Vaginal discharge is the appearance of a liquid or thick discharge of various colors from a woman’s genital tract, more often with an unpleasant odor. The symptom may be accompanied by intense itching of the vulva, the vestibule of the vagina, pain and discomfort in the lower abdomen, unpleasant sensations during sexual contacts. Vaginal discharge occurs with genital infections, diseases of the uterus and appendages, injuries of the genitals. To find out the cause of the discharge, a gynecological examination, bacteriological analysis of the discharge, instrumental methods are necessary. To eliminate the whites, therapy of the underlying disease is carried out.
Normally, women may have slight vaginal discharge without odor. A viscous mucous vaginal discharge, similar to egg white, is observed during ovulation. With pathological whites, the patient notices an increase in the amount of secretions, an atypical color of secretions. Yellowish or brown spots remain on underwear. With a large volume of discharge, the secret accumulates between the labia majora and labia minora, in the perineum area. The discharge may be with a sour, fishy, rotten smell.
Vaginal discharge is often combined with intense itching in the perineum and the vestibule of the vagina, irritations and rashes occur on the skin around the genitals. Sometimes they worry about pain in the lower abdomen. With abundant vaginal discharge, a woman is forced to use sanitary pads for critical days. Patients note psychological discomfort due to the sharply fetid smell of secretions. A change in the color and consistency of the vaginal discharge indicates pathology of the genital sphere or extragenital diseases, therefore, in such cases it is necessary to consult a doctor.
Vaginal discharge is divided into physiological, associated with the reaction of the epithelium of the reproductive organs to natural changes in the hormonal background, and pathological, caused by various diseases. In terms of density and consistency, the discharge from the vagina can be watery, thick and viscous, dense, curd, sometimes foamy discharge from the vagina is observed. For the diagnosis and the choice of medical tactics, the classification of secretions by color is important, according to which such types of whites are distinguished as:
- Transparent. The discharge is mucous, thick or very liquid, watery. Such odorless vaginal discharge occurs when excessive fluid is absorbed into the vagina due to changes in the normal microflora, fluctuations in the level of sex hormones.
- White. Thick curd or stringy discharge is observed with an increase in the secretion of the glands of the cervix and the vestibule of the vagina, which occurs against the background of genital pathology. Pathogenic microorganisms contribute to the formation of white discharge.
- Bloody. Vaginal discharge can be succulent, the color of “meat slops”, more often with a smell. Sometimes it is possible to secrete scarlet or dark red blood. The outflow of blood is associated with endometrial dysfunction, damage to the vaginal or cervical epithelium.
- Gray. Such secretions are the result of a violation of the vaginal microflora, which is accompanied by a decrease in the number of useful Doderlein sticks and the colonization of the vagina with pathogenic bacteria. The discharge is thick, fetid or with a fishy smell.
- Yellow. Such secretions are typical for infectious lesions of the reproductive system. The symptom develops due to an intense inflammatory reaction in the vagina, disruption of the glands of external secretion. Vaginal discharge can be either thick or watery, foamy.
- Purulent (yellow-green). Thick, often creamy vaginal discharge indicates bacterial infection. The characteristic color is caused by dead leukocytes. Copious discharge with a specific purulent odor occurs when the uterus, its appendages are affected, abscesses and cysts are opened.
Vaginal discharge is also classified by smell – in a number of patients, the discharge has a sour, putrid, fetid aroma. Quite often there are secretions with the smell of fish, sometimes the stench of rotten meat is felt. Taking into account the localization of the pathological process that caused vaginal discharge, they are divided into vestibular, vaginal, cervical (cervical). With secretions that form in the uterus and appendages, they talk about corporeal and tubal whites.
Causes of vaginal discharge
Causes of clear vaginal discharge
A meager watery or slimy (“like snot”) secret without fragrance is periodically formed in healthy women. Copious discharge with a sour smell indicates the presence of a disease. Transparent vaginal discharge causes such causes as:
- Physiological factors: exposure to estrogens in the first half of the menstrual cycle, puberty in girls.
- Allergic vulvitis and vaginitis.
- Helminthiasis: enterobiosis, ascariasis, schistosomiasis, etc.
Causes of white vaginal discharge
Thick curd-like discharge is characteristic of the vaginal and cervical localization of pathological changes. The combination of whites with intense perineal itching and soreness during sexual intercourse indicates an infectious process. White discharge from the vagina provokes:
- Physiological changes: the second half of the menstrual cycle, sexual intercourse, pregnancy period.
- Vaginal candidiasis.
- Genital tuberculosis.
- Rare reasons: the use of intrauterine devices, creams for contraception.
Causes of spotting from the vagina
The outflow of blood from the lumen of the vagina, not associated with recent injuries of the inguinal region, as a rule, indicates a serious organic disease. The main pathologies that cause spotting from the vagina are:
- Cervical lesions: erosions, polyps, malignant neoplasms.
- Tumors of the reproductive organs: fibroids, adenocarcinomas, vaginal cancer.
- Injuries of the genital tract: during rough sexual intercourse, due to exposure to foreign objects, with bruises of the pubic area and perineum.
- Taking oral contraceptives.
- Postpartum involution of the uterus.
Causes of gray vaginal discharge
Abundant grayish discharge from the genital cleft is associated with violations of the vaginal microflora as a result of genital infections or damage to other organs. Gray vaginal discharge is characteristic of conditions such as:
- Bacterial vaginosis.
- Inflammatory processes: colpitis, endocervicitis, atrophic vaginitis.
- Sexually transmitted infections: trichomoniasis and chlamydia at the initial stage.
- Rare causes: pathologies of the endocrine system (diabetes mellitus, hypothyroidism, chronic adrenal insufficiency), tuberculosis.
Causes of yellow vaginal discharge
A thick scanty light yellow secret is sometimes found in women a few days before the start of menstruation. Foamy yellow vaginal discharge, which is characterized by an unpleasant odor, is typical for the following diseases of the genitals:
- Infectious diseases: aerobic vaginitis, trichomoniasis, chlamydia.
- Inflammatory process: colpitis, salpingitis, adnexitis.
- Vesico-uterine fistulas.
Causes of purulent discharge from the vagina
With various inflammatory processes, from a few drops to several milliliters of thick, fetid pus can be released from the vagina, which is accompanied by sharp pains in the lower abdomen and fever. With purulent discharge from the vagina, there are:
- Complicated genital infections: gonorrhea, mycoplasmosis, ureaplasmosis.
- Pathologies of the external genitalia: bartholinitis, furuncles of the skin of the perineum.
- Diseases of the uterus, appendages: pyometra, pyosalpinx, postpartum endometritis.
In case of vaginal discharge with or without any unpleasant odor, a gynecologist’s consultation is indicated, during which the external and internal organs of the genital sphere are examined in detail using physical and instrumental methods. To clarify the cause of whites, various clinical and microbiological studies are performed, of which they differ in the greatest diagnostic value:
- Vaginal examination. Examination of the vagina and cervix in mirrors is the main diagnostic method, during which the amount and nature of the pathological discharge are assessed, inflammatory or atrophic changes of the epithelium are detected. The condition of the excretory ducts of the bartholinium glands and the mouth of the urethra is necessarily studied.
- Colposcopy. Visualization of the mucous membrane of the vaginal part of the cervix is necessary to exclude erosions, genital precancerous conditions and malignant neoplasms. During colposcopy, a sample with acetic acid and a Schiller sample are carried out. If necessary, the method is supplemented with cervicoscopy, and if uterine discharge is suspected, hysteroscopy.
- Ultrasound examination. Ultrasound of the pelvic organs is recommended if the discharge is accompanied by severe pain in the lower abdomen, intermenstrual bleeding. Sonography allows you to identify the causes of whites: neoplasms, cysts, inflammatory changes in the fallopian tubes and ovaries. To clarify the diagnosis, hysterography is sometimes prescribed.
- Bacteriological analysis of secretions. Discharge with a fetid odor often occurs with sexual infections, therefore, to detect them, a vaginal smear is taken on the microflora, a cultural study of whites is carried out. To quickly detect the most common pathogens, ELISA reactions and PCR diagnostics are used.
To exclude syphilis, the Wasserman reaction is carried out, according to the indications, tests are performed aimed at diagnosing tuberculosis. Clinical and biochemical blood tests help to determine the causes of the inflammatory process, with volumetric formations, the level of the main cancer markers is determined. For clarifying purposes, CT or MRI of the pelvic organs are used, in difficult cases, diagnostic laparoscopy is resorted to. With constant scanty odorless secretions, an endocrinologist’s consultation may be required.
Help before diagnosis
To reduce itching and other uncomfortable sensations, it is recommended to regularly carry out hygiene procedures, use pads. Local baths with antiseptic solutions and decoctions of medicinal herbs are effective, which are aimed at relieving the inflammatory process, reducing the number of pathogenic bacteria. With severe pain, analgesics from the NSAID group, antispasmodics are taken. With the appearance of fetid whites, secretions with a sour smell, bloody discharge from the vagina, it is urgently necessary to visit a doctor to determine the cause of the disorder.
The treatment regimen is selected individually after finding out the cause of the pain and assessing the condition of the patient’s reproductive system. The main one is etiopathogenetic therapy, supplemented by symptomatic means. Drug treatment is combined with local and physiotherapeutic methods. If the discharge with a noticeably unpleasant odor is caused by genital infections, simultaneous treatment of both sexual partners is desirable. The following groups of drugs are used in clinical practice:
- Antibacterial agents. In venereal diseases and other purulent genital pathology, properly selected antibiotics ensure the eradication of pathogenic microorganisms. Depending on the cause of the discharge, antiprotozoal, anthelmintic medications are sometimes prescribed.
- Antihistamines. Eliminate itching and discomfort in the perineum, quickly reduce the number of inflammatory mediators in the lesion. To enhance the effect, medications are usually combined with anti-inflammatory drugs that have an analgesic effect.
- Medications of local action. Vaginal candles with acidophilic lactobacilli are designed to restore normal microflora in the vagina. To eliminate the cause of secretions, odor, and other unpleasant symptoms, suspensions with tetracyclines, intravaginal candles with other antibiotics and antimycotics are used.
Accumulation of pus in the uterine cavity or fallopian tubes, suppuration of cysts, abscesses of the bartholinium glands are indications for sanitation and drainage of pathological foci. During the formation of fistulas, their excision and plastic surgery are performed to preserve the anatomical structure of the genital tract. In the case of benign neoplasms, it is necessary to exfoliate the tumor within healthy tissues, with a malignant process, ovariectomy, amputation of the uterus is usually recommended. For the treatment of endometriosis, the altered areas of tissue are removed, followed by cauterization.