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Vaginal discharge: definition, causes, and prevention
Vaginal discharge, commonly known as white discharge, is a normal secretion that protects the vaginal flora. The discharge varies according to the period of the woman’s life and reflects the woman’s physiological state. The texture, smell, and appearance of the discharge are indicative of the presence or absence of disease or infection. Thus, it is important to understand the characteristics of normal vaginal secretions to be able to distinguish abnormal discharge for treatment and prevention.
What is vaginal discharge and what causes it?
Vaginal discharge, also known as leucorrhoea or white discharge, is a clear, milky, watery discharge that is usually odourless or has a slight musky odour and differs from woman to woman. Physiological leucorrhoea is a mixture of mucus from the cervix, adnexa, and Bartholin glands, desquamated vaginal epithelial cells, and bacteria. Its production depends on the period in the woman’s life and varies from childhood to menopause.
Causes of white discharge
White discharge is a normal secretion that occurs daily to discard dead cells from the vaginal wall. The vagina automatically cleans itself through secretions from the adnexal and Bartholin glands and oestrogen that produces cervical mucus. Cervical mucus protects the uterus from external invasions.
The general appearance of physiological leucorrhoea will depend on the menstrual cycle, sexual stimulation, pregnancy, the use of oestrogen-containing medication, and fertilisation.
Leucorrhoea is medically important because of the ever-increasing number of women who consult about it. While physiological leucorrhoea is normal and encouraged for vaginal protection, pathological leucorrhoea causes many illnesses and infections and can lead to infertility.
Warning signs of pathological leucorrhoea
Contrary to belief, the colour of white discharge is not necessarily creamy or light, and a different colour is not typically a sign of infection or disease. The colour of physiological leucorrhoea may fluctuate slightly depending on whether the woman is pregnant, ovulating, or post-menstruating.
However, a marked change in discharge colour, for example, to green, yellow, grey, or brown, and a heavier and sometimes smelly discharge, commonly indicates an abnormality. Functional signs are often present and include genital pain (which is usually vaginitis) that is pronounced during sexual intercourse, pruritus, and burning.
Causes of pathological leucorrhoea
As the vagina is an environment colonised by bacteria that live in commensalism, leucorrhoea diagnosis is difficult to establish. However, in the urgency of treatment to relieve the sensation of discomfort caused by vaginal discharge, its occurrence is often considered infectious. There are two main modes of transmission:
- Sexually transmitted infections, including trichomoniasis, gonorrhoea, and chlamydia.
- Non-sexually transmitted infections, including candidiasis and bacterial vaginosis.
How is pathological leucorrhoea diagnosed?
It is typically the feeling of discomfort caused by an abundance of discharge, genital pain, discharge colour, and sometimes discharge odour that leads to a consultation. A medical professional will interview the patient to gather information about the characteristics of the discharge, its appearance, and possible signs in the partner(s).
A clinical examination consisting of an inspection of the vulvar, perineal, and vestibular area, a vaginal touch, and a speculum examination will be conducted to corroborate the information. The specimen will be observed under the microscope or by sniff test. The consultation aims to determine the infection type.
Treatment of pathological leucorrhoea
Pathological leucorrhoea is treated according to the pathogen and the correlation with other diseases or infections. The extent of the infection must be determined to determine whether it is an overt sign of underlying pathology. Several tests can be prescribed if there is a doubt after direct microscopic examination.
Additionally, antibiotic treatment may be recommended to relieve genital pain and reduce vaginal secretions. The prescribed antibiotics will depend on the symptomatology and whether there is a correlation with other diseases. The patient’s history is relevant as social and epidemiological factors may be considered.
Prevention of leucorrhoea
White discharge is normal if it does not cause discomfort. It clears and maintains the vaginal flora. Thus, it is important to maintain rigorous genital hygiene through simple daily gestures, including
- Avoiding tight-fitting clothes
- Avoiding scented sanitary towels
- Choosing cotton underwear over synthetic fabrics
- Avoiding douching unless recommended by a doctor. In this case, a mild, alkaline soap should be used
- Cleaning from front to back to avoid contamination from the anal to the vaginal area
Women’s intimate hygiene should be performed as simply as possible. It is not advisable to insert fingers into the vagina to avoid disrupting the balance of the vaginal flora. If necessary, irritating products that cause vaginal dryness should be avoided.
Women who suffer from this phenomenon should consult a doctor for an ideal local solution. Vaginal dryness can cause severe itching, irritation, and pain during sex. This symptom is often common during menopause due to a decrease in oestrogen levels. Hormonal methods are widely used, although local methods such as vaginal moisturisers and lubricants are preferred.