Vaginal discharge

Vaginal discharge is the most common complaint that requires the lady doctor to do examination. It happens when the genitalia, vagina or internal female organs are swollen. The chances of vaginal discharge increase if there are multiple sexual partners, antibiotic use, oral contraceptive use, poorly controlled diabetes, menopause, altered vaginal flora, cervical cancer etc.

 

Many times, women confuse normal vaginal discharge with abnormal discharge. Consistency of normal vaginal discharge changes during the menstrual cycle. Around the time of ovulation, the discharge maybe thin and watery but it may be thick and sticky at other times.  Its colour maybe clear or white. Its volume may also differ. Sometimes lot of discharge maybe present and at other times lesser amounts are produced. It typically does not have a strong smell. It also does not cause itching or pain except during menstrual periods. Abnormal discharge is suspected if there is itching, pain, unpleasant smell present.

Doctor will need to determine any possible infection by looking at appearance of discharge under microscope. She may also do a pap smear in which scrapping from inner lining of cervix is seen under microscope. Since many cervical cancers may go unnoticed for long time, pap smear is recommended every year in sexually active women.

Sexually transmitted infections like gonorrhea and Chlamydia require special tests. These need urgent antibiotics to be treated effectively. Early treatment with appropriate antibiotics will prevent further spreading to other organs and to other partners. All partners need to be treated as well.

Viral causes like human papilloma virus (HPV) and herpes simplex virus (HSV) are also frequent causes. HPV can cause warts and cervical cancer. HSV is also known to cause recurrent fluid filled sores. Luckily we have a vaccine against HPV that is to be given to teenagers and prevents its infection. Effective treatment is not yet available against these viruses.

Itching is usually associated with yeast infections. Yeast infections may cause discomfort but are not harmful. These can be easily diagnosed my microscopy. These can be easily managed with topical anti-fungal preparations. These may recur and be a cause of frustration for both physician and patient.

If microscopy does not find a cause then an allergy is suspected. Allergy may happen due to many reasons including tight clothing, synthetic underclothes, deodorants, soaps, detergents, tampons, spermicides.

A final piece of advice would be to go for testing before taking any medicine for vaginal discharge. Taking unnecessary triple combos cause unnecessary risk and have been banned in India. Natural is always best for women’s health.