteria of BV (beside pH) should be ruled out.
3) Acidophilus is a bacteria that exists naturally in the intestines and the vagina. It helps to maintain an acidic environment in the vagina, which can prevent the growth of harmful bacteria. It has supportive role though pH is Normal.
Hope, I have answered your query. Good luck and take care.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Okay. Sorry for all of the questions I just want to make sure that I'm doing everything right and you have been very helpful. I'm also very concerned with any interactions with the Nuvaring. I bought probiotic capsules tonight with acidophilus as well as 37 other probiotic bacteria. The brand is Garden Of Life Raw Probiotics Vaginal Care capsules with 50 billion live cultures. My last questions are,
Will these interact with Nuvaring in any way if inserted vaginally?
Do I insert the capsule by itself, or do I need to open it and use a syringe to insert the powder? My pharmacist wasn't sure if I could insert the capsule or if it would dissolve in the vagina. It would be much easier if I could do it that way. Thank you again!
Will these interact with Nuvaring in any way if inserted vaginally?
Do I insert the capsule by itself, or do I need to open it and use a syringe to insert the powder? My pharmacist wasn't sure if I could insert the capsule or if it would dissolve in the vagina. It would be much easier if I could do it that way. Thank you again!
Brief Answer:
No interaction. You can take capsule orally.
Detailed Answer:
Hello Dear,
Welcome back again.
1) There is NO interaction with Nuvaring if you inserted the capsule vaginally or taken orally. Due to poor absorption, I DON'T recommend you to insert capsule inside vagina.
2) DIRECTION OF USE: 1 capsule daily. May be taken with or without food. Capsules can be opened. Contents can be taken directly with water or raw juices.
Hope, it clears your doubt. If you have any other query, you can directly ask me anytime.
Wish your good health and take care.
Regards,
No interaction. You can take capsule orally.
Detailed Answer:
Hello Dear,
Welcome back again.
1) There is NO interaction with Nuvaring if you inserted the capsule vaginally or taken orally. Due to poor absorption, I DON'T recommend you to insert capsule inside vagina.
2) DIRECTION OF USE: 1 capsule daily. May be taken with or without food. Capsules can be opened. Contents can be taken directly with water or raw juices.
Hope, it clears your doubt. If you have any other query, you can directly ask me anytime.
Wish your good health and take care.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
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