Dr. Genevieve von Walstrom

Salutations,
I would need to have a little more information about your yeast infections. For example, are you sexually active, are you taking any medication‘s that might make you prone to yeast infections, are you douching (which Disrupt the self cleaning nature of the vibe vagina terriblydisrupt the self cleaning nature of the vagina terribly and are never advised)

I would advise that you see a doctor An OB/GYN would be the best, but family and internal medicine doctors are also trained in this area sometimes. If appropriate you’ll receive the diagnosis of “chronic, recurrent yeast infection.” Once that happens you will be eligible for prophylactic yeast infection treatment such as weekly Flagyl (in the form of a single oral tablet).

Don’t worry, you are not alone in this. Many women get yeast infections chronically with or without their periods. There is treatment and if you are evaluated and diagnosed properly this doesn’t have to be a problem much longer. I wish you the best of luck, and I am sorry you are suffering from this.

Best Regards,
Dr von

Geneviève M. von Walstrom, MD
Population, Family, and Preventive Medicine
Stony Brook University Hospital
Phone: (203) 554 - 8803
Email: Genevieve.vonWalstrom@stonybrookmedicine.edu

Because I don’t know the details of your demographics I must answer relatively non-specifically. My advice is to skip the home UTI or vaginal infection tests you can get at a drug store and instead, get right to an OBGYN (or even an urgent care if that’s not possible). You need three basic tests, a urinalysis or UA, a urine culture with sensitivities, and a Pap smear with high risk HPV co-testing.
Please don’t delay finding care, if you do have a UTI, it could ascend into the upper urinary tract and cause an infection of the kidneys also known as Pyelonephritis.

Dr. von

Salutations,
Have you been having unprotected sex? Even if you think you have the best thing to do is to get a pregnancy test from a local drug store. If you don’t have a car, you can order one cheaply online too, Amazon would be my best guess. If you don’t feel comfortable doing either of these things, you should make an appointment with your OB/GYN who can run a pregnancy test there. If you don’t have a OB/GYN yet, it’s very important that you get one, not only for this but because you’ll be 21 very soon and you’ll need to start Pap smears and annual visits to protect you from certain cancers that women get. If You don’t feel comfortable telling your parents that you’re going to an OB/GYN you can always go to a planned parenthood which provides all services for women your age for free. Just google “planned parenthood” to find one in your area.
Dr. Von Walstrom

An OBGYN is the specialist to go to if you are looking for the Gardasil vaccination. Gardasil protects against the most high risk types of HPV, a virus which causes most cases of cervical cancer. To date, it is recommended that both boys and girls get this vaccination by age 11. There are certain caveats to getting the vaccination though; for instance, insurance providers only cover the costs of the 3 injections if you are at or below the age of 26. If you are over the age of 26, consult an OBGYN for more information about the vaccination. OBGYNs also administer pap smears and HPV co-testing, which is a way to screen for cervical cancers, and should be a routine part of your gynecologic healthcare regardless of whether you have received the Gardasil vaccination or not.
Regarding breast cancer; mammograms screen for breast cancer, but any physician (family care, internal or general practitioner) can give you a referral to get one. Mammograms are recommended at or over the age of 40 on a yearly basis unless of you have certain risk factors in your medical of family history that change the recommendation to start mammograms at an earlier age (usually 35).
Treating cancer requires further physician specialization. Breast Cancers are treated by Oncologists while gynecologic cancers are treated by Gynecologic Oncologists. I would recommend establishing care with an OBGYN to discuss each of your questions in further detail.

Bacterial vaginitis cannot be treated using OTC medications. Please see your OBGYN or family practitioner to be evaluated and treated properly.

Yes, your pain should be evaluated by an OBGYN who has received specialized training in identifying and treating pain experienced during sexual intercourse.

No opiate medication is safe to be used for chronic pain, if that's what you're referring to. I would recommend high doses of ibuprofen (up to 800mg every 8 hours). If that doesn't help, you may be suffering from another underlying condition (like endometriosis for example). I recommend seeing your OBGYN to discuss the pain you're experiencing in detail. He/She will be able to investigate and treat your dysmenorrhea (cramps) properly. Please do not take opiate medications.

Please see an OBGYN as soon as possible. Whatever is protruding from your vagina needs to be evaluated properly. If, in fact, it is some type of prolapse (uterine, bladder, rectum), intercourse could cause an array of medical problems.

No. Fishy odors need to be evaluated; please see your OBGYN or family practitioner.

Yes, it is safe to have sexual intercourse during pregnancy unless your doctor has diagnosed you with specific conditions which would make vaginal entry (of any kind) unsafe for you and/or the baby. For example, if you are diagnosed with placenta previa or placenta acreta, intercourse of any kind would be putting you and your baby at risk for serious maternal-fetal complications (including vaginal bleeding, placental hemorrhage, or even death). I won't list them here, but there are multiple reasons an OB/GYN may advise a patient to refrain from sexual intercourse. Please ask your OB/GYN (or midwife, etc.) if it is okay for you to have sex with your significant other prior to actually doing so; sometimes patients have diagnoses they aren't aware of. A good rule of thumb is: when in doubt, ALWAYS ask the physician in charge of your obstetric health. They have the right answers because they know everything about your obstetric (and medical/surgical) history.

Best regards,

Dr. von Walstrom

Taking Colace (which is a stool softener, not a laxative) will not harm your baby. Unfortunately, stool softeners can often be ineffective. If it's been more than seven days since you've had a bowel movement, it's safe to try alternative therapies for constipation. Mirilax (polyethylene glycol) has an extremely low bioavailability (meaning there's no real risk of malformations or adverse pregnancy outcomes). I would not advise its use for more than 3 days in a row. If the Mirilax still isn't working, your last (but some patient's favorite) resort is to try an enema (I would recommend a Fleet enema, any pharmacy will have it). When using an enema, it's important to be in a relaxed and calm environment, especially if this is the first time you're using one or it's the first time you're inserting something into you're rectum. Do not use an enema more than once; go to see you're ObGyn instead. As always I do not know you're complete medical history nor have I examined you, so the best recommendation I can give you is to talk to your doctor before trying any of these options.

The procedure itself isn't painful, but the post-operative period (while you're healing) can get uncomfortable. Make sure to wear loose fitting clothes, keep the area clean and dry, and always call your doctor if you notice signs of an infection (redness, swelling, drainage or disproportionate pain).