Common gynecological health issues, like yeast infections and bacterial vaginosis, can be incredibly uncomfortable and tedious to deal with. If you’re experiencing itching or pain down there, it can be hard to determine whether a simple urgent care appointment will do or if you need to rush to the gynecologist for more extensive testing.

Ob-gyns weigh in on when patients should walk into a clinic today — and when you can wait to see a gynecologist.

Urgent care-approved issues

Dr. Nichole Butler, a gynecologist at Weiss Memorial Hospital’s Women’s Health Center in Chicago, says you’ll probably want to see someone right away if you:

• Experience pain or burning on urination.
• Feel like you need to pee all the time.
• Experience vaginal or vulvar itching and burning.
• See signs of vaginal bleeding or unusual discharge.
• Suffer pelvic or abdominal pain or pressure.

As a rule of thumb, call your gynecologist or primary care doctor’s office first, she advises. You may be able to see a nurse practitioner or someone the same day, or the clinic can advise you on where to go for testing and treatment. Resolving the issue on your own can be dicey. “Dr. Google has hurt us all,” Butler says.

If you’ve had yeast infections frequently in the past, you may be able to take an over-the-counter treatment with your doctor’s blessing, says Dr. Jessica Lee, ob-gyn at the University of Maryland Medical Center and assistant professor at the University of Maryland School of Medicine in Baltimore. Yeast infections can often be treated with over-the-counter antifungal treatments. 

If you can’t get into the office or it’s the weekend, head for urgent care during open hours. There, the health provider can run tests to determine your discomfort’s cause. While you may not see a physician, most urgent cares are staffed with physician assistants or nurse practitioners who are qualified to diagnose and treat illnesses like common vaginal concerns.

“Some patients think they know what they have, but you won’t really know until someone looks under the microscope,” Lee says. Burning on urination is a symptom of a UTI and bacterial vaginosis. Itching and discharge could be bacterial vaginosis, a yeast infection or a sexually transmitted infection. After diagnosis, the care provider will prescribe antibiotics or other medication to address the cause.

It’s important to seek treatment quickly, because in some cases, treatment delays can lead to additional problems. For example, an infection that starts in the urinary tract can spread to your kidneys or bloodstream. An undiagnosed sexually transmitted infection could progress to pelvic inflammatory disease.

More serious conditions

If heavy bleeding occurs—such as in a miscarriage or ectopic pregnancy, which occurs when a pregnancy develops outside of the uterus—you may need to head to the emergency room. 

Lee defines heavy bleeding as soaking more than one pad in an hour. Many otherwise unexceptional symptoms can become life-threatening emergencies for a pregnant person. During pregnancy and the year after, it’s essential to watch for danger signs, including fevers, dizziness, severe nausea or belly pain, vaginal fluid leakage or trouble breathing.

Once again, first contact your ob-gyn. “It’s never a wrong option, trying to call your doctor,” Lee says. Many urgent and emergency care departments may not have an ob-gyn on staff, so it’s important to get clear instructions and direction. “Pregnancy is a whole other ballgame for an emergency department and/or urgent care to deal with, and they may feel unequipped.”

Pregnant people undergoing one of these issues may require transfusions, anti-nausea medications, ultrasounds, IV medications and advanced gynecological care at a local hospital’s emergency room. Urgent care facilities may not offer these treatments, Lee points out. 

Outside of these issues, if you’re experiencing pain, burning or discharge and urgent care is closed, it’s best to wait (if possible) for it to open. 

“Vaginal discharge is not an emergency, but a lot of people think it is,” Butler says. “It’s not a life-or-death situation, and there’s a huge expense to go to an emergency room for vaginal discharge. Go to urgent care.” 

Not only will you save yourself potentially high costs and exposure to other people’s infectious diseases, but a long wait. “If people are coming in with gunshot wounds, but you have vaginal itching, they won’t get to you for many hours,” she says. “It’s just not a priority.”

When to get expert advice

Urgent care should not replace an annual gynecological check-up. If you have a chronic problem such as premenstrual migraines or suspect urgent care made a misdiagnosis, Butler says you’ll also want to see an ob-gyn for further treatment.

For example, Lee says that recurrent vaginitis (vulvar itching) looks like three or more infections per year. Your primary care doctor or ob-gyn won’t necessarily get records or reports from your urgent care visit, so you’ll be responsible for your follow-up.

It’s important to remember that urgent care professionals aren’t gynecologists. Urgent care facilities may not be as careful or curious as to your ob-gyn in diagnosing the specific bacteria causing reinfection, which would require a different antibiotic.

Gray areas exist, too, Lee says. For example, a lump or bump on your vulva can generally wait. But if the spot becomes increasingly red or you spike a fever, it may be harboring a nasty infection.

In this case, an urgent care clinic can likely drain the area and start you on a round of antibiotics.

In short, few life-or-death vulvar situations require the emergency room — but plenty of itchy, burning, painful symptoms can require a same-day visit. Can you wait without severe consequences? Possibly. But it’s usually best to address issues today so you can sleep tonight.

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