Help me help my angry vagina
August 13, 2014 8:38 PM   Subscribe

Can you have a yeast infection with a negative culture? I have all the standard symptoms, but they do not go away with treatment and two cultures have come back negative. More info inside.

Symptoms have been plaguing me for the past 2 months or so: itching, sore feeling, thick white discharge with no odor. They have gone away at times, but always come back in a couple weeks. A course of Monistat and three Diflucan pills have not alleviated the problem. I have had multiple doctors check me out and they always say that it looks just like yeast, but I have had two swabs done and the cultures have come back negative both times (“no yeast cells identified“). I was sent home today with no prescription and a helpful diagnosis of “I seriously have no idea, come back if it gets worse.“

More info:
- I am in my mid-20s and otherwise in good health.
- I live in Canada and do not have my own GP, so I have been forced to rely on walk-in clinics and see different doctors every time which has made this more difficult. If I managed to get a referral to a gynaecologist, it would probably take several months.
- I have also been tested for BV, Trich, Gonorrhea, Chlamydia, Syphilis and HIV. All negative. I had a pH test done (one of the little paper strips) and it was also normal.
- I already: only wear cotton underwear (which I wash in hot water, put through the dryer twice and iron between wearings) if I wear any at all, wear skirts without tights, sleep naked, take lukewarm showers only, never douche or use wet wipes, never soap my junk, eat tons of yogurt and probiotics, have cut down on my sugar and alcohol consumption, etc.
- I was sexually active before this whole mess started, but have not had any sexual contact since, so I am not passing anything back and forth with my boyfriend
- I am not on birth control or any other daily medication. I have not taken antibiotics for the past year.
- I have read about vulvodynia as a possible explanation, but it does not explain the discharge I have which is definitely abnormal

I know YANMD, but since my MDs have not helped much maybe someone has some experiences or advice. This is incredibly frustrating and stressful and I am seriously at my wits end here. I have read a lot about alternative remedies for YIs, but those are probably besides the point if I do not even have one in the first place. Is it possible to have a yeast infection despite a negative culture? Are there any other tests I could ask for or possibilities I could pursue?
posted by anonymous to Health & Fitness (13 answers total) 2 users marked this as a favorite
What sort of laundry detergent do you use? Are you possibly sensitive to it?
posted by mollymayhem at 8:53 PM on August 13, 2014 [2 favorites]

Could it be allergies?
posted by spunweb at 8:55 PM on August 13, 2014

Have you ruled out pregnancy?
posted by hush at 8:55 PM on August 13, 2014

Cultures are not 100% sensitive/specific, so it's possible, but it's not likely, especially since treatment for yeast has not helped. I strongly suggest looking for a gynecologist who specializes in vaginitis. These people deal with cases like yours which are not straightforward, and GPs are probably not going to have the specialized knowledge to help you with it (especially if you're doing walk-in clinics with a different person each time).
posted by treehorn+bunny at 8:59 PM on August 13, 2014 [2 favorites]

HSV 1 or 2? Often has atypical presentations, although your symptoms would be unusual.

Have you changed your diet or exercise recently?
posted by fritillary at 9:18 PM on August 13, 2014

a few things, not sure if any will apply in your situation though:

- persistent yeast infections can be a sign of diabetes, do you have any other symptoms that would make this a potential guess?

- i have gotten rid of heinously persistent yeast infections with a 2-week course of oral antifungals like Sporanox. nb they are terrible for your liver in prolonged doses so don't get excited if they end up being a miracle cure because you want to save this as your nuclear option

- is there any chance that the water source in your home has changed or become contaminated? a source of reinfection for me was not adjusting well to a changed pH in my water source (overseas, rural, well water), and also from gross sediments stirred up by a water main break on my block (nyc).
posted by elizardbits at 9:42 PM on August 13, 2014

I have had much less severe "not yeast/not BV" episodes, and my nurse told me to try antibacterial shower gel on the vulva/labia each time I showered. Dry off really well. It works for me. I don't use antibacterial anymore, just regular soap.

Your issue sounds more difficult than mine was, but I did hear this recommendation while in the clinic under a similar circumstance.
This could be a cheap and simple solution, but I do hope it doesn't make anything worse for you. You would know quite quickly if it is effective. A matter of hours.
posted by littlewater at 9:52 PM on August 13, 2014 [1 favorite]

I had a similar problem a while back, and some of the info there might be helpful to you.

Get a referral for an ob/gyn, even if it takes months. A doctor telling you "I have no idea, sorry" is not acceptable when you know something is wrong!

Have you been tested for mycoplasma/ureaplasma?

Adding a serious probiotic might help. My ob/gyn recommended VSL, which is pricey, but it's been the best one I tried. You can take them orally and insert them vaginally.

And although it sounds crazy, I found boric acid to be more effective and more gentle than Monistat.

Best of luck. I know exactly how frustrating this can be!
posted by inertia at 10:14 PM on August 13, 2014

If you live in Toronto, you can probably (I think; I've never been there during the hours for female-identified people) see either a gynecologist or get a quicker referral to one via the Hassle Free Clinic at Church&Gerrard. If not in Toronto, find the local equivalent. I have no idea if there are gynecologists on staff in sexual health clinics, but I'd be astonished if they weren't plugged into knowing who's taking new patients, specialized clinics, etc.

Also if you're in Toronto, the Family Practice Unit at St Mike's is taking new patients. Queen East, just east of the hospital on the south side, enormous motorized revolving door in front. I am 99% certain they have an OB/GYN on staff in the clinic, and if not they'd refer you to a specialist within the hospital anyway, which tends to be quicker.
posted by feckless fecal fear mongering at 10:33 PM on August 13, 2014

Have any of your docs suggested cytolitic vaginosis? It can present exactly as a yeast infection, when in fact it's an overgrowth of lactobacillus, the bacteria that usually helps keep yeast in the vagina under control. It's less common, but if your yeast cultures are coming back negative, maybe mention this as a possibility to the next doc you see.
posted by JuliaIglesias at 11:26 PM on August 13, 2014 [1 favorite]

When they did a swab was it specifically for yeast or was it a general culture? In the past I have experienced similar symptoms to what you have described and thought it was yeast. When the results came back, it turned out that there was just a slight overgrowth of everything, but mostly an overgrowth of the good bacteria that normally keeps the vagina healthy. At the time I was taking a lot of probiotics and eating a lot of yogurt. I stopped taking quite so many probiotics and it sorted itself out pretty quickly.

Whatever it is, I hope you can get to the bottom of it soon!
posted by kinddieserzeit at 11:37 PM on August 13, 2014

JuliaIglesias's link above did not work for me, here's another: Cytolytic Vaginosis.
posted by mareli at 5:53 AM on August 14, 2014

When I've had these symptoms and they have not been yeast infections or anything else that you mention, what has helped me is to use antibacterial/ph balanced wash as already suggested, but also, I use this stuff meant to treat bacterial vaginosis called Balance Activ that really helps. You can buy it over the counter and 7 applicators come in a pack. Usually just a couple nights using the applicators fixes me.

I am in the UK so I don't know if you can get this in Canada but perhaps there is something else. It's not the same as Monistat or Diflucan which are meant to treat fungus rather than bacteria.
posted by Polychrome at 7:23 AM on August 14, 2014

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