Brief Answer:
The description of the discharge suggests Trichomoiniasis

Detailed Answer:
Dear XXXX,

I hope I have written your name rightly, if not please correct me.

I must complement you for giving such a detailed, relevant and comprehensive history of your problem.

You seem to have number of infections which were treated by different medicines.

You have been given Azithromycin and Taxim for the urinary bacterial infection and sertaconazole (Onabet) for the yeast infection.

However, your current discharge is suggesting Trichomonal infestation of vagina. This discharge is greenish white in colour, free flowing, with froth and causes substantial itching in the private parts also. This infection also causes burning urination even without urinary infection. Do you have vaginal itching and burning urination?

Usually yeast and trichomonal infestations are sexually transmitted, though it is not a rule. Many a times, these two infections may coexist. Even broad spectrum antibiotics, if given without probiotics coverage, also may cause yeast infection in the different organs of the body.

The crux of the treatment for such vaginal infections is that it should be taken simultaneously by both the sexual partners to avoid reinfections.

I feel both of you should get treated simultaneously for yeast by antufungfal vaginal pessaries and cream respectively, and trichimonal infection by Metronidazole for 7 days. Along with the medicinal treatment, please follow (both the sexual partners, simultaneously) the following tips:
1. Observe sexual abstinence till both of you are declared completely cured of these infestations.
2. Shave private parts clean to avoid reinfections.
3. Use panty liners or pads. (This is for you only)
4. Boil underwear daily to kill the organisms painted in them.
5. Cut the nails short. The organisms stay in the nail beds when you scratch.
6. Consume B-complex and Sporlac tablets along with.

The low abdominal pain you are having is due to the inflammation of the top of vagina. As these infestations are eradicated, this will go.

I hope this much information would give you quite a relief. Please let me know more about the details about the discharge and reply to my questions.

If any more information is needed, I am always available for you, XXXX

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Brief Answer:
You may wait till 10th October

Detailed Answer:
Dear XXXX,

1. Trichomonas infestation is diagnosed by wet hanging drop method. It requires a special slide with a dip. Under the microscope the activity of the organisms is noticed. These are protozoa organisms. Usually, we do not perform this test in clinical practice. We diagnose this infestation by the characteristics of the discharge. May be when your vaginal smear was done, you were having only yeast infection.
2. It is not a very serious infestation. However, it is nasty and embarrassing condition which is known to recur if proper hygiene is not observed. Also, it may create hostile atmosphere for the sperms, interfering the fertility.
3. The suggested treatment is not reported to have any interaction with Cervarix. However, today is 5th October, which is almost gone. Your Cervarix dose in due on 9th October. So finish it and then go for the treatment of white discharge.

I hope this solves your queries. For any other information, I am always available for you, XXXX

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