How to treat persistent foul-smelling vaginal discharge?

Question

Hello doctor,

I would like to consult you regarding my mother’s health. She is experiencing the following symptoms:

Persistent foul-smelling white vaginal discharge for two to three years.
Lower abdominal pain and a feeling of heaviness.
Leg pain and general fatigue.

She has a history of pelvic inflammatory disease (PID), confirmed recently through a transvaginal ultrasound. She completed a 10-day course of allopathic treatment, including antibiotics and multivitamins, but her symptoms have not improved significantly. Additionally, she has mild skin allergies and symptoms suggestive of a pitta imbalance (such as acidity and heat-related issues).

Kindly advise on any further tests, medications, or precautions that could help her achieve full recovery.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your mother’s symptoms suggest chronic or unresolved PID (pelvic inflammatory disease) and possibly a vaginal or cervical infection. Given the persistent discharge, incomplete response to antibiotics, and associated pain and fatigue, further evaluation is essential.

Recommended next steps:

Pelvic examination and repeat transvaginal ultrasound to rule out conditions such as tubo-ovarian abscess, endometritis, or hydrosalpinx.
Suggested tests: High vaginal swab (HVS) culture to check for bacterial or fungal infections, CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), Pap smear to rule out cervical abnormalities, urine routine and culture to exclude urinary tract infection (UTI), blood sugar, and HbA1c (glycated hemoglobin), as undiagnosed diabetes can worsen infections.
Gynecologist referral: A longer or stronger course of antibiotics may be needed (such as Doxycycline with Metronidazole for 14 days). If a fungal infection is suspected, antifungal treatment such as Fluconazole or Clotrimazole vaginal pessaries may be added.

Ayurvedic or supportive suggestions:

Avoid spicy and oily foods to help reduce pitta imbalance.
Consider cooling herbal formulations like Ashokarishta (only under an Ayurvedic doctor’s guidance).
Maintain proper hygiene, wear breathable cotton undergarments, and keep the vaginal area dry.

I hope this helps you.