DEAR DR. DONOHUE: I am a 34-year-old mother of two children. I have a vaginal discharge, the first I have ever had. My twin sister is just getting over the same kind of discharge. She has medicine left over, and she says I should try it. Should I? We have had similar illnesses throughout our lives. – J.D.

ANSWER: Don’t. Blindly treating a vaginal discharge rarely meets with success. You have to know what you’re treating before you treat it. Three common conditions cause vaginal discharges in women who are premenopausal.

Bacterial vaginosis is the leading cause of such discharges. This infection comes about when the normal bacteria inhabiting the vagina are displaced by other, unfriendly bacteria. Those newcomers irritate the vaginal lining and cause a discharge due to irritation. The discharge is clear or white, and somewhat watery. It has an offensive odor. Flagyl or clindamycin are two antibiotics prescribed for this condition.

In second place is the yeast infection Candida. Here the discharge is thick and white. Candida infection usually causes an itch and a burning sensation upon urinating. Miconazole suppositories or cream, clotrimazole suppositories or cream, Mycelex cream and oral Diflucan are a few examples of medicines for Candida.

Third on the list is a one-celled organism called Trichomonas (TRICK-oh-MOAN-us). It produces a grayish-green exudate that has an unpleasant smell. Flagyl or Tindamax are two medicines for Trichomonas.

If you believe you can tell the infecting agent by looking at the discharge, you will be misled more often than not. The doctor has to check the acidity of the discharge and its odor when a few drops of potassium hydroxide are added to it and, most importantly, has to make a microscopic examination of it. That’s the only way proper treatment can be assured.

Readers wanting more information on vaginal infections can order the booklet on that topic by writing to: Dr. Donohue – No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a male in his 70s. Each year I get a flu shot. With the frequent articles about the Tamiflu vaccine, I am uncertain as to what to do. If I get the regular flu shot, will I be eliminated from getting the Tamiflu shot? Please shed some light as to whether or not I can take both flu shots. – A.M.

ANSWER: Tamiflu isn’t a shot or a flu vaccine. It’s a pill designed to shorten the duration and severity of a flu infection. It’s also used to prevent flu when there’s a flu outbreak in a community. Tamiflu has been proposed as a medicine for bird flu, but the virus might have developed resistance to it.

If you get the flu shot – and you should get one – you can still take Tamiflu should you come down with flu. Chances are that you won’t have to. The vaccine provides between 80 percent to 90 percent protection.

DEAR DR. DONOHUE: I would like to know how habit-forming caffeine is. I am 43, and I drink about three cups of coffee a day and have been doing so for most of my adult life. Would it be more healthy for me to stop drinking it? – P.O.

ANSWER: Coffee isn’t bad. Its stimulating effect gets many people moving in the morning. It’s been said to raise blood pressure a bit, but the elevation is only brief and happens mainly to those not used to drinking it. It can also increase the heart rate a little. That too is a short-lived effect. There is no link between coffee and heart attack or stroke. It might actually afford protection against type 2 diabetes.

One or two cups are the recommended daily amount. You shouldn’t exceed four. Your three cups are OK.

If a person who is used to drinking coffee on a regular basis suddenly stops drinking it, that person can develop headaches and a run-down feeling for several days. There’s no health reason for you to stop, but if you do, taper the amount you drink over a week’s time.

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.

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