Common women’s health issues, like yeast infections and bacterial vaginosis, can be incredibly uncomfortable and tedious to deal with. If you’re experiencing itching or pain around your vulva, 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 women 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 UTIs and 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.
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.
“Some women 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 urinary tract infection (UTI) and bacterial vaginosis. Itching and discharge could be bacterial vaginosis, a yeast infection or a sexually transmitted disease. 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 a woman’s kidneys or bloodstream. An undiagnosed sexually transmitted disease could progress to pelvic inflammatory disease.
More serious conditions
If heavy bleeding occurs, such as in a miscarriage or ectopic pregnancy, 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.
Pregnant people 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.
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.”
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 critical care 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 the urgent care made a misdiagnosis, Butler says you’ll also want to see an ob-gyn.
For example, Lee says that recurrent vaginitis (vulvar itching) looks like three or more infections per year. More than three UTIs per year could be troubling (not to mention uncomfortable). 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 who specialize in women’s healthcare. 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.
In some cases, as with UTIs, your primary care doctor or ob-gyn could order additional tests to determine potential causes. Grey 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.