DEAR DR. DONOHUE: I have bacterial vaginosis. My doctor tells me that I have exhausted his ability to go any further for a cure. Do you have any knowledge that can help me and others with this awful condition? – D.W.

ANSWER: Normally, the lactobacillus bacterium constitutes the normal bacterial population of the vagina. It keeps the vagina on the acid side, and, in so doing, it curtails the growth of other, more harmful bacteria. When the lactobacillus population dwindles, for any number of reasons, nature’s balance is upset, and the result is bacterial vaginosis – a common problem.

The primary symptom is a profuse, white, watery vaginal discharge with a foul odor. There can also be pain, itching or burning.

Even though you have tried these remedies (mentioned in a deleted part of your letter), let me list them for other women. Metronidazole vaginal gel or clindamycin vaginal cream can often eliminate the harmful bacteria. If neither works, oral metronidazole might.

Relapses are common, so repeat treatments are indicated. If treatment after treatment doesn’t bring lasting results, it might be that the lactobacillus bacterium has not come back. Although it has not been proven to work and although its detractors are many, some doctors advise their patients to eat yogurt containing lactobacillus. It’s a treatment without risk, and it might do some good.

In most instances, treating a sexual partner is not necessary. But again, though unproven, such treatment could benefit women with recurrent episodes of bacterial vaginosis.

My final piece of advice is to check with another doctor to be absolutely certain that you are dealing with bacterial vaginosis. There are many conditions with similar symptoms but quite different treatment.

The booklet on vaginal infections deals with this and related vaginal problems. 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./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Melanoma is the most dangerous kind of skin cancer. It can be deadly, and its incidence has grown at an alarming rate. There are more new cases yearly than there are AIDS cases, but still most people know nothing about it. Ultraviolet exposure from sunlight is responsible for most cases. Every time a person sunburns, that person is at a higher risk. Much of this damage is done when we are young, but the effects don’t show up until years later. I am dealing with it, and it is my fervent wish that others should not have to. – D.H.

ANSWER: I’ll do anything I can to spread the word about melanoma. Melanoma ABCDs have served as a good memory aide for people who have a suspicious skin lesion. “A” is for “asymmetry.” If you, in your imagination, fold a skin patch in half, and the two halves don’t cover each other, that is a melanoma sign. It’s asymmetric. “B,” for “border,” indicates that the typical melanoma has a ragged border or one with blurred edges. “C,” for “color,” is a most important feature of melanomas. They are shades of black or brown often interspersed with whites, reds or blues. “D” is for “diameter,” one larger than 6 mm (1/4 inch) – about the size of a pencil eraser. Recently, “E” has been added to the list of letters. It stands for “evolving.” Melanomas often change color, grow larger or begin to sprout upward from the skin surface.

Any suspicious skin lesions should be examined immediately by a doctor.

DEAR DR. DONOHUE: My girlfriend is 62 and has not had sex for 12 years. It is impossible for us to have intimate relations because she is so tight. Can you suggest a possible cure? – R.W.

ANSWER: A doctor can dilate the woman in the office and without a great deal of discomfort. It might take more than one session.

Lubricants also help this condition.

I am positive your friend will be surprised at the usually relative ease of this treatment.

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.