Sexually Transmitted Diseases/BV,trick, yeast infection?


Hi, I am 18 & never been to a gyno before I am sexually active and just recently had intercourse . Before this I was washing with vagisal odor block daily. After a while I felt like burn/irritation down there so I stopped. Had my period & just when I was off I had sex. After sex I had a fishy smell. When I wiped I saw tiny brown like flakes & it was irritated & kind of burns. Although it doesn't burn when I pee it is after wards when I have problems. I also would like to know about my libia minoria. It is bumpy & chicken skin like. I pray I don't have genit warts but I'm not sure. Can you help me determine what that may be? Help please

Hello Ashley,
Unfortunately, I am unable to diagnose you in this fashion. However since you are sexually active, it is important that you find a Planned Parenthood or similar family planning clinic, or a doctor's office (gynecologist or family medicine) to get a meaningful history and conduct a physical exam. The physical exam includes a pelvic exam, examining and looking at labia and vagina, taking specimens for microscopic examination and tests to determine exactly what you may have.

You could have bacterial vaginosis (BV), trichomonas (trich), yeast, gonorrhea, chlamydia, or herpes, or combinations of any of these. Fishy smell usually means an overgrowth of anerobic bacteria from disruption of the acid base balance down there, possibly from washing with soap, which is alkaline. This also accompanies BV and trich. The brownish flakes may reflect some blood. The "chicken skin" appearance of the labia may be normal variation, human papillomavirus (HPV) or warts, or Fordyce spots, a normal variation.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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