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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34995
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Greenish vaginal discharge. No odor. No itch. I have had five

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Greenish vaginal discharge. No odor. No itch. I have had five swap tests all of which are negative and also a pap smear which was also clear
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.


This is likely to be chronic yeast infection. Some women experience chronic recurrent vulvovaginitis, which often require long-term or prophylactic oral azole therapy for control. So for that, the recommended regimen is fluconazole 150 mg every other day for 3 doses, followed by weekly fluconazole 150-200 mg for 2-3 months. This regimen abate the symptoms and prevents further recurrence in majority of women.

Boric acid wash for vagina can be used in resistant cases, as an alternative measure with the consultation of your physician. A specific culture; Nickerson or Sabouraud mediums should be performed in refractory or recurrent cases of vaginal candidiasis to confirm the infection. So you can talk to your doctor to get this culture before you start the treatment.

Women who do not improve with above can use, clotrimazole 500 mg vaginal suppositories administered once per week for six months which is also effective.

Also avoid (if you do) following;

1) panty liners,

2) pantyhose,

3) sexual lubricants

The other possibility to consider would be "desquamative vaginitis" which is not due to infection. It is due to chemical hypersensitivity to the repeated vaginal medicines, which, after all, are chemicals. Following treatment would help you;

1) Get a refillable script for Acigel vaginal cream with applicator. Begin with 1/2 applicator at bedtime every other night for two weeks.

2) Then increase to a full applicator every other night for two weeks.

4) You can help restore the normal bowel flora by eating live bacterial culture yogurt every day for a few weeks and take acidophilus tablets three times a day for one month.

4) You do not have to use the Acigel while menstruating. Do not use tampons until the treatments end.

5) Wear loose, all cotton underwear as they absorbs body moisture.

5) Wipe front to back when you urinate or have a bowel movement. Bowel bacteria can infect vagina.

7) Do not shave the vulvar area as the pubic hair protects against chemicals making contact with the skin.

8) Avoid all chemicals in the Vulvo vaginal area.
9) Avoid pantyhose and tight pants such as jeans which trap moisture near in the perineum
10) After exercise or any sweat producing activity, bathing or swimming, make sure the perineum is air dried., Moist surfaces that rub against each other break down and provide an area for yeast secondary growth ,

11) Follow a low carbohydrate diet. Take steroids, antibiotics and oral contraceptives only if very necessary.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Dr. Arun
Customer: replied 5 years ago.
I was positive for a yeast infection in december and have had two swab tests since then and all were negative for yeast infections. I do have the herpes simplex virus but have not had an out break in over a year and the vaginal discharge has been present for eight months. I have also had a pelvic ultrasound which was all clear apart from a polysistic ovary. Before my initial swap tests and medication I had not taken any medication
Expert:  Dr. Arun Phophalia replied 5 years ago.

A yeast culture is a special culture which is not diagnosed by the ordinary culture test. So, I am not sure if your doctor specifically ordered for yeast culture which are special media like Nickerson or Sabouraud mediums. I would do following;

1) Get a yeast culture if not sure.
2) If yeast culture done; treat it like desquamative vaginitis.
3) Look for atypical bacteria like mycobacterial infection by special culture.
4) See the discharge under microscope by staining them to identify the microorganism directly.
5) Give the therapeutic trial of chronic yeast infection treatment (as we discussed above).

It is privilege assisting you.

Dr. Arun
Customer: replied 5 years ago.
they were specific tests for Yeast and related STDs
Expert:  Dr. Arun Phophalia replied 5 years ago.

Gram staining would be the step to identify the organism. Meanwhile you may consider treating it as desquamative vaginitis, which does not have any tests and a therapeutic trial would be good, to confirm it.

Dr. Arun
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