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Vaginal & Vulval Health · Nagpur

Vaginal Infections Treatment in Nagpur

Dr. Kunda Shahane · MBBS · MS (Obs & Gynae) · FIFM · FMF (London) — examination and testing first, then treatment matched to the actual diagnosis.

Woman doctor throughout Examination-based diagnosis Recurrent cases welcome Dhantoli, Nagpur
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75%of women have at least one episode of vaginal thrush in their lifetime
17%of Candida isolates at a Nagpur STI centre were resistant to fluconazole
>50%of bacterial vaginosis recurs within six months of treatment
3+episodes in a year means recurrent disease and a different plan
Start here

Discharge, itching and odour are symptoms — not a diagnosis

Most infective vaginal complaints come down to one of three conditions: bacterial vaginosis, vulvovaginal candidiasis (thrush, often called a yeast infection), or trichomoniasis. They produce overlapping symptoms, they are treated differently, and a substantial group of women with exactly the same complaint have no infection at all. Dr. Kunda Shahane examines you, tests where a test changes the answer, and treats the diagnosis rather than the symptom — which is the difference between a treated infection and a repeatedly treated symptom.

She is a gynaecologist by training — MS in Obstetrics & Gynaecology before she subspecialised into fetal medicine — so the consultation covers the whole picture: the history, the examination, the cervix, your cycle, your contraception, your sugar levels and, where relevant, your pregnancy. Her patients are women; where treatment requires her partner to be seen and treated as well, that is arranged as part of the same plan.

Dr. Kunda Shahane — fetal medicine specialist and consultant obstetrician-gynaecologist, Mayflower Fetal Medicine Centre Nagpur

Dr. Kunda Shahane

MBBS · MS (Obstetrics & Gynaecology) · FIFM · FMF (London) · MMC 2005/01/0317 — 20+ years in medicine, 14+ years in fetal medicine.

She trained as an obstetrician-gynaecologist and taught obstetrics and gynaecology at university level before subspecialising into fetal medicine. That order matters here: the person who takes your history is the person who examines you, decides which test is worth doing, prescribes, and reviews you afterwards. Recurrent vaginal symptoms are rarely solved by a new prescription — they are solved by someone holding the whole story.

Normal, and not an infection

Not every white discharge needs treatment

The vagina produces discharge as a matter of normal physiology. It is usually clear to white, changes in amount and consistency across the cycle, increases around ovulation, in pregnancy and with hormonal contraception, and it does not itch, burn or smell offensive. Many women treated for months for "white discharge" are treating a normal function of their own body.

The features that make a discharge worth investigating are: a change from what is normal for you, itching or soreness of the vulva, a genuinely unpleasant odour, burning on passing urine, pain during intercourse, blood staining, or discharge that appears after a new sexual contact. Those are the reasons to be examined — not the presence of discharge in itself.

Comparison

The three infections at a glance

FeatureBacterial vaginosisThrush (candidiasis)Trichomoniasis
What it isLoss of the normal lactobacilli and overgrowth of mixed bacteria — an imbalance rather than a classic infectionOvergrowth of Candida, a yeast normally present in small numbersInfection with Trichomonas vaginalis, a parasite — a sexually transmitted infection
Typical dischargeThin, grey-white, coats the wallsThick, white, curd-likeFrothy, yellow-green, often profuse
OdourFishy, often worse after sex and after periodsUsually noneOften offensive
ItchingUsually mild or absentProminent — the dominant symptomPresent, with soreness
Vaginal pHAbove 4.5Normal, 4.5 or belowAbove 4.5
Amine (whiff) testPositiveNegativeMay be positive
Partner treatmentProvided here for ongoing male partners in recurrent, symptomatic cases, in line with 2025 guidanceNot routinely neededAlways — this is an STI
Relevance in pregnancyAssociated with preterm birth, late miscarriage and postpartum infectionCommon; treated for symptom relief with pregnancy-appropriate agentsAssociated with preterm birth and low birth weight

Two of these can coexist. A woman can have bacterial vaginosis and thrush at the same time, which is one reason a single course aimed at one of them appears to half-work and then fails.

How the diagnosis is made

What actually separates them

The distinction is not made by looking at the discharge alone, and it is certainly not made over the phone or across a pharmacy counter. It is made by a short, structured assessment.

  1. HistoryOnset, relation to periods and intercourse, previous episodes and what was taken for them, contraception, diabetes, recent antibiotics or steroids, menopausal status, and any new sexual contact. Half the diagnosis sits here.
  2. ExaminationThe vulva, the vaginal walls and — importantly — the cervix. A speculum examination is what distinguishes a vaginal problem from a cervical one, and no amount of empirical treatment substitutes for it.
  3. Vaginal pHA pH above 4.5 points towards bacterial vaginosis or trichomoniasis and away from thrush. It is a simple bedside measurement that immediately changes which treatment is appropriate.
  4. Amine (whiff) testA drop of potassium hydroxide on the sample releases a fishy odour in bacterial vaginosis. This is the third of the four Amsel criteria, alongside the appearance of the discharge, the pH, and clue cells on microscopy — and any three of the four confirm the diagnosis. Three of them are available at the bedside without a laboratory, which is why an examination answers the question in most cases where a phone consultation cannot.
  5. Laboratory testing where it changes managementMicroscopy is not performed in the clinic; where it is needed, a swab is taken during your examination and sent to a laboratory. That covers wet-mount microscopy for clue cells and trichomonads, Gram stain (Nugent scoring is the reference standard for bacterial vaginosis), culture with species identification, and nucleic acid amplification testing. It is not needed in every straightforward first episode. It is essential in recurrent, resistant, pregnant and post-menopausal cases, and the result is interpreted by the same doctor who examined you.
  6. Look for the reason, not just the organismUncontrolled blood sugar, an immunosuppressant, a retained foreign body, oestrogen deficiency after menopause, an untreated partner, or a contact irritant. Treating the organism without addressing the reason produces a recurrence rather than a resolution.
First-hand

Why the same tablet, taken again and again, stops working

India's syndromic case management system treats vaginal discharge with pre-packed colour-coded kits — a design intended for settings with no laboratory and no clinician able to examine, where treating promptly beats waiting for a result that will never come. It is a reasonable public-health compromise. It is not the same thing as a diagnosis, and it has two measurable costs.

The first is over-treatment. In a Delhi hospital series, 1,797 women reported vaginal discharge and were treated with the national STI/RTI kits; on PCR testing, 81% had none of the three organisms — gonorrhoea, trichomonas or chlamydia — that the kit is aimed at. That does not mean nothing was wrong with them. It means the treatment they received was not matched to what was wrong.

The second is resistance, and there is local evidence for it. At the regional STI centre at Government Medical College, Nagpur, 128 confirmed Candida isolates were tested for azole susceptibility: 17.18% were resistant to fluconazole, with C. glabrata the most resistant species. The authors concluded that extensive fluconazole use in syndromic management of vaginal discharge is the probable reason. That is Nagpur data, not an imported statistic — and it is the reason a woman on her fourth single-dose antifungal in a year needs a species identified, not a fifth dose.

An honest limitation. Examination and bedside testing will not answer every case. Some women have persistent symptoms with no organism found, some have a skin condition of the vulva that needs a biopsy, and some have a cause that only becomes clear over two or three visits. Where that is the situation, it will be said plainly rather than covered with another course of tablets.
Clinical situations

Five presentations, and what each one actually needs

"It itches, and the third course of tablets hasn't worked"

Recurrent vulvovaginal candidiasis is defined as three or more episodes in twelve months, and it is managed differently from a single episode. The species is identified by culture, because non-albicans species — C. glabrata in particular — respond poorly to the standard agent. Blood sugar is checked, because recurrent thrush is a recognised presenting sign of undiagnosed diabetes. Where a maintenance regimen is appropriate it runs for months, not days.

"The smell comes back after every period, and after sex"

That pattern is characteristic of bacterial vaginosis, because menstrual blood and semen both raise vaginal pH. More than half of treated cases recur within six months. In October 2025 the American College of Obstetricians and Gynecologists updated its guidance to recommend considering concurrent partner therapy — a combination of oral and topical antimicrobials for the male partner — in adults with recurrent, symptomatic bacterial vaginosis, on the strength of trial evidence that treating the partner delays and reduces recurrence. This is a reversal of long-standing practice, and it is offered here: where bacterial vaginosis keeps returning, treatment for the ongoing male partner is arranged as part of the same plan rather than left as something you have to organise separately.

"There's discharge, and some bleeding after intercourse"

This is the presentation that must not be treated as vaginitis. Bleeding after intercourse points at the cervix — an ectropion, a polyp, a cervical infection, or a cervical lesion — and it needs a speculum examination and, usually, cervical screening. It is one of the clearest reasons to be examined rather than treated blind. See Pap smear testing and colposcopy.

"I'm pregnant and I have discharge"

Discharge increases normally in pregnancy. What matters is whether there is an infection behind it. Symptomatic bacterial vaginosis in pregnancy is treated, because it is associated with preterm birth, late miscarriage and postpartum infection. Routine screening of pregnant women who have no symptoms is a different question, and the evidence does not support it in women not at increased risk of preterm birth. Thrush in pregnancy is treated for symptom relief with agents appropriate to pregnancy. Any discharge that could be leaking fluid rather than discharge is assessed urgently.

"I'm past menopause and it burns, but nothing grows on the swab"

After menopause the vaginal lining thins as oestrogen falls, and the resulting dryness, burning and soreness are frequently mistaken for infection and treated with repeated antifungals that cannot help. This is genitourinary syndrome of menopause, it has established treatments, and it is diagnosed by examination. See menopause care.

Other causes

When it is not an infection at all

A meaningful proportion of women referred with "recurrent infection" have something else. The common alternatives are:

Non-infective causes worth excluding

  • Contact irritation from soaps, intimate washes, wipes, panty liners or spermicide
  • Oestrogen deficiency after menopause, or while breastfeeding
  • Vulval skin conditions such as lichen sclerosus or lichen planus, which need a specialist look and sometimes a biopsy
  • A retained foreign body — a forgotten tampon, or rarely a displaced device
  • Cervical causes: ectropion, polyp, cervicitis, or a lesion needing screening
  • Physiological discharge, correctly identified and left alone

What makes recurrence more likely

  • Douching or washing inside the vagina — it removes the protective lactobacilli
  • Repeated over-the-counter courses without a diagnosis
  • Stopping treatment as soon as symptoms settle
  • An untreated sexual partner in trichomoniasis, and in recurrent bacterial vaginosis
  • Uncontrolled diabetes or unrecognised high blood sugar
  • Home remedies applied inside the vagina, including curd and herbal preparations

A pelvic ultrasound is not part of assessing a straightforward vaginal infection. It becomes relevant when the picture suggests something above the vagina — pelvic pain with tenderness on examination raising the possibility of pelvic inflammatory disease, a suspected retained or displaced intrauterine device, or persistent symptoms with no vaginal cause found. Dr. Kunda performs the scan herself in that situation, so the finding and the examination are interpreted together. See pelvic pain assessment.

Treatment

How each one is treated

Treatment is standardised and effective once the diagnosis is right. Bacterial vaginosis is treated with a nitroimidazole or clindamycin, orally or intravaginally. Thrush is treated with an azole antifungal, oral or intravaginal, with the choice and duration depending on severity, pregnancy and whether the species is albicans. Trichomoniasis is treated with a nitroimidazole, and current guidance prefers a multi-day oral course in women over the older single large dose, with the partner treated at the same time and retesting at three months, since repeat infection is common. Where the partner needs treating — always in trichomoniasis, and now in recurrent symptomatic bacterial vaginosis — that is arranged here as part of your treatment plan, so the two of you are not treated weeks apart by two different clinics.

Specific drugs, doses and durations are not published on this page deliberately. Choosing them depends on the diagnosis, on pregnancy or breastfeeding, on previous treatment, on species where that has been identified, and on other medicines you take. Self-prescribing from a page like this one is precisely the pattern that produced the resistance figures above.

Before your appointment

  • Do not douche or use an intravaginal medication for 48 hours beforehand — it makes examination and testing less reliable
  • Bring the packaging or names of anything you have already taken, including pharmacy purchases
  • Bring recent blood sugar or HbA1c results if you have them
  • An appointment can be kept during a period, though testing is easier outside one
  • Note when the symptoms started and what makes them worse

Who examines you, who decides, and who follows it up

Dr. Kunda Shahane takes the history, performs the examination, decides which test is worth doing, interprets it, prescribes, and reviews you afterwards. There is no handover between a person who examines and a person who decides. That continuity matters most in exactly the cases that get passed around — the recurrent ones, where the answer usually lies in a detail from the last three episodes rather than in the current swab.

Where the finding belongs to another part of your care — a cervical abnormality, a pregnancy complication, blood sugar that needs managing, or a fertility question — it is handled within the same practice rather than referred out and lost.

See the full women's health and gynaecology service

Cost

What it costs

The cost of assessment and treatment depends on what the consultation shows: whether any laboratory test is needed, whether a culture with species identification is required, whether a cervical screening test is done at the same visit, and the treatment prescribed. A first consultation with examination is charged separately from any investigation.

For current charges, send a WhatsApp message to +91 8087471244 or call +91 712 6692706. You will be told the consultation fee and the likely range for testing before you attend.

Common questions

Frequently asked questions

Is white discharge always an infection?
No. The vagina normally produces a clear to white discharge that varies through the cycle and increases in pregnancy and with hormonal contraception. It is not an infection if it does not itch, burn or smell offensive. Discharge is worth investigating when it changes from what is normal for you, or when it comes with itching, an unpleasant odour, soreness, pain during intercourse, burning on passing urine, or any bleeding.
How do I know whether it is thrush or bacterial vaginosis?
Reliably, you do not — which is the point. Thrush typically causes intense itching with a thick white curd-like discharge and no odour, while bacterial vaginosis typically causes a thin grey-white discharge with a fishy odour that is worse after periods and after sex. But the two overlap, they can occur together, and the vaginal pH separates them in seconds during an examination: it is raised in bacterial vaginosis and normal in thrush. Treating the wrong one is the usual reason a course fails.
Why does my yeast infection keep coming back?
Three or more episodes in twelve months is recurrent vulvovaginal candidiasis, and it needs a different approach from a single episode. The usual reasons are that the species was never identified — non-albicans species such as C. glabrata respond poorly to the standard antifungal — that an underlying factor such as undiagnosed or uncontrolled diabetes has not been addressed, or that treatment was too short. A study at the regional STI centre in Government Medical College, Nagpur found 17.18% of Candida isolates resistant to fluconazole, which is why repeating the same single dose is not a plan.
Is bacterial vaginosis a sexually transmitted infection?
It is not classified as one. It is a disturbance of the normal vaginal bacteria rather than an organism caught from a partner, and women who have never been sexually active can develop it. However, sexual activity clearly influences it, and evidence has accumulated that the bacteria involved are exchanged between partners. That is why guidance on partner treatment changed in 2025 for recurrent cases.
Does my husband or partner need treatment?
For trichomoniasis, yes, always — it is a sexually transmitted infection and treating only one person leads to reinfection. For thrush, not routinely. For bacterial vaginosis the position changed recently: in October 2025 the American College of Obstetricians and Gynecologists recommended considering concurrent partner therapy, using a combination of oral and topical antimicrobial agents for male sexual partners of adults with recurrent, symptomatic bacterial vaginosis. Dr. Kunda follows that guidance, so where your bacterial vaginosis keeps recurring, treatment for your partner is arranged alongside yours rather than left to you to organise. Whether it applies to your situation is decided at the consultation.
Can I just use a cream or a single tablet from the pharmacy?
For a first, mild, typical episode of thrush in a woman who has had it before and recognises it, a short antifungal course is often reasonable. The problem is repetition. If symptoms return within two months, if the treatment does not work, if there is any odour or bleeding, if you are pregnant, or if you are past menopause, treating blind delays a diagnosis and contributes to the resistance now measurable in Nagpur. Bring what you have already taken to the appointment.
Are intimate washes and douching good for hygiene?
Washing inside the vagina is not advised. The vagina maintains its own acidic environment through lactobacilli, and douching or using intravaginal washes strips that protection and makes bacterial vaginosis more likely, not less. Plain water on the vulva is enough. Scented soaps, wipes and liners are also a recognised cause of irritation that is often mistaken for infection.
I am pregnant and I have discharge. Is it dangerous for the baby?
Increased discharge is normal in pregnancy and is usually not a problem. What matters is whether there is an infection behind it. Symptomatic bacterial vaginosis in pregnancy is treated, because it is associated with preterm birth, late miscarriage and postpartum infection. Screening pregnant women who have no symptoms is a separate question and the evidence does not support it in women who are not at increased risk of preterm birth. If there is any possibility that you are leaking fluid rather than producing discharge, that needs assessment the same day.
Can a vaginal infection cause infertility?
Vaginal infections themselves are not a common cause of infertility. The concern is when an untreated sexually transmitted infection ascends to the uterus and fallopian tubes and causes pelvic inflammatory disease, because tubal damage from that can affect fertility. This is one reason trichomoniasis, chlamydia and gonorrhoea are treated properly and partners treated alongside, rather than managed with repeated symptom-directed courses.
Do I need a Pap smear if I have discharge?
Not for the discharge itself — a Pap smear is a cervical screening test, not a test for vaginal infection. But discharge with bleeding after intercourse, bleeding between periods, or an abnormal-looking cervix on examination does need cervical assessment, and if you are due for screening it is sensible to do it at the same visit rather than making a second trip.
Will I be seen by a woman doctor?
Yes. Dr. Kunda Shahane is a woman gynaecologist and performs the consultation and examination herself. If you would prefer a female attendant present during the examination, or would prefer to speak without a family member in the room, say so when you arrive and it will be arranged.
How long does treatment take to work?
Symptoms of thrush usually settle within two to three days of appropriate treatment, and bacterial vaginosis within a few days of starting a full course. Finish the course even after symptoms stop, because stopping early is a common reason for early recurrence. If there is no improvement at all after a completed course, that is a reason to come back rather than to start another one — it usually means the diagnosis needs revisiting.
Dr. Kunda's note
Women often lower their voice when mentioning vaginal discharge or recurrent itching, as though it's embarrassing. I always tell them, 'You don't need to apologize for a medical problem.' These symptoms are very common. A proper history and clinical examination are far more useful than repeatedly treating yourself for an infection that might not even be there.
Dr. Kunda Shahane MBBS · MS (Obs & Gynae) · FIFM · FMF (London) · MMC 2005/01/0317
References
  1. American College of Obstetricians and Gynecologists. Concurrent Sexual Partner Therapy to Prevent Bacterial Vaginosis Recurrence. Clinical Practice Update, October 2025. Obstet Gynecol 2025;146:e111–e114. acog.org
  2. American College of Obstetricians and Gynecologists. Practice Bulletin No. 215: Vaginitis in Nonpregnant Patients. Obstet Gynecol 2020;135:e1–e17.
  3. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021 — Bacterial Vaginosis. cdc.gov
  4. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021 — Trichomoniasis. cdc.gov
  5. US Preventive Services Task Force. Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery, 2020. uspreventiveservicestaskforce.org
  6. Gedam ST, Waikar MM, Deogade KS, et al. Is there a need to review the syndromic case management of vaginal discharge due to candida in the Indian scenario? Int J Res Med Sci 2023;11(8):2880–2884. Regional STI centre, Government Medical College, Nagpur. imsear.searo.who.int
  7. Comparative evaluation of syndromic case management against PCR diagnosis in women with vaginal discharge, Delhi. ncbi.nlm.nih.gov
  8. National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India. STI/RTI Syndromic Case Management. naco.gov.in
  9. Vodstrcil LA, et al. Male-partner treatment to prevent recurrence of bacterial vaginosis (StepUp). N Engl J Med 2025;392:947–957.

Written and medically reviewed by Dr. Kunda Shahane, MBBS, MS (Obs & Gynae), FIFM, FMF (London) · Last reviewed: 30 August 2026

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Get it examined once, properly

If the same symptom has been treated more than twice this year, the next step is an examination and a diagnosis — not another course. Consultations with Dr. Kunda Shahane are by appointment.

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Mayflower Clinic, Surdham Complex, Behind Silver Palace Building, 2nd Lane from Panchsheel Square, Opp. Yashwant Stadium, Dhantoli, Nagpur – 440012 · Monday–Saturday, 10:00 AM – 6:00 PM · Sunday closed

PCPNDT Act Notice: Mayflower Fetal Medicine Centre strictly complies with the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. Sex determination and sex-selective practices are strictly prohibited and punishable by law. All ultrasound and prenatal diagnostic services at this centre are performed exclusively for lawful medical indications — fetal anatomy assessment, fetal wellbeing, and diagnosis of maternal-fetal conditions. Disclosure of fetal sex is illegal and is not performed at this centre under any circumstances. Read our PCPNDT compliance statement.
Medical Disclaimer: This page is for general patient education only and does not constitute medical advice, diagnosis, or treatment. Please consult Dr. Kunda Shahane or your treating gynaecologist for advice specific to your situation.