Persistent Urinary/Vaginal Burning Sensation During Pregnancy: What to Do

Question
Dear Brenda

Several days ago I asked you about the unrinary infection and today I visited my doctor and told him that I am still having burning senation.In brief, I had taken 10 days of antibiotics and still have the burning senation.

He told me that I don't have to worry as
1) uninary infection and vaginal infection are very common during pregnancy
2) he does not want do any tests again as both urinary an vaginal infections should not have any harmful effect on my baby right now(even though if I have them both), I am at 33 weeks.
3) and since I have GBS, he will give me antibiotics during delivery, and that antibiotics will have effect on both the unrinary and vaginal infection, and no problem for normal vaginal delivery.
4) even if I have both infection, he does not want me to take too many antibiotics
5) he will only treat the infections if and only if bleeding occurs.

So, do you think that he has his points? will the antibiotics used during delivery for GBS can have such a great effect on urinary and vaginal infections?

Thanks

Answer
Dear Jennifer,

It's extremely common to get a yeast infection while pregnant because of the high levels of pregnancy hormones present. This could account for the "burning" you describe also. Other symptoms of a yeast infection include a thick white discharge (sometimes described as a cottage cheese type discharge), redness or irritation of the outer vaginal lips, and sometimes severe itching. Yeast infections in pregnancy do not normally travel up into the uterus or harm the baby in any way, and they only require treatment if the mother's symptoms are bothersome. However, if untreated, yeast infections can pass to your baby's mouth during delivery. This is called "thrush" and is quite effectively treated with Nystatin.

Most yeast infections can usually be avoided/minimized by doing the following:
-Wear loose, cotton, breathable clothing, and cotton underwear.
-After regular, thorough washing, use your blow dryer on a low, cool setting to help dry your genital area and try to keep area as dry as possible. (Do not blow air directly into vagina! Use at an angle to avoid this or simply lay bottomless under a ceiling fan.)
-Always wipe from front to back after using the restroom.
-Shower immediately after you swim. Change out of swimsuit, workout clothes or other damp clothes as soon as possible.
-Don't douche; and don't use feminine hygiene sprays, sanitary pads, and tampons that contain deodorant, bubble bath, colored or perfumed toilet paper
-Include yogurt with "lactobacillus acidophilus" in your diet
-Limit sugar intake, as sugar promotes the growth of yeast
-Get plenty of rest to make it easier for your body to fight infections

There are some topical creams that you can use to minimize the itching of a yeast infection. I don't know if your doctor is wanting you to use over-the-counter vaginal creams/suppositories and it doesn't sound like he has even diagnosed you with a yeast infection. But you can ask about trying the topical cream on the outer genital area to see if it will help with the itching/burning. This, in addition to staying very dry, may help a great deal with your discomfort.  

If this is a urinary tract infection, he obviously has chosen to allow it to run its course until delivery. Urinary tract infections caused by GBS are fairly common and difficult to treat while you remain pregnant. Any burning with urination will not decrease until it is treated.

For the GBS - to avoid transmission to your baby - you'll receive intravenous antibiotics, such as penicillin or ampicillin, when your labor begins. If you're allergic to penicillin and related drugs, you may receive clindamycin or a similar alternative. Typically, this type of an antibiotic will also treat a urinary tract infection if present. A yeast infection would be treated with another type of medication.

Here's the thing - at this point, your doctor has examined you and essentially knows whether what he has observed is cause for concern. If you trust his judgement, you should have no cause for worry. The discomfort is frustrating, I know, but if you try some of the above suggestions, as well as the ones I shared in the previous answer, it may help a bit during these last few weeks. Plus - the end result will be well worth it!  :-)

Hope that helps. Be well!

Brenda