Vaginal Discharge

I use bioidentical vaginal hormone cream for extreme vaginal dryness by prescription 2-3 times each week. I am 9 years post menopause. Starting last month I noticed that I have yellowish spotting for at least 3 days after using the vaginal cream and sometimes the discharge lasts longer longer. I have to use a pad in my underwear.  I had a negative culture both  for bacteria and for yeast when I first noticed the discharge . I did test positive for Strep B. I was given the option of an alternative to penicillin (since I am allergic) but decided not to use it since I know that I am a Strep B carrier. How do I know if the staining is "normal" or a symptom of something that needs treatment?  Would treating the Strep B end my discharge? It is annoying and physically irritating (although not smelly) and like the discharge I had all those years ago when I had periods.

[Machelle Seibel, MD]

Vaginal discharge can be very frustrating as well as irritating. Usually an exam is very helpful. If the vagina looks pale and the walls seem flat (which are symptoms of menopause) the most likely problem is not enough estrogen and the cause is something called atrophic vaginitis. Try using an over the counter remedy called Replens. Apply in into the vagina for one week then twice per week after that. Sometimes it will cause a whitish discharge which is neither infection or yeast. It is caused when the vaginal cells shed normally each week. You can see the cells because the Replens is attached to them. There are also non-penecillin treatments for Strep. The person best to know what you have is the examining doctor. But you should not have to live with this discharge. It should be possible to treat it and make it better.
Machelle M. Seibel, MD