Hi ,

Thanks for your query.

History of strong ammonia vaginal odor since 9 months plus milky discharge since recently ,requires a clinical examination(per speculum examination to examine the vaginal walls and cervix).

Here are the few causes of vaginal foul smelling discharge.
1. Bacterial vaginosis.
2. Trichomoniasis
3.Candidiasis
4.Chlamydial infection.

The test that are done are to see the exact cause are:
1.Examination of vaginal discharge under microscope for finding the causative microorganism.
2.cultures of your cervix
3.Pap smear

Since you not had any improvement in the past medication a change over to oral antibotics or other effective topicals can be advised only after the examination and the relevant test.

To help prevent and treat vaginal discharge/odor the simple that can be followed are:

1.Keep your genital area clean and dry.
2.Do not douche. While many women feel cleaner if they douche after menstruation or intercourse, it may actually worsen vaginal discharge because it removes healthy bacteria lining the vagina that are there to protect you from infection. It can also lead to infection in the uterus and fallopian tubes, and is never recommended.
3.Use pads and not tampons.
4. Check your blood sugar level,keep your blood sugar levels under good control if you have diabetes.
5.If the discharge is caused by a sexually transmitted disease, your sexual partner (or partners) must be treated as well, even if they have no symptoms. Failure of partners to accept treatment can cause the infection to keep coming back and may lead to pelvic inflammatory disease or infertility.
6.Use condoms to avoid catching or spreading sexually transmitted diseases.

Since a detailed clinical examination and the relevant tests are essential to tell what's going on, I suggest you to see a Gynaecologist for the same.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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