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  • Writer's pictureTheGyn Guru

Maybe it's not a yeast infection..

Yeast infections are common, and you're bound to experience the fun of that if you haven't already. But not all vaginal issues are yeast infections...

If you feel like you want to scratch the inside of your vagina and there is a cottage-cheese discharge coming out, then yes it probably is a yeast infection. Just go get some over-the-counter monistat and feel better.

If your symptoms are different, or treatment didn't help, then it's probably not a yeast infection. Here are some other possibilities..

1. Vaginal dryness. Especially if you're in menopause, vaginal dryness can feel just like a yeast infection. The lack of estrogen causes thinner skin and drier tissue. The vagina can get easily irritated, especially with sex. It's so important to use a gentle soap to cleanse, use lubrication every time you have sex, and you should talk to your OBGYN about using estrogen cream. (If you're going to be sexually active, you will likely need estrogen cream.)

2. BV - "Bacterial vaginosis." This is a heavy discharge with a fishy odor, that can irritate the vagina as well. It's caused by an overgrowth of normal vaginal bacteria. I describe it as kinda like a yeast infection, but with a different bacteria, so it requires a different treatment. You would need an antibiotic to help clear this, so you would need to see your healthcare provider and get tested to see if that's definitely what you need.

3. An STD, such as chlamydia, gonorrhea or trichomonas. Some women don't notice any symptoms at all, but any of these infections can increase vaginal discharge and be irritating to the vagina as well. They're all easily treatable, so don't be afraid to go get tested.

4. Herpes. Unfortunately, I've seen women mistake this for a yeast infection as well. If there is just one specific area anywhere on your labia that really burns, it could be herpes. It will look like a blister. Sometimes there is just one big one, sometimes there can be a few of them. They can be really tiny and hard to see. We need to see you when that blister is present so we can culture it and let you know for sure.

5. Contact dermatitis. Anything that rubs on your labia can irritate the skin... pantyliners, leggings, thongs, wet bathing suits, exercise clothes, bike seats, urine, wipes, harsh detergents, soaps or lotions with perfumes or dyes, condoms... The best treatment is to identify what's irritating you and stop that. Then either cover the area with some vaseline to let it heal on its own, or you could apply some over-the-counter 1% hydrocortisone cream to the outside as needed.

6. Lichen Sclerosus. This is a condition where the labia become dry and inflamed due to chronic irritation over time. (Urinary incontinence is often a cause). So try to eliminate the irritant, protect the skin with vaseline, and go see your OBGYN for a definitive diagnosis and proper treatment. Steroid creams can be helpful, but you need a proper diagnosis first.

7. Vaginal or Vulvar Cancer. Rare, but possible. That's why it's important to get an annual exam. If you've got a growth or area that bleeds easily, please go get it checked out.

Basically, it's OK to use an over-the counter treatment for a yeast infection. The 3 or 7-day treatments seem to work better than the one-day. But if the treatment isn't working, then it's not a yeast infection, and it's time for a trip to see your healthcare provider.

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