Why you DON’T need a pelvic exam to diagnose yeast infections…

And Why Troglodytes Need to Retire and Leave the Vaginas to Doctors Who Actually Have ONE!

The times are hopefully changing now that OB/GYN residencies comprise more women than men, but that was not the case decades ago. All of the ‘old’ male gynecologists seem to want to publish these ridiculous articles about how women don’t know when their genitals itch. 

These troglodytes need to retire and leave the vaginas to doctors who actually have ONE! 

Because if I read one more article written by a male gynecologist who has long standing issues with needing to shove speculums into itchy, sore, and swollen vaginas, I’m going to scream. It is simply an unproven medical behavior—to insert a speculum—when the symptoms of a yeast infection are external to the vagina (meaning the vulva or labial lips). 

More on that in a bit. Let’s start with VAGINITIS 101. 

Yeast vaginitis or vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV), as they are all officially called, have very distinct symptoms that a monkey could diagnose. VVC is usually caused by the species, Candida albicans. VVC causes itching, burning, pain, swelling, and discharge and the BV causes a discharge with a fishy odor. BV almost never causes itching unless it’s accompanied by VVC. Not all of the symptoms listed for VVC must be present, but I can assure you that itch or pain is always present and is the reason why women self-diagnose and self-treat immediately with OTC remedies. 

Most of those OTC creams, however, don’t work very well, and often cause the symptoms to worsen intensely before they get better. BV’s discharge tends to be watery and there is some external irritation, but there is always a smell that is very distinct. 

While the yeast or fungus (Candida) populate the vagina normally, it’s the white blood cells (PMNs) that cause the itch because they come out in force when the ‘candida’ sprouts hyphae, which are like roots that invade the tissue. These soldier-like PMNs are totally worthless, subsequently die and release their contents in a process called degranulation. It is the PMNs that cause the symptoms much like an autoimmune response. Some women get these maddening infections all the time and then others will never experience this flare-up in their lives. 

So, all a doctor really needs to do is swab the vulva and that does not require her vagina to be pried open forcefully. ‘At home’ tests are also available if anyone is confused. 

You do not need a gynecologist to tell you that you itch! Ask any man—“Do you know when your scrotum or penis itches?” Case closed. Females and males have the same type of nerves and they feel itch. However, the itch is never inside—as in the vagina because the vagina has fewer nerves than the vulva. And the vulva has lots of nerves. The symptoms start at the hymen and spread to the clitoris, labia minora and majora—the outer set of lips.

Besides, BV, the only reason to have a pelvic exam with a speculum is if you have been exposed or think you have a STI like gonorrhea, chlamydia, or trichomonas, and for a pap smear. There are other non-infectious reasons to have a pelvic exam, but spare yourself the misery and try an OTC product first if you itch. Boric acid capsules placed intravaginally can help prevent yeast infections, according to some reports. And, prolonged use up to 10 days or more can eradicate many infections. You can buy them online.


Kimberly Langdon M.D.

Kimberly Langdon is a Doctor of Medicine and graduated from The Ohio State University in 1991. She completed her residency in Obstetrics and Gynecology at The Ohio State University Hospitals, Department of OB/GYN. Board-Certified in 1997, she is now retired from clinical practice after a long and successful career. Currently, she is the Founder and Chief Medical Officer of a Medical Device Company that is introducing a patented product to treat vaginal microbial infections without the need for drugs. She is an expert in Vaginal Infections, Menstrual disorders, Menopause, and Contraception.