Menstrual cycle alteration, menstrual pain & genital infections

Genital infections

Genital infections are very common and can affect women at any age. They can cause discharge, itching, burning, bad smell or pain. Sometimes they are due to fungi or bacteria. Other times symptoms are caused by irritation, changes in hormones or skin conditions and not by infection at all.

In Lisbon, Dra. Joana Faria offers consultations about genital infections in Portuguese, English, French, and Spanish. The aim is to understand your symptoms, identify the cause and choose a treatment that works in real life, not only in theory.

This page focuses on infections and discharge. For more information about cycle changes and period pain you can also read the pages on menstrual cycle alteration and menstrual pain.

What it is

The vagina is not a sterile space. It has its own microbiome, with protective bacteria that vary during the cycle and throughout life. Because of this, some discharge is normal. It is usually clear or white, without strong smell and without itching or burning.

Genital infections occur when microorganisms grow in excess or when germs that are not usually present reach the genital tract. Common examples include:

  • Vaginal yeast infection (candidiasis) thick white discharge, itching, burning and irritation.
  • Bacterial vaginosis grey or whitish discharge, often with a stronger smell that may worsen after sexual intercourse.
  • Sexually transmitted infections (STIs) such as chlamydia, gonorrhoea or trichomoniasis, that may cause discharge, pain or no symptoms at all.
  • Vulvar and skin conditions such as dermatitis, lichen sclerosus or simple irritation from products or clothing, which can mimic infection.
  • Urinary tract infections which affect the bladder and cause burning when urinating, sometimes mixed with vaginal symptoms.

Because the causes are varied, it is important not to assume that every episode of discomfort is the same infection as before. Treatment that helped once may not be the right option later.

Main symptoms and when to worry

Some changes in discharge are expected around ovulation, before the period, during pregnancy or with hormonal contraception. Other changes suggest infection or irritation and deserve attention.

You should consider booking a consultation if you notice:

  • New discharge with different colour, amount, texture or smell.
  • Itching, burning or soreness in the vulva or vagina.
  • Pain during sexual intercourse.
  • Burning when urinating or needing to pass urine very often.
  • Redness, cracks, small wounds or white patches on the vulva.
  • Recurrent episodes that improve and then come back several times per year.

You should seek urgent care if you have strong pelvic or abdominal pain, fever, chills, very painful urination with blood, or if you feel very unwell. These may be signs of pelvic inflammatory disease or more serious urinary infection.

Diagnosis: exams and what to expect

Many women feel embarrassed when talking about genital symptoms. Dra. Joana Faria is used to hearing these concerns and creates a calm, respectful environment during the consultation.

Depending on your situation, the evaluation may include:

  • Clinical history
    Questions about when symptoms started, what they feel like, what makes them better or worse, your menstrual cycle, sexual life, contraception, previous infections and treatments.
  • Gynecologic examination
    Assessment of the vulva, vagina and cervix. Many conditions can be recognised visually and with simple tests during the exam.
  • Vaginal and cervical swabs
    Samples taken with a soft swab to study the microbiome, yeasts, bacteria and sexually transmitted infections when indicated.
  • Urine tests
    Urinalysis and urine culture in cases with urinary symptoms.
  • Blood tests
    In selected situations, tests for specific infections or to assess the immune system and blood sugar, especially in recurrent infections.

These exams usually cause little or no pain. If at any moment you feel discomfort, you can tell the doctor and the procedure will be adapted.

Treatment options and prevention

Treatment depends on the cause of symptoms. It is common to use different approaches for infections caused by fungi, by bacteria or by sexually transmitted germs. In many cases, the partner also needs treatment or testing.

Examples of options that may be discussed include:

  • Topical treatments such as vaginal tablets, creams or gels.
  • Oral medicines for infections that need treatment from the inside.
  • Changes in hygiene habits, avoiding internal douches, perfumed products and aggressive soaps.
  • Adjustments in clothing, such as preferring breathable fabrics and changing out of wet clothes quickly.
  • Specific prevention plans for women with recurrent infections, including strategies around periods, sexual intercourse or antibiotic use.
  • Testing and treatment of partners in cases of sexually transmitted infections.

It is important not to treat every episode with the same over the counter product without examination. Repeated self treatment can mask underlying problems and may make it harder to identify the real cause later.

How Dra. Joana Faria approaches genital infections in practice

Dra. Joana Faria knows that genital symptoms can affect intimacy, self esteem and daily comfort. Her approach is practical, respectful and focused on long term solutions, not only on short term relief.

In daily practice she:

  • Listens carefully to your description of symptoms and previous experiences.
  • Explains in simple language what the likely diagnosis is and what has been excluded.
  • Avoids unnecessary antibiotics and chooses treatments that are truly useful for your situation.
  • Discusses how to reduce the risk of recurrence, integrating small but effective changes in your routine.
  • Coordinates STI screening and partner management when needed.

Many patients feel relieved to understand that there are clear reasons for their symptoms and that they are not alone or at fault. With a structured plan, genital infections become easier to manage and to prevent.

FAQ

Frequently Asked Questions


How can I tell if my discharge is normal or a sign of infection?

Normal vaginal discharge is usually clear or white, does not have a strong smell and is not associated with itching, burning or pain. It can change during the cycle, for example becoming more elastic around ovulation. Discharge that is green, grey, very yellow, with a strong smell or accompanied by itching, burning, pain or bleeding is more suggestive of infection or irritation. Only an examination and, when needed, swabs can confirm the cause, so it is better not to self diagnose based only on colour or consistency.

Can I treat genital infections with over the counter products without seeing a doctor?

Some women recognise a pattern of occasional mild yeast infections and improve with over the counter treatments. However, repeated self treatment without examination can mask other causes, delay appropriate diagnosis and contribute to resistance to some medicines. If symptoms are intense, recurrent or different from previous episodes, it is safer to have a gynecology consultation and a targeted treatment plan.

Do genital infections always come from poor hygiene?

No. Genital infections are rarely a sign of poor hygiene. In fact, excessive washing, internal douches and perfumed products can irritate the vulva and vagina, damage the natural microbiome and increase the risk of symptoms. Factors such as antibiotics, hormones, diabetes, tight clothing and sexual activity often play a larger role. Your doctor can advise you on simple hygiene habits that protect rather than harm the natural balance.

Should my partner also be treated if I have a genital infection?

This depends on the type of infection. For many yeast infections and cases of bacterial vaginosis, partner treatment is not always necessary. For sexually transmitted infections, both you and your partner (or partners) usually need testing and treatment to avoid reinfection. During consultation, your doctor will explain whether partner management is recommended in your specific situation.

Why do my infections keep coming back even after treatment?

Recurrent genital infections can have several reasons. Sometimes the first treatment was not the best choice for the germ involved. In other cases, infections are linked to underlying factors such as diabetes, changes in immunity, frequent antibiotics, hormonal contraception or irritant products. Sexual practices and partner infections can also play a role. A consultation focused on recurrence allows your doctor to review your history, adjust tests and propose a prevention plan adapted to your life.

Schedule

Book your consultation


In person

XClinic

Av. Eng. Duarte Pacheco, nº26 - Piso intermédio 1070-110 Lisboa (in front of Amoreiras Shopping)

Online

Video consultation

On zoom

photo gallery of Dra Joana Faria operating and performing lectures