Sexually Transmitted Diseases/Yeast infection

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Question
Dear Doctor,
     I am 17 years old and I live in Jamaica. I think I have a terrible yeast infection, for 5 years. When I was about 12 years old, I remember experiencing vaginal discharge for the first time. At first I thought it was premenstrual symptoms and I couldn’t wait to have my first menstrual cycle since everybody else my age had started. The following year I started my menstrual cycle, for 5 days per month (NEVER HAD IRREGULAR CYCLE). I still had vaginal discharge and I tried hot water baths but still the discharge was still there. As the years go by, my period changed from 5 days to 7-8 days and my vulva darkened and I also had bumps coming up occasionally and then disappearing. This had affected my self-esteem and so I hid this from parents and I didn't want to visit any doctor, I tried many home remedies including garlic insertion and hot/ room temperature baking soda water baths and hydrocortisone. (All Failed). Finally, I decided to visit a doctor and he prescribed 1 pill since I was a virgin and still a virgin but the symptoms didn’t go away (that is discharge, red bumps that leaves back spots, mild itching). Whenever I shave, I get razor bumps and it leaves spots behind, the bumps are along the bikini area, and they don’t disappear. Also, I have constipation for one year and no prescribed pill worked, do you think my yeast has something to do with it? Do I have a yeast infection because my symptoms seem like it?
         Concerned Female.

Answer
Hello Kerry,
It is not likely that you have had a vaginal yeast infection for 5 consecutive years!  Even if you have untreated diabetes or some other immunologic dysfunction, it is not likely.  Vaginal discharge without itching is normal, and is called physiologic vaginal discharge.  Mucous is normally secreted by the cervix, and the inner lining of vaginal and vulvar cells are periodically shed during the normal phases of cell turnover.  These cells combine with the mucous, and appear whitish or with whitish clumps.  The same thing happens elsewhere on the skin, but without the mucous!

The vulvar bumps that come and go are also NORMAL variations of how the skin down there responds to your normal monthly hormonal fluctuations.  The razor bumps are from shaving trauma due to the injury of the skin and underlying oil and hair follicles.  Stop shaving and the bumps should go away within a few weeks, or use an electric/battery operated "buzz" shaver, so the skin doesn't get injured.  Your constipation is from not eating enough fiber like fresh fruit and vegetables, and not drinking enough water.

Stop using the hydrocortisone, garlic, baking soda and other things that won't treat something that is NORMAL and can't be treated!

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

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!

Experience

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.

Organizations
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)

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

Education/Credentials
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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