Vaginal Infections: Candida, Bacterial Vaginosis and Chlamydia
A change in discharge, itching, stinging or an unpleasant smell are among the most common reasons for a gynecological appointment. Behind them most often lie three conditions that are easily confused: a fungal infection (candida), bacterial vaginosis and chlamydia, which often produces no symptoms at all. They are treated differently, so the wrong self-treatment prolongs the symptoms and delays the right diagnosis. This article explains how these infections differ, which swab is taken, how to prepare and when the partner is treated too.
How they differ
| Infection | Typical signs |
|---|---|
| Candida (fungal infection) | Strong itching and stinging, a white, thick, lumpy discharge like cottage cheese, redness. More common after antibiotics, in pregnancy and with diabetes. |
| Bacterial vaginosis | A thin greyish discharge with an unpleasant smell, more noticeable after sex and after a period; itching is absent or mild. A disturbance of the balance of bacteria in the vagina; it often comes back. |
| Chlamydia | Most often no symptoms; sometimes increased discharge, bleeding after sex or between cycles, burning on passing urine, pain in the lower abdomen. A sexually transmitted bacterial infection; untreated it can damage the fallopian tubes. |
| Trichomoniasis | A yellowish green, frothy discharge with an unpleasant smell, stinging. Sexually transmitted; both partners are treated. |
Which swab is taken
- Vaginal swab: examination of the secretion from the vagina; it shows fungi, signs of bacterial vaginosis and other bacteria.
- Cervical swab: taken from the cervix, for bacteria that settle in that place.
- Chlamydia test: most reliably done by a molecular method (PCR) from a cervical swab, and in men from the first part of the urine stream.
- The Pap test is not a test for infections: it checks the cells of the cervix and is done on its own schedule.
Preparing for a swab: no vaginal preparations or douching for two to three days beforehand, no sex the day before, and not during a period.
Candida: when self-treatment is not a good idea
Antifungal preparations bought without a prescription make sense for an occasional fungal infection in a woman a doctor has already given that diagnosis to and who recognizes the symptom. An appointment is needed when the symptom appears for the first time, in pregnancy, with four or more episodes a year, when the symptoms do not clear after treatment, and when the itching comes with an unpleasant smell, abdominal pain, fever or bleeding. Frequent fungal infections are also a reason to check blood sugar.
Is the partner treated too
With bacterial vaginosis and candida a male partner as a rule does not need treatment, unless he has symptoms himself. With chlamydia and trichomoniasis both partners are treated at the same time, with no sex until the treatment is finished. Bacterial vaginosis comes back in a large proportion of women over the following months, and avoiding douching and scented intimate care products helps.
Chlamydia: why you do not wait
In most women and in a large proportion of men chlamydia produces no symptoms, and untreated it can cause pelvic inflammatory disease, damage to the fallopian tubes, an ectopic pregnancy and difficulty conceiving. A test makes sense with a new partner or several partners, with bleeding after sex and before planning a pregnancy or having an IUD fitted. Treatment is prescribed by a doctor, and a follow-up test is done on their advice.
What an appointment at Miren Medic looks like
Gynecological appointments at the Miren Medic clinic are held by Prof. Dr Snežana Rakić, Prim. Dr Radojka Cerović-Popović and Dr Miljan Čuljić. The appointment includes a conversation, a speculum examination and taking a swab, and an ultrasound if needed. The vaginal and cervical swabs are taken at the appointment, and the result comes from the laboratory. Men with burning on passing urine or a discharge are seen by the urologist Dr Aleksandar Lazić. All of it without a referral.
Prices
| Service | Price |
|---|---|
| Gynecological appointment | 12.000 RSD |
| Gynecological appointment (Dr Radojka Cerović Popović) | 10.000 RSD |
| Vaginal swab | 1.000 RSD |
| Cervical swab | 1.000 RSD |
| GBS swab (in pregnancy) | 1.500 RSD |
| Pap test | 2.000 RSD |
| Gynecological ultrasound | 8.000 RSD |
| Urology appointment (Dr Aleksandar Lazić) | 6.000 RSD |
Frequently asked questions
How do I know whether I have thrush or bacterial vaginosis?
With thrush the itching is marked and the discharge is white and lumpy, while with bacterial vaginosis the discharge is thin, greyish and unpleasant smelling, with mild or no itching. The symptoms do overlap, though, so a reliable answer comes from a swab.
Is candida a sexually transmitted disease?
Not in the strict sense. Fungi normally live on the skin and mucous membranes, and an infection arises when the balance is disturbed, for example after antibiotics, in pregnancy or with a raised blood sugar.
How is chlamydia confirmed?
By a molecular (PCR) test from a cervical swab in women, and in men from the first part of the urine stream. Since chlamydia often has no symptoms, the test is done even when there are no complaints, with a new partner or before planning a pregnancy.
Does the partner have to be treated?
With chlamydia and trichomoniasis yes, both partners at the same time. With candida and bacterial vaginosis the partner as a rule does not need treatment, unless he has symptoms.
Can a swab be taken during a period?
Better not, because blood makes the result harder to interpret. The swab is taken after the period, with no vaginal preparations for two to three days beforehand and no sex the day before the appointment.
Why does my fungal infection keep coming back?
Common reasons are a wrong diagnosis, because bacterial vaginosis is treated as thrush, incomplete treatment, a raised blood sugar and frequent use of antibiotics. With four or more episodes a year an appointment with a swab and a blood sugar check is needed.
Book an appointment
If you have a change in discharge, itching or an unpleasant smell, book a gynecological appointment at the Miren Medic clinic. The examination and the swab come in a single visit, without a referral.
