Gynecology And Obstetrics-

Vaginal discharge

definition

Discharge from the vagina occurs in every woman and is a natural and usually harmless process that serves vaginal cleaning, renewal and moistening processes. In addition, the natural discharge fulfills protective functions to protect the vagina from pathogens.

The liquid is usually clear to milky-white and almost odorless. Also an easy one sexternal, yogurt-like odor is to be regarded as harmless.

The color, smell, consistency and also the frequency and amount of discharge can change due to the influence of drugs, but also due to pathological processes, such as infections of the vagina. In particular with inflammatory processes, accompanying symptoms such as burning or itching sensation in the vagina can occur. Even if the issue of vaginal discharge is embarrassing for many patients, a gynecological consultation should be carried out in the event of changes or abnormalities.

Causes of vaginal discharge

A harmless and natural cause of vaginal discharge is the female hormone balance. The amount and nature of the secretion are subject to typical fluctuations during the monthly cycle.

Around the time of ovulation and shortly before the start of your period, secretion is increased under the influence of estrogen.
Towards the middle of the cycle, a rather thin and clear discharge occurs.
Around the period of menstruation, the fluid may be thicker and appear milky.
Sexual arousal, stressful situations, taking the pill, and pregnancy can also increase the amount of discharge.
In addition, vaginal renewal processes are responsible for secretion production, as the discharge contains dead cells from the vagina and cervical mucus. The patient became a so-called intrauterine device if a coil is used, for example, the glands on the cervix can react with increased mucus production due to the permanent stimulus of foreign bodies.
Bacterial, parasitic, and viral vaginal infections or the influence of yeasts are other possible causes of vaginal discharge, with fungal infections and bacteria being particularly common.
In rare cases, tumor diseases of the female genital organs can also be responsible for increased or changed secretion production.

Read about it too: Diseases of the vagina

Concomitant symptoms

Depending on the cause of the discharge, accompanying symptoms may or may not be absent. In particular, the naturally occurring discharge has no disease value, which is why there are usually no further complaints.
However, the absence of accompanying symptoms is not always a guide for a healthy intimate area. Some pathogens, for example chlamydia, can go completely unnoticed despite infection. If the discharge is inflammatory, it often goes with it itch and Burn of the genital area. Pain in the external and internal genital organs can also be the case, with abdominal pain in particular in infections that have already risen.

Further information: Vaginal infections

Burn

If the vaginal discharge is associated with a burning sensation in the vagina and the external genitals, it is often an infection of the vagina, a so-called infection Vaginosis. The stinging is caused by some bacterial pathogens or by yeasts, in particular Candida albicans, triggered.

These bring the natural vaginal flora out of balance, which reduces its protective function. This makes the intimate mucous membrane more susceptible to micro-injuries, which are further stressed by contact with acidic urine or mechanical irritation, for example when walking. This can cause the burning sensation.

In addition to burning, infections can also be accompanied by itching, reddening of the labia and changed color and consistency of the discharge.

Read more about this:

Vaginal fungus
Burning vagina - these are the causes

itching

If vaginal discharge is accompanied by increased itching of the genital area, an infection of the female genital organs is often the cause.
Bacterial pathogens or yeasts usually play a role, with the latter often having more pronounced symptoms. Often the itching is accompanied by other symptoms that make the diagnosis of a Vaginosis make it more likely. These include the reddening of the vagina and the labia, a changed color and consistency of the discharge and, especially in the case of bacterial infections, a fish-like odor of the secretion.

Find out more here: The bacterial vaginosis

Pain

Increased or changed vaginal discharge in connection with pain can be an expression of inflammatory processes in the female reproductive organs. If the pain is burning in the area of the labia and vaginal mucosa, the inflammation has often not progressed far and is limited to the vulva and vagina.

However, inflammation can also rise and affect the internal genital organs. Inflammation of the cervix, uterus, fallopian tubes and ovaries can then occur. Such inflammations are often accompanied by more severe pain, which mainly occurs in the lower abdomen.

Fever and a general feeling of illness also often occur in such cases. In many cases, ascending inflammation is caused by gonococci or chlamydia. In rare cases, discharge, especially if it appears reddish to brownish, in connection with pain, can be an expression of a tumor disease of the genital organs. A gynecologist evaluation is warmly recommended.

You might also be interested in: Pain at the entrance to the vagina

Changes in discharge

Yellowish discharge

Vaginal discharge can take on a yellowish color, especially due to bacterial infections of the female genital organs. The yellow can either be very light or, for example, from a trichomonas infection appear yellow-greenish. The yellowish color can be caused by purulent admixture of the vaginal discharge. This means that the immune system has already been switched on and white blood cells, the so-called leukocytes, intervene in what is happening.

The sexually transmitted disease gonorrhea can also lead to a purulent-yellow discharge, whereby completely asymptomatic courses are possible. In addition to the change in color of the discharge, itching, burning sensation when urinating and redness of the labia harden the suspicion of an inflammatory cause. A fish-like odor can also occur in bacterial vaginal infections.

Whitish discharge

A change in the color of the discharge can be an indication of a pathological process. Especially yeasts, above all Candida albicans, can cause fungal infections of the vagina with white discharge and a crumbly or crumbly consistency. A whitish-yellow color of the discharge reminiscent of buttermilk is also possible. In addition, whitish coatings on the labia can occur in the course of a candida infection.

Other possible symptoms of a yeast infection are burning, severe itching, and reddening of the genital area. Bacteria can also cause whitish discharge that can sometimes appear gray. A fishy odor from the discharge is characteristic of many bacterial vaginal infections.

If the discharge is milky-white and viscous, it can individually be a normal condition. This is particularly the case if this change occurs shortly before or after the period and is subject to cyclical fluctuations.

Brownish discharge

Discharge that appears brown or brownish-red may indicate blood in the discharge. This need not be a cause for concern in every case. For example, if you have a discharge immediately after your period, old-blooded remnants may be added, which may be responsible for the brownish color. The discharge can also appear reddish to brown in the context of light intermenstrual bleeding or spotting caused by hormonal fluctuations or taking the birth control pill.

A clarification with a gynecologist can be useful, since, in addition to numerous other reasons, hormone doses that are too low can lead to inadequate pregnancy protection and intermenstrual bleeding.

A forgotten tampon can also cause it to turn brown. Small superficial injuries to the vaginal mucous membrane are also possible through sexual intercourse, which can bleed easily and affect the discharge.

In addition to benign changes such as polyps or myomas, tumors of the genital organs can also lead to blood in the discharge. Therefore, women after menopause in particular should see a gynecologist if they have a brownish discharge. A so-called portioectopy, a tissue change in the external cervix, can also lead to blood in the discharge.

Greenish discharge

A greenish coloration of the vaginal discharge is often an indication of a bacterial infection. Gonococci For example, the causative agent of the sexually transmitted disease gonorrhea, often referred to as gonorrhea, can cause green discharge.

Also trichomonads cause sexually transmitted diseases and can lead to a greenish-yellow discharge. This often appears frothy and gives off an unpleasant odor. Other bacteria can also be considered if the discharge is green. In addition to the color change, severe itching and reddening of the genital area as well as pain when urinating often occur as part of inflammatory processes.

Fishy smell

Does the vaginal discharge take a fishy, unpleasant odor, in most cases it is a bacterial inflammation.
In the context of an imbalance in the vaginal flora, pathogenic germs multiply. These metabolize proteins, which leads to the formation of amines and thus the characteristic fish-like odor develops. Often, as part of bacterial infections, there is also a change in the color of the discharge, as well as burning, itching and reddening of the intimate area.

Sour or vinegar odor

Normal discharge is usually odorless, but it can also smell slightly acidic. The vaginal pH environment is naturally acidic.
This condition is mainly due to Lactic acid bacteria, so-called Döderlein bacteriacaused. The acidic pH value and the colonization of the vagina with the named bacteria are used to ward off possible pathogens and impair their reproduction. Due to the lactic acid bacteria, the smell is described as sour and sometimes as yoghurt-like. The odor intensity and quality can fluctuate and is subject to numerous influences.

diagnosis

As part of the diagnosis, the doctor first gets an overview of the prevailing symptoms by asking the patient a few questions. The amount, the nature and the beginning of the discharge are discussed. Usually after possible accompanying complaints like Burn, itch or changed odor the intimate zone asked. Depending on the answers given, additional, more detailed questions may be necessary.

This is followed by the gynecological examination. The external genital organs are first observed and examined for visible changes. The vagina and cervix can be opened with the help of instruments such as the Specula and possibly via a so-called Colposcope can be viewed.

If the patient reports brownish or reddish discharge and changes in the cervix have been found, a tissue sample can be taken and examined for possible cervical cancer. During the examination, the mucus in the vagina can be examined for its amount, consistency and smell. If necessary, a sample can be taken, which is further examined by laboratory medicine and microscopically. In this way, possible pathogens can be recorded. Determining the vaginal pH value can also be useful in some cases.

treatment

Not every discharge requires therapy. For example, increased secretion formation during pregnancy is normal and is usually not treated. The treatment of altered or increased discharge as a symptom of a disease depends on the cause of the disease.

Antibiotics are used for bacterial inflammation of the external or internal genital organs. The active ingredient used depends on the pathogen to be controlled, which must be determined in advance in order to achieve optimal results. Depending on the accompanying symptoms, other medications can be used, for example the use of febrile drugs at elevated temperatures.

If the changed discharge is a symptom of a yeast disease, antifungal agents, so-called antimycotics, are used. As with antibiotics, these can be administered in the form of suppositories, as a cream or a combination of both for external inflammation.

However, if the inflammation has increased, for example of the ovaries, this usually has to be treated with medication taken orally or administered intravenously.

If the vagina is infected, it may be necessary to co-treat the partner in order to avoid re-infection through subsequent sexual intercourse. After antibiotic treatment, a lactic acid cure can be useful to rebuild the vaginal flora.

In the case of polyps or fibroids, removing them can reduce the discharge.

If malignant tumor diseases were detected in the course of the discharge diagnosis, these are treated by surgery, chemotherapy and / or radiation, depending on the type of tumor and cancer stage.

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Duration of discharge

The duration of the discharge depends on the cause of the increased or changed secretion production. As a result of natural hormonal influences, the changed discharge usually only lasts a few days, depending on how long the individual monthly cycle is.

Symptoms that are caused by an infection often last as long as the fungus or bacterial pathogen can act. Timely drug treatment is therefore recommended in order to prevent complications such as infertility caused by a chlamydial infection.

The duration of the discharge, which is caused by tumor diseases, is very variable. Secretion production can return to normal, but this does not make the underlying disease less dangerous. Therefore, a medical examination and treatment is strongly recommended.