Brief Answer:
Some sort of vaginitis

Detailed Answer:
Dear XXXX,

I hope I have spelt your name correctly and it is not your nickname. If so please correct me by informing your name, if you do not mind. .

I have gone through your nicely narrated embarrassing history. I fully empathize your situation.

From your history it appears that soiling of your underwear could be one of the following causes:

1. Excessive vaginal discharge
2. Leaking of the urine

Let us discuss both one by one.

1. Every woman after she has attained puberty is having continuous vaginal discharge, which is mainly dependant up on the levels of hormone called as Oestrogen. This discharge as you have very rightly described, stains underwear yellowish. It is insensible discharge, however. This discharge increases around midcycle when the egg is getting released. However, if you are having too copious discharge, which smells foul also, the chances of vaginal infection need to be ruled out. Usually, vaginal infections set in after sexual life has started; though it is not a rule. Vaginal infections are noted even in commode users.
Are you sexually active?
Vaginal infections by and large are of three types:
a. Fungal infection: The discharge is white and flaky in nature and causes tremendous itching. This type does not seem to fit in your description. It can be treated by antifingal vaginal pessaries.
b. Trichomonal infection: Gives rise to greenish white free flowing discharge. This also causes lot of itching. Your description seems to fit in this. It can be treated by Metronidazole tablets taken orally
c. Bacterial infection: Bacterial vaginosis causes copious mucoid discharge. The other bacterial infections will cause pus like discharge. They are treated by antibiotic. Usually for vaginal bacterial infections, Doxycycline may work, however the decision depends up on the causative organisms.
All these infections may be present simultaneously.

2. the possibility of urine leaking at such a young age is very remote. However, let us consider it since you describe urine smell to your underwear. Does this leaking increase when you cough, laugh or sneeze? If so this is a sign of Urinary incontinence and needs to be evaluated by a urosurgeon and/or Gynaecologist.

I hope, I have put the whole panorama of your problem in front of you. Please analyse your problem with this information and revert back to me with whatever conclusions you have derived. Also I would appreciate the information I have asked you through some questions. Then we can arrive at some definite diagnosis and plan the treatment for you instead of gun shot therapy.

Mean while till the diagnosis is made and the treatment is implemented, please start using panty liners to avoid embarrassment in the society. If panty liners prove to be too thin for your discharge, you may even use the pads. Tampons are not advisable with the possibility of infection and the amount of discharge.

I feel I have provided you with detailed medical information useful for you. If you want any more information or you want to put forward any more problems, I am always available for you, XXXX.

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Brief Answer:
Seems to be excessive local sweating

Detailed Answer:
Dear XXXX,

In fact, you are not sexually active, hence the vaginal infections is a remote possibility. However, as I mentioned earlier, commode, too much of travelling, etc. can cause such infections. Please get your discharge examined, if it is there.

If it is not a discharge but is only watery fluid from your vagina without any other symptoms, it could be the physiological flow. Does it increase in the midcycle phase of your menstrual cycle? For such flow, nothing need be done.

Moreover, if it is not staining your underwear and staining only the jeans, the discharge is less likely to be from the vagina. May be you are sweating a lot in the area due to probably tight clothes. The intertrigo which causes quite an itching is known to occur due to excessive sweating. Do you have dark discolouration in that area where it is itching? If so, it suggests ring worm infection. If there is no discolouration, you may have intertrigo due to excessive wetness. If you apply steroid cream locally, it will go.

Do you shave your private parts? Thick hair on the private parts are responsible for heavy sweating. So you may try shaving the parts to minimize the wetness in the area.

I hope this should solve your problem. If you want to share any more information with me and want to have any other advice, I am always available for you, XXXX.

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