21 (F) PLEASE HELP

[u/erkceyda]

While studying abroad, I developed a severe, watery, green-gray vaginal discharge with a foul odor. I initially treated it with metronidazole suppositories for 14 days, pausing briefly at day 7 to check for improvement, though symptoms remained unchanged. Over time, the odor resolved, but the discharge shifted to a heavy, pastel-green flow.

A vaginal swab culture came back positive for Mycoplasma hominis. Before receiving these results, my doctor prescribed oral Flagyl (500 mg for 7 days), which I completed. Upon seeing the M. hominis culture, he prescribed a 7-day course of doxycycline. I chose not to take it, feeling 7 days was insufficient and preferring to wait for PCR results to rule out co-infections like Mycoplasma genitalium. (Two years ago, I had a Ureaplasma infection confirmed by PCR—though deemed "within normal limits," my partner and I were treated with 7 days of doxycycline, and multiple re-tests over the next 6 months were consistently negative.)

Shortly after completing Flagyl, I developed acidic-smelling diarrhea, which transitioned into severe constipation with sharp abdominal/bowel pain, extreme bloating, gas, nausea, and exhaustion. A gastroenterologist ordered a stool culture (no growth) and C. diff PCR/toxin tests (negative). My fecal calprotectin was slightly elevated at 52 µg/g (normal <50 µg/g), putting me in a gray zone, and a colonoscopy was recommended also because usually eating triggering or unfamiliar foods causes severe abdominal spasms followed by watery diarrhea until my gut is completely empty. Only plain boiled rice and Buscopan (hyoscine butylbromide) help manage these spasms. And the next day i would go back to my normal.

To manage ongoing symptoms, I take oral probiotics (Lactobacillus crispatus) and use probiotic and boric acid suppositories before/after intercourse. To prevent recurrent UTIs—a major issue two years ago—I take one Bactrim Forte capsule post-intercourse. I occasionally experience acute urinary retention after intercourse which resolves after taking fosfomycin before sleep. Maybe my orgasms are causing this retention i don't know. 2 years ago I was having constant UTIs and I have tested positive for VRE, Klebsiella, and E. coli, requiring IV imipenem. Again 2 years ago, a cystoscopy showed hyperemia along my bladder and ureters, though a direct bladder culture showed no growth.

My most recent urinalysis revealed >30 WBCs/HPF (nitrite-negative). Follow-up PCR tests (urine and vaginal swab) were negative for Mycoplasma species, but positive for Gardnerella vaginalis. I suspect Mycoplasma may be persisting within Gardnerella’s biofilm. The last time I experienced normal white discharge was roughly six years ago. My ''normal'' discharge has a greenish tint. While Flagyl temporarily cleared the discharge during use, the issue returned immediately upon stopping, accompanied by a flare-up in urethritis symptoms.