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Vaginal discharge
Lower abdominal pain
Yeast infection
Abnormal discharge
Painful urination
Burns when I pee
Vaginal odor
Vaginal itching
Fishy smell
Thick white discharge no smell
Irritation in vaginal area
Bad odor after period
Not seeing your symptoms? No worries!
A healthy human vagina contains various types of bacteria. When the balance of bacteria is disrupted, some types can overgrow and cause symptoms. Common triggers include vaginal washing, sexual intercourse, or use of an Intrauterine Device.
Your doctor may ask these questions to check for this disease:
Antibiotic cream or tablets may be given to treat the bacterial overgrowth.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Dec 6, 2024
Following the Medical Content Editorial Policy
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This questionnaire is customized to your situation and symptoms, including the following personal information:
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Female, 30s
The symptom checker helped me get a better idea of what was going on with me and eased my anxiety. Ubie even helped find me a doctor in my network, whom I'm consulting right away!
(Jun 16, 2025)
Female, 30s
Ubie let me explain all my symptoms, and it also asked questions relating to my symptoms, after which it placed all of my issues into possible conditions. Based on my symptoms, it showed me all of the possible outcomes: STD, STI and vaginal health-related, and gave me a better outlook on what I may be experiencing. Very helpful! I saw a doctor and got a diagnosis for Bacterial Vaginosis, in line with Ubie's report.
(Mar 27, 2025)
Q.
Metronidazole for Women: Side Effects, BV Relief, and Your Next Steps
A.
Metronidazole is a first-line, highly effective treatment for bacterial vaginosis, with relief often starting in 2 to 3 days; complete the full course, avoid all alcohol during treatment and for 24 to 48 hours after, and expect mostly mild side effects like nausea or a metallic taste while seeking care for any severe or unusual reactions. There are several factors to consider, including oral vs gel choices, what to do if BV keeps coming back, possible yeast overgrowth, sex and partner management, pregnancy safety, drug interactions, and when to get checked; see the detailed guidance below to decide your best next steps.
References:
* Workowski KA, Bachmann LR, Chan PA, Johnston CM, Muzny CA, Reno H, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. PMID: 34292926; PMCID: PMC8344968.
* Saini S, Gupta S, Chander J, Gupta N. Recurrent Bacterial Vaginosis: An Overview of the Etiology, Risk Factors, and Strategies for Management. Cureus. 2023 Jul 19;15(7):e42152. doi: 10.7759/cureus.42152. PMID: 37593257; PMCID: PMC10437434.
* Muzny CA, Schwebke JR. New Insights Into the Pathogenesis of Bacterial Vaginosis: An Update on Its Therapy. Clin Infect Dis. 2020 Feb 28;70(5):953-960. doi: 10.1093/cid/ciz053. PMID: 31050731.
* Loughran-Faber KL, Slayton EE, Taggart EA, Miller E, Jhaveri M, Ndirangu S, et al. Side effects from intravaginal versus oral metronidazole for bacterial vaginosis in women who use alcohol: A secondary analysis from a randomized controlled trial. J Am Coll Health. 2023 Oct 12:1-7. doi: 10.1080/07448481.2023.2268798. Epub ahead of print. PMID: 37824128.
* Bilardi JE, De Guingand DL, Temple-Smith M, McNamee K, Chen M, Fairley CK, et al. The "why" and "why not" of adherence to bacterial vaginosis treatments: a qualitative study. BMC Womens Health. 2016 Oct 27;16(1):65. doi: 10.1186/s12905-016-0447-0. PMID: 27788647; PMCID: PMC5084323.
Q.
Chronic Yeast Infections: A Woman's Guide to Real Relief
A.
Chronic vaginal yeast infections usually mean 4 or more episodes a year or symptoms that return soon after treatment, and real relief comes from confirming the diagnosis, ruling out look-alikes like bacterial vaginosis, addressing triggers such as antibiotics, hormones, diabetes, immune stress, tight clothing, or non-albicans yeast, and using tailored induction plus maintenance therapy with supportive habits; see below for details that can change your next steps. There are several factors to consider. See below for how to get the right tests, the differences in treatment when pregnant or postmenopausal, guidance on sex and partners, warning signs that need urgent care, and practical lifestyle tips that help prevent recurrences.
References:
* Rosati D, Van der Velden L, Donders G, Bekkers R, Sen A, Mylotte JM. Recurrent vulvovaginal candidiasis: current management and future perspectives. Clin Microbiol Infect. 2021 Jun;27(6):829-840. doi: 10.1016/j.cmi.2021.03.033. Epub 2021 Apr 13. PMID: 33862215.
* Hassan S, Akilanda S, Amsden JR, Johnson MR, Brubaker D, Johnson BJ, Johnson SR. Recurrent Vulvovaginal Candidiasis: An Overview of Pathogenesis, Diagnosis, and Management. J Fungi (Basel). 2022 Oct 24;8(11):1098. doi: 10.3390/jof8111098. PMID: 36294713; PMCID: PMC9692482.
* de Sessa C, de Placido S, Masciullo A, Pirozzi G, D'Auria M, Di Spiezio Sardo A, Zullo F. Updates in the treatment of vulvovaginal candidiasis. F1000Res. 2021 Jul 15;10:656. doi: 10.12688/f1000research.51000.1. PMID: 34295462; PMCID: PMC8290333.
* Rosati D, Van der Velden L, Donders G, Bekkers R, Mylotte JM, Sen A. Updates on the treatment of non-albicans Candida vulvovaginitis. Expert Rev Anti Infect Ther. 2021 Aug;19(8):1021-1029. doi: 10.1080/14787210.2021.1942004. Epub 2021 Jun 23. PMID: 34161962.
* Blostein F, Levin-Sparenberg E, Dearing D, Nejat S, Lee J, Tamma P, Kim Y. Recurrent vulvovaginal candidiasis: novel therapeutic approaches. Future Microbiol. 2020 Mar;15:193-201. doi: 10.2217/fmb-2019-0268. Epub 2020 Feb 4. PMID: 32019445; PMCID: PMC7111267.
Q.
Yeast Infections After 65: Addressing Post-Menopausal Risks
A.
After 65, yeast infections can still be common due to lower estrogen, shifts in vaginal bacteria, certain medications, diabetes, and age related immune changes; symptoms may be drier or milder and can mimic BV or vaginal atrophy, so getting the right diagnosis matters. There are several factors to consider; see below for guidance on accurate testing, safe treatment options like antifungals and when vaginal estrogen may help, prevention steps, and red flags that mean you should speak to a doctor.
References:
* Sobel JD. Vulvovaginal Candidiasis: Epidemiology, Diagnosis, and Management. J Fungi (Basel). 2021 Jul 26;7(8):602. doi: 10.3390/jof7080602. PMID: 34436154; PMCID: PMC8398030.
* Ma S, Liang S, Cui B, Li J, Wang B, Li Y, Yang H. Vaginal microbiome and its association with vulvovaginal candidiasis. Microorganisms. 2021 Nov 22;9(11):2381. doi: 10.3390/microorganisms9112381. PMID: 34835492; PMCID: PMC8619623.
* Palacios S, Mejía A, Noguera M. Genitourinary syndrome of menopause: an update. Climacteric. 2019 Jun;22(3):241-249. doi: 10.1080/13697137.2019.1574972. Epub 2019 Mar 26. PMID: 30913959.
* Sobel JD. Recurrent Vulvovaginal Candidiasis. Clin Infect Dis. 2016 Oct 15;63 Suppl 1:S109-12. doi: 10.1093/cid/ciw482. PMID: 27698246; PMCID: PMC4999146.
* Pappas PG, Sobel JD. Management of Vulvovaginal Candidiasis. Obstet Gynecol Clin North Am. 2015 Dec;42(4):619-35. doi: 10.1016/j.ogc.2015.07.009. PMID: 26546115.
Q.
Why can antibiotics cause yeast infections?
A.
Antibiotics can cause yeast infections because they kill both bad and good bacteria, which can upset the balance and allow yeast to grow. See below to understand more.
References:
Spinillo A, Capuzzo E, Acciano S, De Santolo A, & Zara F. (1999). Effect of antibiotic use on the prevalence of symptomatic .... American journal of obstetrics and gynecology, 9914570.
https://pubmed.ncbi.nlm.nih.gov/9914570/
Drummond RA, Desai JV, Ricotta EE, Swamydas M, Deming C, Conlan S, et al. (2022). Long-term antibiotic exposure promotes mortality after .... Cell host & microbe, 35568028.
https://pubmed.ncbi.nlm.nih.gov/35568028/
Samonis G, Gikas A, Anaissie EJ, Vrenzos G, Maraki S, Tselentis Y, & Bodey GP. (1993). Prospective evaluation of effects of broad-spectrum .... Antimicrobial agents and chemotherapy, 8431017.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Bagnall P, Rizzolo D. Bacterial vaginosis: A practical review. JAAPA. 2017 Dec;30(12):15-21. doi: 10.1097/01.JAA.0000526770.60197.fa. PMID: 29135564.
https://journals.lww.com/jaapa/Fulltext/2017/12000/Bacterial_vaginosis__A_practical_review.3.aspxCoudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Feb;245:143-148. doi: 10.1016/j.ejogrb.2019.12.035. Epub 2019 Dec 24. PMID: 31901667; PMCID: PMC6989391.
https://www.ejog.org/article/S0301-2115(19)30602-5/fulltextSoper DE. Bacterial vaginosis and surgical site infections. Am J Obstet Gynecol. 2020 Mar;222(3):219-223. doi: 10.1016/j.ajog.2019.09.002. Epub 2019 Sep 6. PMID: 31499057.
https://www.ajog.org/article/S0002-9378(19)31107-X/fulltextOnderdonk AB, Delaney ML, Fichorova RN. The Human Microbiome during Bacterial Vaginosis. Clin Microbiol Rev. 2016 Apr;29(2):223-38. doi: 10.1128/CMR.00075-15. PMID: 26864580; PMCID: PMC4786887.
https://journals.asm.org/doi/10.1128/CMR.00075-15