Brief Answer:
Most probably a UTI ma'am, no chances for an STD at all

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms do indicate an infection, possibly a simple urinary tract infection, and most probably not an STD (as both of you are faithful to each other).

With the given circumstances, I would recommend a visit to your doctor for the following:

+Urine analysis : To confirm the infection
+Urine culture and sensitivity examination: To confirm the infection causing organism and also to provide information on which antibiotics would be most effective in treating your infection rapidly and completely.

In the meantime, please follow these suggestions:

+No sexual contact in any form
+Drink plenty of water
+Cranberry juice as tolerated
+1 tbsp of baking soda in a glass of water 2-3 times a day
+Try to get your hands on a syrup containing Di sodium hydrogen citrate (e.g. citralka), which will help relieve the burning sensation; 1 tbsp to be mixed in a glass of water and taken 3 times a day

I hope you find my response helpful. Please do not hesitate to write to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
Could be possible, but you should have responded to the clotrimazole then

Detailed Answer:
Hi ma'am.

It is quite possible, but if it were jock itch then you should have responded to the clotrimazole.

Either way, a urine tests will provide us with the infection causing organism and we can accordingly treat it with antibiotics (if it is a bacterial infection), or anti-fungal medications (if it is a jock itch or candidiasis). So please do schedule that appointment for the investigations ma'am :)

Best wishes.

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Brief Answer:
Yes pls, clotrimazole twice daily for the next 10 days :)

Detailed Answer:
Hi ma'am.

Yes, please do apply the clotrimazole in the meantime, twice daily for the next 10 days. If you did experience an improvement, it could quite possible be a jock itch. :)

But let us go through with the urine tests either way, just to make sure :)

Wishing you a speedy recovery ma'am :)

Best wishes.

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Brief Answer:
Lets hope; they can be used, but carry a lot of baggage with them

Detailed Answer:
Hello once again ma'am.

Yes, I do hope so too.

Tetracyclines can be used to treat urinary tract infections, but they are usually related to those caused due to sexually transmitted infections. Also, they are a little strong and usually many individuals are allergic to them, so we need to administer a test dose before prescribing a course and so on.

But usually 500 mg is given 4 times a day, for 3-7 days depending on the severity of the infection.

Best wishes.

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Brief Answer:
I do believe it is purely due to the infection you have

Detailed Answer:
Hi ma'am.

The irritation in the labia majora can be seen with any type of infection, and so yours could be any of the suspected causes (i.e. candidiasis, jock itch, UTI). Shaving really does not have to do with anything ma'am, and theoretically the pubic hair should not be so long that it can get plucked out (which can in turn result in irritation, inflammation, and possibly even an infection). So shaving is recommended to maintain better hygiene; but in your case the irritation could purely be due to the infection you currently have.

Hope this helps ma'am. If you wish to share an image of the region for my analysis and comments, you can do so by attaching the image here or emailing it to me at:

YYYY@YYYY

and please do mention 'ATTN: Dr. Shoaib Khan' in the subject line so it can be directed to me.

Best wishes.

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Brief Answer:
No signs of genital herpes seen; anal fissure yet still to be proved

Detailed Answer:
Hello once again ma'am.

I have viewed the attached image and would like to say that the region is of course inflamed mildly and looks irritated, but the picture is not due to herpes, and merely due to the infection which you have (either bacterial UTI or of fungal source).

Now coming to the anal fissure; you were once tested positive for HSV- 1 (oral herpes), which increases the chances of your husband also having the virus. Your husband provides you with oral sex every now and then, which can result in genital herpes (as is proved that HSV-1 can result in genital herpes from oral-to-genital contact).

But the first manifestation of genital herpes has to be the lesions and blisters, and so on, which you did not or are not displaying. Suspecting the anal fissures to be due to genital herpes at this juncture is still not a 100 % plausible, and anal fissures are only associated with genital herpes and not oral herpes.

So to find the cause for the anal fissures, you may have to undergo an STD-panel to first find any STD's, and from there on think about what is causing it.

I hope I have explained things in a manner best understood by you. Please do not hesitate to write back to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
Can be gonorrhoea, chlamydia, yeast infection or bacterial vaginosis

Detailed Answer:
Hello once again.

Yellowish vagina discharge can be associated with a few STDs i.e. gonorrhoea and chlamydia (which we can rule out as you have no chance of contracting them; and also yeast infections and bacterial vaginosis (which is a common bacterial infection = UTI).

So your vaginal discharge also really does not raise any eyebrows or caution, so you need not worry ma'am. But no signs of herpes noted or observed yet ma'am :)

Best wishes.

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Brief Answer:
Unfortunately none available OTC; no it is not healthy

Detailed Answer:
Hi ma'am.

Bacterial vaginosis (BV) needs antibiotic coverage, none of which is available over-the-counter ma'am.

You can try having 1tbsp baking soda in a glass of water 3 times a day, take sitz baths with epsom salt in it 2-3 times a day, drink plenty of water, and drink cranberry juice as tolerated. But the most important thing is that we are not sure whether you have BV or not.

Do not apply baking soda over your genitals, this is not healthy ma'am.

Best wishes.

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Brief Answer:
Yes, d'mannose does help; pls also add the clotrimazole

Detailed Answer:
Hello once again ma'am.

D'mannose is a good supplement and helps to treat UTIs (mostly bacterial) and suppress symptoms. I am sure the supplement is what is helping you yo feel better, but why don't you also continue the application of clotrimazole twice daily (as you are almost sure it is a yeast/fungal infection), this will take care of the yeast infection (if at all that is the cause), and the d'mannose will help treat your symptoms and make you feel more comfortable.

Best wishes.

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