Understanding Vaginal Discharge: Causes, Diagnosis, and Management

Introduction

Vaginal discharge is a common physiological process that promotes vaginal health and guards against infections by removing dead cells and bacteria. While normal discharge varies in consistency and volume throughout the menstrual cycle, abnormal discharge could indicate infections or other medical conditions. The causes, diagnostic approach, and management of vaginal discharge are discussed below.

Types of Vaginal Discharge

There are normal (physiological) vaginal discharges and abnormal vaginal discharges. The former is usually clear to white, odorless, and varies with hormonal changes and increases during ovulation, pregnancy, and sexual arousal (Rao and Mahmood, 2019).

The latter, on the other end, varies in colour, consistency, and smell indicating possible infection, for instances mucopurulent (yellow, pus-like) discharges are common in gonorrhea or chlamydia infections, yellow-green, frothy, foul-smelling discharges are indicative of Trichomoniasis, and grayish-white, fishy-odored discharges are associated with bacterial vaginosis (BV) (Hay, 2018; Ibid., 2019; Sim, Logan and Goh, 2020).

Causes of Vaginal Discharge

Non-infectious causes of vaginal discharge include hormonal changes due to oral contraceptives, menopause, or pregnancy; allergic reactions to hygiene products, soaps, or spermicides; foreign bodies, such as contraceptive devices or retained tampon; and vaginal atrophy in postmenopausal women (McCathie, 2006).

Infectious causes include bacterial vaginosis (BV), an overgrowth of harmful bacteria, often linked to douching and multiple sexual partners; Pelvic Inflammatory Disease (PID), an infection of the female reproductive organs, often due to untreated STIs, candidiasis (Yeast infection), caused by Candida species, commonly associated with antibiotic use, diabetes, and pregnancy; Trichomoniasis, a sexually transmitted infection (STI) caused by Trichomonas vaginalis; and Gonorrhea and Chlamydia, STIs caused by Neisseria gonorrhoeae and Chlamydia trachomatis, respectively (Khan et al., 2009).

Diagnosis and Evaluation

Some of the factors considered in diagnosis and evaluation are the patient history, which includes onset, duration, and characteristics of the discharge; associated symptoms, e.g., itching, burning, pelvic pain, dysuria, or fever; sexual history, contraceptive use, and hygiene practices (Rice et al., 2016).

In addition to considering patient history, physical examinations, such as external genital examination, speculum examination, and bimanual examination, can be carried out; as well as laboratory tests, such as pap smear, STI testing, gram stain and culture, wet mount microscopy, and vaginal pH testing (Ibid., 2020).

Preventative Measures, Management, and Treatment

Some of the ways to generally prevent abnormal vaginal discharges include practicing safe sex, using barrier protection and limit multiple sexual partners; maintaining proper hygiene, avoiding harsh soaps and douching; having regular gynecological check-ups, which helps with early detection of infections and other abnormalities; having a healthy diet and lifestyle, which refers to a balanced diet and hydration can support vaginal health (Ibid., 2006; Ibid., 2020).

Management and treatment of abnormal discharge involves treatment and preventative measures associated with the underlying infections, some of these are Bacterial Vaginosis, whose treatment includes the use of prescribed oral or vaginal antibiotic medication, and can be prevented by avoiding douching and unnecessary antibiotic use; candidiasis, whose treatment includes the use of antifungal medication or creams, and can be prevented by wearing breathable underwear and avoiding excessive moisture; Trichomoniasis, whose treatment includes the use of bactericidal antibiotic medication (both partners should be treated), and can be prevented by practicing safe sex and routine STI screening; and STI-related discharge (gonorrhea/chlamydia), whose treatment includes the use of antibiotic medication, and can be prevented by regular screenings, condom use, and partner treatment (Ibid., 2006; Ibid., 2020; Richardson & Robinson, 2022).

Conclusion

Vaginal discharge is a natural physiological process, it can also be a sign of infections or other illnesses. Early diagnosis and effective treatment are facilitated by knowledge of the traits of normal and abnormal discharge. In order to guarantee prompt treatment and avoid complications, women who experience persistent, unusual, or symptomatic discharge should seek medical evaluation.

References

Hay, P. (2018). Vaginal discharge. Medicine, 46(6), 319–324.

Khan, S., Amir, F., Altaf, S., & Tanveer, R. (2009). Evaluation of Common Organisms Causing Vaginal Discharge. J Ayub Med Coll Abbottabad, 21(2).

McCathie, R. (2006). Vaginal discharge: common causes and management. Current Obstetrics & Gynaecology, 16(4), 211–217.

Rao, V. L., & Mahmood, T. (2019). Vaginal discharge. Obstetrics, Gynaecology & Reproductive Medicine, 30(1).

Rice, A., ElWerdany, M., Hadoura, E., & Mahmood, T. (2016). Vaginal discharge. Obstetrics, Gynaecology & Reproductive Medicine, 26(11), 317–323.

Richardson, A., & Robinson, A. J. (2022). Vaginal discharge. Medicine, 50(5), 254–258.

Sim, M., Logan, S., & Goh, L. (2020). Vaginal discharge: evaluation and management in primary care. Singapore Medical Journal, 61(6), 297–301.

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