QUESTION
I was married for nearly a decade but have gotten divorced. I am just getting back into the dating scene for the first time in years. I've been dating a guy, and we're already pretty serious. We are pretty close to having intercourse, but I want to be safe. I'm on the Pill already. What is the best way to bring up protection?

ANSWER
A healthy relationship requires open communication. Sit down with your partner and tell him your concerns directly. Say that you are happy with the direction in which your relationship is headed and that you would like to take it to the next level, but you want to do so safely. Be sure to ask him about any sexually transmitted diseases (STDs) that he may have had, including genital warts or herpes. Suggest that you both be screened for STDs before becoming more physically involved. Remember that although condoms can decrease the risk of transmitting STDs, they do not completely prevent transmission. Also, continue with the birth control pill for added protection against pregnancy.

QUESTION
I am having vaginal discharge. How do I know if I should see a doctor?

Photo by Camilo Morales

ANSWER
Vaginal discharge can be normal. This fluid is produced by the cells that line the vagina and cervix, and normal discharge is usually clear and odorless. Its thickness varies during the menstrual cycle and is thickest after ovulation.

You should see a doctor, though, if the discharge is green or yellow, if there is an odor or if you are experiencing other symptoms such as vaginal itching or irritation.

A yeast infection, also known as vaginal candidiasis, usually presents with a curd-like discharge and itching. It more commonly occurs after taking antibiotics, during pregnancy and in patients with diabetes. Over-the-counter treatments for yeast infections can be used, or your doctor can prescribe an oral medication. If you have never had a yeast infection before, see your doctor first before treating yourself with over-the-counter products.

Another potential cause of abnormal discharge is bacterial vaginosis (BV), which is most commonly associated with a discharge with a fishy odor. Anything that changes the pH balance of the vagina, such as intercourse or even menstruation, can lead to BV. BV can be treated with an oral antibiotic or a vaginal antibiotic cream.

Trichomoniasis, a parasite that can be sexually transmitted, is another potential culprit. The discharge is usually thick, frothy and green. Treatment is an oral antibiotic, and both partners should be treated. Chlamydia and gonorrhea are other sexually transmitted diseases that can lead to discharge as well. Both of these are treated with antibiotics for both you and your partner.

Some women may experience local irritation that leads to discharge. This can occur from frequent intercourse, use of condoms and from douching, among other causes.

Dipika Dandade is an obstetrician/gynecologist practicing in the Los Angeles area.

ABCDlady does not provide medical advice, diagnosis or treatment. See additional information.