It's futile to treat vaginal infection not knowing cause
DEAR DR. DONOHUE: For three months I have been treating a vaginal yeast infection with just about every cream and ointment I can buy. Nothing has worked. What do you think the problem is? Are these medicines really effective? — D.D.
ANSWER: The problem could well be you don't have a yeast infection. The medicines you have tried are effective only if the cause really is a yeast.
The most common vaginal infection is bacterial vaginosis, an infection with more than one strain of bacteria. It occurs when the normal bacterial population, lactobacilli, are replaced by unfriendly bacteria. Lactobacilli keep the vagina on the acid side, which discourages the growth of other bacteria. The discharge of bacterial vaginosis is grayish-white, and it has an unpleasant odor. Itching or burning are common. Metronidazole or clindamycin — both prescription items — are the usual treatment.
I don't know your age, but atrophic vaginitis is another cause of a discharge. "Atrophic" means "thinning," and it's an age-related condition with burning, itching or pain on intercourse. It sometimes produces a watery discharge. Vaginal estrogen can put an end to it.
Candida is the yeast infection you speak of. Its discharge is thick, white and curdlike. The many medicines for it work if candida is found.
I have given you three causes of vaginal infections. There are more. You can't expect to win the battle without knowing the enemy. That takes a microscopic exam of the vaginal discharge and some other office-based tests.
The booklet on vaginal infections presents the details of each and how each is treated. Readers can obtain a copy by writing: Dr. Donohue — No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am 11 years old and keep getting strange lumps. They'll appear on my body at night. They're not bug bites. Can you help me with this problem? — J.F.
ANSWER: Do they itch? They could be an allergic reaction. Has your mom changed the detergent she uses to wash clothes and sheets? That could be the problem.
Do they hurt? If they do, it opens a whole new set of possibilities.
I have the impression that the lumps are not there during the day. If they are, the fastest way to find out what might be the cause is to show them to the family doctor. If they are gone by daytime, how about having one of your parents take a picture of them to show the doctor.
I'd like to do more for you, J.F., but I need more input.
DEAR DR. DONOHUE: My husband, who is in his 30s, used to be a heavy cigarette smoker. Does he need to get the pneumonia shot? — Anon.
ANSWER: "Pneumonia shot" is misleading. It's a vaccine against only one kind of pneumonia, pneumococcal (NEW-moe-KOK-ul) pneumonia. It's the most common kind of bacterial pneumonia and it is particularly deadly for older people. In the days before antibiotics, it was close to the top of leading causes of death.
The age to get this vaccine is 65.
Younger people are candidates for the vaccine if they have any illness that puts them at high risk for this infection. Current smokers, regardless of their age, also should consider getting it.
There's another pneumococcal vaccine designed for children. That's a different story, and I'll cover it at a later date.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.