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At her annual gynecological exam two years ago, Leilah, 29, was expecting a clean bill of health. But when her doctor asked if she had any concerns, she remembered she'd had some mild vaginal itching. "My gynecologist ran some tests, and later I learned I had chlamydia," Leilah says. "I was carrying around this infection that could've eventually made me infertile, and I didn't even know it."

Fortunately for Leilah, chlamydia, a sexually transmitted infection, is easily cured with prescription antibiotics if detected early enough, as hers was. But her story illustrates a common scenario: When a vaginal infection strikes, symptoms can be subtle or nebulous. And sometimes, a vaginal infection that can lead to serious consequences (like infertility) can be present with no symptoms at all. "Millions of women will experience at least one vaginal infection in their lifetimes," says Barbara Soltes, M.D., associate professor of obstetrics and gynecology at Rush-Presbyterian-St. Luke's Medical Center in Chicago. "Yet the symptoms of vaginal infections can be confusing." The result: Many women leave an infection untreated or misdiagnose it on their own and reach for the wrong panacea.

To be aware of what's normal and what's not, and to keep your reproductive system healthy, follow this advice.

1. Don't ignore suspicious discharge.

During your childbearing years, some vaginal discharge is normal, and you may see mild fluctuations in its quantity and consistency throughout the month because of changing estrogen levels. "What's considered 'normal' varies from woman to woman," says Jill Huppert, M.D., adjunct associate professor of clinical obstetrics/gynecology at the University of Cincinnati College of Medicine. "Some women's discharge is clear or white all month long, while some women may see a thickening or yellowing of their discharge at certain times." What's important to note, Huppert says, is what your discharge is like over a monthly cycle. (If you take the pill, however, you no longer ovulate and don't experience the resulting changes in cervical mucus.)

If you see unusual changes in the color or quality of the secretions, that may be the sign of an infection, especially if you have other symptoms. For example, a thick, white, clumpy discharge and intense itchiness are typically the signs of a yeast infection. Thin, discolored discharge accompanied by a fishy odor, especially after sexual intercourse, could signal bacterial vaginosis (BV), the most common vaginal infection in women under 40. Or greenish, bubbly discharge and a foul odor could be the symptoms of trichomoniasis. Bottom line: If you notice anything out of the ordinary, consult your doctor, rather than self-diagnosing.

2. Address recurring symptoms.

Seventy-five percent of women will have at least one yeast infection during their lifetimes, If you're already familiar with the symptoms and confident you've identified them correctly, you can treat yourself with over-the-counter, three- or seven-day anti-fungal vaginal suppositories or creams.

But if you're unsure if you have a yeast infection, or if your symptoms persist after you've finished treatment, see your doctor. She may run tests to rule out other possible infections (such as BV or sexually transmitted diseases) and take cultures to determine whether you have a less-common species of yeast. While over-the-counter medications are effective against certain species of the fungus, they're ineffective against others. So if you have a persistent yeast infection that hasn't responded to over-the-counter anti-fungals, your doctor may prescribe the single-dose oral anti-fungal Diflucan. (Because over-the-counter topical treatments do cure most yeast infections and oral anti-fungals pose a very small risk of liver damage, Huppert prescribes the tablets only as a second line of treatment or to women who are uncomfortable with creams or suppositories.)

3. Be aware of infection triggers.

Anything that affects hormone levels or the normal pH balance in the vagina -- diabetes, pregnancy, taking antibiotics or going on or off the pill -- can increase your risk for yeast infections. If you're prone to infections, be proactive: Keep a supply of over-the-counter yeast infection medications in the house (and remember to check expiration dates) and apply them at the first signs of infection. Likewise, the use of antibiotics and oral contraceptives appears to increase some women's chances of getting bacterial vaginosis. While it's frequently mistaken for a yeast infection, BV can't be cured with over-the-counter anti-fungal medications. If you experience symptoms (remember, a fishy odor is a significant one), see your doctor, who can make a diagnosis and prescribe antibiotics.

Other environmental factors can also trigger vaginal infections. Douching, for example, flushes away protective bacteria in your vagina that help keep the less friendly bacteria in check, and can lead to bacterial vaginosis; for this reason, most doctors recommend against douching. And, perfumed products may cause vaginal infections in some women. "Using bubble baths, perfumes or even powders in the genital region can disrupt the normal flora that are protecting the vagina," Soltes explains. (Such products may also cause a noninfectious allergic reaction called nonspecific vaginitis.) So if you suspect those fragrant bath salts you got as a gift are causing your vaginal irritation, toss them.

4. Get screened to save your health -- and your life.

Many women believe that a negative Pap smear automatically means they're free of all sexually transmitted infections. Not true. "The Pap can screen for cancerous and precancerous cells, and may detect the human papillomavirus (HPV)," Huppert says. But because the Pap test doesn't screen for sexually transmitted diseases other than HPV, you must share any new, unusual symptoms with your doctor, who can perform the appropriate tests.

Even if you have no symptoms, you may still want to talk to your doctor about being screened for sexually transmitted diseases (STDs), especially if you've had a new sexual partner. Sexual activity, particularly with a new partner, is believed to increase the risk of bacterial vaginosis. Research suggests BV is linked to pelvic inflammatory disease (PID), which can cause infertility and tubal (ectopic) pregnancy; however, half of women with BV have no symptoms. Chlamydia frequently displays no symptoms and can also lead to PID. Trichomoniasis, which has been linked to premature or low-birth-weight infants, is often silent as well.

Besides the potential threat of infertility and pregnancy-related complications, there's another reason to be screened for BV and STDs: Both put you at increased risk for HIV infection if you have been exposed to the virus. "If you have any STD, your body's defenses are down, making you more susceptible to HIV infection," Huppert says. "Early diagnosis and treatment of sexually transmitted diseases reduces one's risk for contracting HIV."

5. Protect yourself during sex. We probably don't have to remind you of the importance of practicing safe sex, but we will anyway: The best way to shield yourself against sexually transmitted infections is by using a latex male or female condom during sex. Still, condoms don't guarantee 100-percent protection, so if you notice any unusual symptoms, don't wait -- see your doctor right away. "Women have to be vigilant," Huppert says. "Sexually transmitted diseases in general have so few symptoms in women, and such terrible consequences."

Kelly James-Enger, a free-lance writer, lives in Downers Grove, Ill.