Definition & Overview
A healthy vagina produces secretions in the form of bacteria, which helps prevent infections by creating an acidic environment. These secretions are a normal type of vaginal discharge. However, there is a delicate balance in healthy vaginal secretions. If this balance is disturbed for some reason, the vagina becomes prone to infections.
One the most common signs of an infection is also a vaginal discharge, but one that is accompanied by other factors, such as an itching sensation, rash, or white and clumpy semi solid materials. The discharge often has a foul odor, especially if it has a yellow/green or green/white color.
Almost every woman will experience some sort of vaginal infection at least once in her lifetime. This is because the delicate balance of healthy vaginal secretion is disturbed during menstruation, which happens every month. The vagina is least acidic during menstruation and this provides a window of opportunity for infections.
Apart from menstruation, plenty of other factors can also affect the balance. These include antibiotics, birth control pills, cervical cancer, diabetes, scented soaps, lotions, and even a bubble bath.
Normally, vaginal discharge is not a serious concern for a woman. However, because it could also indicate an infection, a woman should be able to differentiate between normal vaginal discharge and one that indicates an infection.
In most cases, a woman will be able to identify the type of infection just by checking the appearance of the vaginal discharge. If the discharge is cloudy or yellow, it is a strong indication of gonorrhea. If the discharge is frothy with a yellow or greenish color and is accompanied by a foul odor, it could mean trichomoniasis. If the discharge is thick, white, and cheesy, the woman is likely to have a yeast infection. If the discharge is white, gray, or yellow and has a fishy odor, this is an indication of bacterial vaginosis.
If a vaginal discharge contains blood or is brown in color, it is referred to as vaginal bleeding and is not considered as a vaginal discharge. It could be caused by irregular menstrual cycle or cervical or endometrial cancer.
Cause of Condition
Vaginal discharge infections usually occur when the vagina is least protected by normal acidity levels. There are a number of infections, including sexually transmitted diseases (STDs) that can result in an abnormal discharge.
Some of the most common STDs are trichomonas, gonorrhea, and chlamydia. Apart from these three STDs, a vaginal discharge infection could also be caused by bacterial vaginosis or a yeast infection.
The symptoms of vaginal discharge infections vary according to the type of infection. The most common symptoms are pain, itching while urinating, pain during intercourse, and swelling of the vagina.
If the infection is caused by gonorrhea, the symptoms will include bleeding between periods, pelvic pain, and urinary incontinence. A trichomoniasis infection will display symptoms such as pain and itching while urinating.
For non-STD infections, bacterial vaginosis displays symptoms such as itching and burning sensation of the vagina or vulva. If a woman has a yeast infection, she will likely experience pain during sexual intercourse, and itching and/or pain around the vulva.
Who to See & Types of Treatment Available
The first person to see for an abnormal vaginal discharge is the family doctor. However, if your doctor suspects that the discharge may be caused by cancer, you will be referred to a cancer specialist for further diagnosis and treatment.
Your doctor will review your medical history and perform a physical examination, which would include an examination of the external genital area, using a speculum to examine the cervix and vaginal walls.
Vaginal fluid samples will then be obtained and submitted to a laboratory for culture. This will help the doctor identify the precise infection and formulate a treatment plan. Treatment will depend on the type of infection. The goal of the treatment is to eliminate the symptoms and eradicate the infection.
Most vaginal discharge infections require prescription medications, except for yeast infections, which can be treated using over-the-counter drugs.
Medications will include antibiotics and anti-fungal drugs. These can be oral, injectible, or topical. Common medications include metronidazole, tinidazole, and clindamycin. For instance, when treating trichomonas, the medications used are usually metronidazole and tinidazole. When treating gonorrhea, doctors will prescribe ceftriaxone, cefixime, or other oral antibiotics. Chlamydia is treated with oral azithromycin or doxycycline.
It’s imperative that sexually transmitted diseases are treated promptly as they could progress into more severe infections, such as pelvic inflammatory disease. This can result in infertility, ectopic pregnancies, and other serious conditions.
It’s normal for a woman to try to avoid vaginal discharge infections. However, due to a wide variety of factors that could interrupt the balance of acidity in the vagina, prevention is mostly difficult or impossible. All a woman can do is to practice safe sex, avoid harsh soaps and scented products.
Some women may be tempted to practice alternative forms of treatment or prevention, such as douching. It’s important to understand that the vagina has a delicate environment and the body has its own natural way of protecting that environment. Douching will disturb that environment and make the vagina more prone to infections, which is why doctors do not recommend this procedure.
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Merritt DF. Vulvovaginitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 543.
Schrager SB, Paladine HL, Cadwallader K. Gynecology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.