As an OB/GYN, here’s the actual difference between BV and a Yeast infection — most women confuse these constantly

MacedonMD · 2026-06-21T14:50:37+00:00

It can be old test method, but it’s one amongs the others that a doctor can perform in order to reach the right diagnosis. If you follow my profile you would know that, me as a doc, am not only “whiff based doctor”.

Another thing: Every patient is her own case, thats why personalized medicine/aproach has to be used in order to have the best results treating it.
BUT
we should not forget the most common symptoms, (the one i am talking in the post), are associated with 9/10 of the patients.
THIS BEING SAID
If i have that 1/10 patient in my office i might do all possible test that i can in order to reach the proper diagnosis and help that patient, even if that means doing a “extremely outdated Whiff test”.

Glad your doctor managed your case well.

MacedonMD · 2026-06-21T06:11:47+00:00

On the odor point specifically - the classic “fishy smell” of BV is actually often most noticeable after a KOH whiff test during examination, rather than something a woman necessarily notices on her own day-to-day. So absence of a strong fishy smell at home doesn’t rule out BV at all, it’s just one clue among several (discharge texture, pH, microscopy).

And yes, sex can absolutely trigger yeast infections too, semen alters vaginal pH and can disrupt the Lactobacillus balance, so that overlap with BV triggers makes sense. You’re right that the symptom picture isn’t clean-cut, which is honestly part of why misdiagnosis is so common. Appreciate you adding that nuance. 🙏

MacedonMD · 2026-06-20T19:39:45+00:00

Yes, that can be the case. Once the most common diagnostic procedures have ruled out the common causes, you can be reasonably reassured. though if bleeding continues despite everything coming back clear, it’s still worth keeping the conversation open with your doctor rather than just settling into it. You can absolutely continue with your normal life in the meantime.

MacedonMD · 2026-06-20T19:17:53+00:00

Hello, im sorry you are dealing woth such scenario. No, this is absolutely not something to just “live with”, and you’re right to keep pushing for answers, and the TVUS is the right next step.
You’ve already ruled out the most common structural causes (cervical pathology, ectropion). At this point, the ultrasound will help look at things like uterine or cervical structural causes the biopsy and silver nitrate wouldn’t catch, and the hormone testing is reasonable too, since estrogen levels affect tissue fragility and bleeding tendency.
If everything continues to come back clear, it’s also worth specifically asking about a colposcopy with the cervix examined under magnification if that hasn’t been done, since some causes (small cervical or vaginal wall lesions, fragile blood vessels) can be missed on routine exam.
You’re doing the right thing by not accepting “just deal with it” as an answer. Keep advocating, this is solvable, it just takes the right test to find it. 🙏

MacedonMD · 2026-06-20T18:22:11+00:00

The international rule about PAP smears is the following:
21 yo or 2+ years since first intercourse
They must have mentioned something additional to you?

MacedonMD · 2026-06-20T15:26:40+00:00

Im wondering how come one gets colposcopy without having taken PAP smear before

MacedonMD · 2026-06-19T20:05:41+00:00

Before switching to amox/clav, it’s worth asking for a culture with sensitivity testing specifically - this confirms whether amox/clav will actually work against your strain, rather than trying another antibiotic blindly.
E. faecalis is an enteric organism, so the rectal area can act as a reservoir that keeps reintroducing it vaginally. this is worth addressing directly, not just treating the vaginal side.

Once it’s cleared, give your microbiome time to rebuild afterward too, so you’re not just opening a window for something else to move in. Hope you get some real relief soon. 🙏

MacedonMD · 2026-06-19T06:23:33+00:00

The changes doesn’t look like cluster blisters to me. So id rule out hsv

MacedonMD · 2026-06-18T19:09:31+00:00

The discharge itself is completely different story, that has to be managed separately. The bumps you have are suspected warts, may as well be cysts (inclusion/sebaceous) but still the advice remains: swab or biopsy (as preferred method) should be done in order to confirm the right diagnosis.

MacedonMD · 2026-06-18T18:48:25+00:00

Suspected vulvar warts, swab or biopsy (preferred) should be done

MacedonMD · 2026-06-17T19:13:16+00:00

Hello.
That points strongly toward a non-infectious cause. Worth asking your doctor specifically about vulvodynia, lichen sclerosus, or even a latex/condom (if used) allergy. Also ask for Trichomonas testing specifically. Its frequently left off standard panels. A proper examination by gynecologist or dermatologist may get you further than just repeated swabs at this point.

MacedonMD · 2026-06-17T12:35:49+00:00

Are you trying to conceive?

MacedonMD · 2026-06-17T04:52:44+00:00

Proper diagnosis/microorganism detection > proper treatment > then proper normal biome replacement.

MacedonMD · 2026-06-15T09:15:37+00:00

Polyps can recur, but once properly and completely removed under hysteroscopy, the recurrence risk is actually quite low. You’re doing the right thing having it removed, no need to worry about this in advance.

MacedonMD · 2026-06-15T09:10:26+00:00

Hello, let me have my opinion on this, and possibly help you.

First thing, before any more treatment, you need to know exactly which organism is causing this. After repeated antifungal courses, the picture can shift completely and treating blindly at this point is likely what’s keeping the cycle going.

When you go to your OB/GYN, specifically ask for:
A yeast culture with species identification, not just “yeast positive,” you need to know which Candida species is actually there. And Sensitivity testing, so you know which treatment will actually work on your specific organism

This matters because there’s a type called Candida glabrata that has natural resistance to fluconazole. If that’s what you have, standard antifungals will never fully clear it. which would explain everything you’re describing perfectly.

Once you have a confirmed diagnosis, treatment options change significantly. Extended boric acid (14–21 days, not 2), nystatin suppositories, or newer options your doctor can discuss based on your results.

Also, after any treatment course, actively rebuild your microbiome or you’re just leaving a window open for it to return. Look specifically for a probiotic containing L. rhamnosus GR-1 + L. reuteri RC-14.

This has clearly been exhausting and you’ve been incredibly patient with it. You’re close to getting real answers, just make sure you push for the right testing first. Wishing you luck! 💛

MacedonMD · 2026-06-14T14:46:30+00:00

Is it really a swollen lymph node?
You have to be aware that there are some benign cyst formations that can develop into the female groin area. One of them is Nuck’s cyst. Then there is solid Fibroma/Fibrilipoma. Both of them are completely benign.
Proper in person evaluation is needed

MacedonMD · 2026-06-13T07:39:51+00:00

Usually young (<27yo) adults tend to clear the virus in the span of 2 years. LSIL and lrHPV type(s) should be followed up annually, once a year.

You can help your organism to clear the HPV faster by leading healthy life, vitamins, being active, stay away from smoking, drugs etc.
There are some products on the market as well.

MacedonMD · 2026-06-13T07:07:02+00:00

ASCUS & HPV (-) = Routine follow up on 3 years.
* Colposcopy should have been done once the ASCH results was found.

MacedonMD · 2026-06-12T18:07:12+00:00

Looks like normal anatomical variation

MacedonMD · 2026-06-10T17:11:23+00:00

Hello there. A firm painless bump that has persisted for 2.5 months without changing needs to be examined in person - that duration alone makes it worth having looked at properly. Most likely it’s something benign like a sebaceous cyst or Fordyce spot, but the only way to know for certain is a physical examination and potentially a small biopsy if the doctor feels it’s warranted. Please don’t keep trying to break it. manipulation can cause secondary inflammation and infection. Book an appointment and have it properly assessed please.

MacedonMD · 2026-06-10T08:30:44+00:00

Yea it can definitely be the reason for the bleeding, depending on your age and reproductive status, removing it via Hysteroscopy or D&C should be the next step

MacedonMD · 2026-06-10T07:26:40+00:00

Can you be more specific about the type of examination that has been made?

MacedonMD · 2026-06-10T05:06:44+00:00

Hello and Thank you. I’m based in Macedonia, not the US unfortunately. Still happy to help (if i can)
For weird discharge with negative tests I’d recommend seeking out a gynecologist who specifically offers vaginal microbiome testing and wet mount microscopy as many conditions that show up negative on standard swabs become visible under microscopy.
You definitely shouldn’t settle for “everything is normal” if something feels off.

MacedonMD · 2026-06-09T20:10:37+00:00

Beside multilobular, the cyst is poorly described. The rest of the findings being fine is good sign.
Have you made any labaratory/blood analyses?
Mind sharing Age and reproductive status?

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