I keep getting itching and discharge. Why does it keep coming back?

Recurring symptoms usually mean one of three things: it is thrush and something keeps setting it off, it is bacterial vaginosis and the balance keeps shifting back, or it was never what it was treated as. The two feel similar and are treated completely differently, which is why repeated over-the-counter treatment without a diagnosis often fails.

Things that genuinely help both: stopping douching and internal washes, avoiding scented soaps and wipes on the vulva, and washing with water only. Things that do not: yoghurt, lemon, and most of what is sold for 'intimate hygiene'.

Diabetes, antibiotics, pregnancy and some hormonal methods make thrush more likely. Bacterial vaginosis is not a sexually transmitted infection, though it is associated with sexual activity, and it is not caused by being unclean.

Four or more episodes in a year is defined as recurrent and is managed with a longer plan rather than another short course.

This cannot tell you which one you have. A swab does, and it is the step that usually breaks the cycle after months of guessing.

• Can we take a swab to confirm what this actually is?
• Should my blood sugar be checked?
• What is the plan if it comes back again?
• Does my partner need anything?

See a clinician rather than self-treating for discharge with pelvic pain or fever, for bleeding after sex, for sores or ulcers, or for symptoms in pregnancy.