Vaginal discharge is a clear or whitish fluid that is released from the vagina. The fluid may be produced from the vagina, cervix or uterus and be finally discharged through the vaginal orifice. One must understand that some amount of vaginal discharge is common in all women. Not all discharge suggests an infection. Many women have some amount of discharge daily; some have it during particular periods of the menstrual cycle. The amount of discharge varies in every woman. A normal vagina is free from all infection. Thus a clear, non offensive, colourless discharge is normal in women. It is a normal way for the body to discard fluid and old cells of the mucosal lining of vagina and the cervix. Only if there is a change in the amount, smell, texture or colour, must be investigated. In some cases women may complain of excessive itching or discomfort around the vaginal orifice which is suggestive of an infection.
The vagina contains normal flora – lactobacillus which provides the vagina with an acidic pH which prevents growth of pathogenic bacteria. Also the mere presence of normal vaginal flora protects the vagina from invasion of pathogenic bacteria. Hence douching must be avoided in all cases, as it may itself cause vaginal infection or may alter the vaginal flora and make it favourable to the growth of pathogenic bacteria.
Symptoms of vaginal infections and treatment of thick white vaginal discharge: Following symptoms may be the sign of a vaginal infection: excessive itching, offensive odour of the discharge, and change in colour – green, yellow or gray in colour, frothy or foamy texture of the discharge. Candidiasis of the vagina causes thick curdy vaginal discharge, with white patches adherent to the vagina and severe pruritis vulvae. It is a common infection in diabetics and pregnant women. It grows well with a high amount of carbohydrate which is available in women suffering from diabetes. It is treated with antifungal medication and an antifungal vaginal pessary. Trichomoniasis causes a greenish thick discharge with pruritis. It produces a condition in which the cervix looks like a strawberry. This vaginal infection and discharge is diagnosed by a wet film preparation of the vaginal discharge and examination under a microscope. Gram staining and culture of the discharge too may help in isolating the organism. Treatment includes administration of Metronidazole 200 mg orally three times a day for 7 days. It must be given to both the partners. The partners must be advised to avoid sexual intercourse or use a barrier contraceptive until the treatment is over.
Bacterial vaginosis causes white discharge which has a fishy odour. Chlamydia may be asymptomatic but the infection may spread to the pelvis and cause pelvic inflammatory disease. Gonorrhoea causes pelvic inflammatory disease and pelvic pain.
Women prone to vaginal infections are as follows: Unprotected sexual intercourse makes the woman prone to develop an infection in cases where the partner has been carrying the infection. The woman may suffer from trichomoniasis, gonorrhoea, Chlamydia infections from unprotected sexual intercourse. Also a woman having multiple sexual partners becomes vulnerable to vaginal infections and vaginal discharge due to the infection. Those suffering from diabetes are excessively prone to develop vaginal candidiasis. Immunosuppressed women too have a higher chance of suffering from infections. Those on prolonged antibiotic treatment and on birth control pills.
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