Vaginal discharge is a natural physiological process aimed at protecting against infections, maintaining healthy vaginal microflora, and moisturizing the vaginal mucosa.
The amount of discharge, its color and consistency vary depending on age, hormonal status, phase of the menstrual cycle (for example, during ovulation), during pregnancy, and when taking oral contraceptives. Normally, the discharge is transparent, milky-white, watery, and odorless. During the postmenopausal period, the amount of discharge usually decreases, this is due to a decrease in estrogen production.
Depending on the cause, atypical discharge may be accompanied by itching and burning in the vagina, inflammation of the vaginal mucosa and external genitalia, pain during urination, discomfort and pain during intimacy, pain in the lower abdomen and pelvis, and fever.
Prices for services
Initial appointment with a gynecologist + ultrasound (assessment of complaints, medical history, examination in a gynecological chair, pelvic ultrasound, consultation)
Primary appointment – visiting a doctor of a specific specialty for the first time. Make an appointment
1680 ₽ 2400 ₽
Repeated appointment with the gynecologist
With the exception of repeated appointments with doctors: Blatsios N.D., Dzhashiashvili M.D. Make an appointment
1200 ₽
Ultrasound of the pelvis in women (uterine cavity, ovaries)
Make an appointment
1500 ₽
Prognosis and prevention
To completely cure vaginal candidiasis, it is necessary to both consult a doctor in a timely manner and follow all his recommendations. Antifungal drugs are sold in pharmacies without a prescription, but DIY in this case is not only ineffective, but also dangerous. Only a specialist can correctly select the necessary medications, determine the characteristics of their use, and also monitor the effect of the medications.
It is important to understand that it is much easier to prevent vaginal candidiasis than to treat it. To minimize the risk of developing the disease, you must adhere to the following rules:
- give preference to cotton underwear;
- stop using panty liners;
- use specialized products for genital hygiene;
- do not use douching without a doctor’s prescription;
- monitor the condition of the body, promptly treat pathologies of the genitourinary and digestive systems, endocrine glands;
- avoid casual sex and infection with sexually transmitted diseases;
- do not use antibiotics without a doctor’s prescription and do not change the dose and regimen without permission;
- if long-term antibiotic therapy is necessary, take antifungal agents.
Vaginal candidiasis is an unpleasant disease that can be prevented and, if necessary, quickly cured. The main thing is to consult a doctor in a timely manner and follow all his recommendations.
About normal discharge
Normally, a woman's vagina should release fluid. But not all discharge is normal. “Good” discharge includes clear, not abundant (from 50 mg per day), odorless mucus. Normal discharge does not cause discomfort, it does not cause itching, burning or irritation of the vagina. If you take a smear for microflora, it should reveal a normal number of leukocytes with a predominance of lactobacilli. Mucus discharge gradually increases in quantity until the day of ovulation (approximately 14 days after menstruation). During this period, the mucus changes its properties. The feeling of moisture in the external genital area at this time is absolutely normal.
But you need to be very careful about brown discharge! A brown, brownish tint to the liquid clearly indicates bloody or bloody additions to the mucus. And this, in turn, may indicate disorders of the female genital area. Further on such violations and their causes.
When secretion is normal
The secretion of a healthy woman is characterized by the following signs:
- its volume does not exceed five milliliters per day (one teaspoon);
- it should have a whitish, transparent or milky tint and a uniform texture;
- the structure of the secretion should be thick, viscous or mucous and have small compactions up to 4 mm;
- the discharge should not be accompanied by an odor;
- White discharge in women should not be accompanied by redness, itching or swelling.
If a woman's white, odorless discharge meets these criteria, then there is no need to worry. In addition, leucorrhoea may not be a pathological condition even in the case of natural causes that characterize the woman’s condition.
Endometritis
Brown discharge may be a sign of chronic endometritis - inflammation of the endometrium, the mucous membrane of the uterine cavity. Brown discharge with endometritis appears before and after menstruation and often has an unpleasant odor. Sometimes brown mucus appears in the middle of the cycle and is combined with aching pain in the lower abdomen. Chronic endometritis is dangerous during pregnancy; it can lead to miscarriages at different stages. This pathology is due to the fact that the process of attachment of the fertilized egg in the uterine cavity and its further development are disrupted.
Chronic endometritis can result from:
- acute postpartum or post-abortion endometritis that has not been completely cured;
- intrauterine interventions;
- imbalance between the body's hormonal and immune systems;
- hidden infections.
Diagnostics
The presence of a woman with copious white secretions coming from the vagina, especially with a noticeable sour odor, is an indication for visiting an obstetrician-gynecologist. A diagnostic search involves a comprehensive physical and instrumental examination of the genital tract to determine the cause that provoked the white discharge, as well as clarifying laboratory methods. The most informative ones are:
- Gynecological examination.
The technique is aimed at studying the condition of the mucous membrane of the reproductive organs; during the examination, areas of hyperemia or destruction of the epithelium, a dense cheesy coating surrounded by an inflammatory border are determined. The speculum examination is necessarily complemented by a digital vaginal examination. - Endoscopic methods
. Detailed visualization of the epithelium of the cervical mucosa during colposcopy makes it possible to detect erosions and other suspicious changes. To clarify the cause of the discharge, it is necessary to conduct a Schiller test and a vinegar test. If there is possible damage to the uterus, hysteroscopy is required. - Sonography
. Ultrasound of the pelvic organs is a standard non-invasive method that effectively detects signs of inflammation of the uterus and appendages, and large tumors. In doubtful cases, diagnostic laparoscopy may be prescribed. - Lab tests
. As a screening, an analysis of vaginal microflora and bacteriological culture of discharge is recommended. If there is a cheesy discharge with a distinct acidic odor, the smear is examined under a microscope to detect candida. If there is a probable tuberculosis infection, specific tests for mycobacteria are done.
A comprehensive gynecological examination includes determining the level of estrogen and progesterone in the blood on different days of the menstrual cycle. If there are difficulties in diagnosis, X-ray visualization of the internal organs of the reproductive system with contrast is performed - hysterosalpingography. According to indications, consultations with other specialized specialists are prescribed.
Endometriosis
Brown or bloody discharge are also the main symptoms of endometriosis of the cervix or uterine body. This does not necessarily cause pain. Endometriosis of the cervix is nodular, small cystic formations or growths in the form of red or purplish-blue stripes. Dark bloody and brown discharge may appear from individual lesions. Endometriosis of the uterine body is the growth of endometrial cells in the myometrium (the muscular layer of the uterus). Pathological discharge decreases in size after menstruation, and its color becomes lighter.
Make an appointment
Causes
Atypical discharge may be a symptom of the following diseases:
- thrush;
- vaginitis;
- bacterial vaginosis;
- pelvic inflammatory diseases (PID);
- cervicitis;
- trichomoniasis;
- gonorrhea;
- chlamydia;
- malignant neoplasms.
The appearance of pathological discharge may be associated with exposure to chemicals contained in detergents, fabric softeners, bleaches, intimate hygiene products, pads, and spermicides. In older women, these symptoms may cause urinary or bowel incontinence. Atypical vaginal discharge can also be caused by douching, using tampons not according to instructions (they need to be changed every 6-8 hours), and taking antibiotics.
Endometrial hyperplasia
Spotting, bloody, brown discharge at the end of the cycle before menstruation or for a long time after menstruation may indicate endometrial hyperplasia. The causes of hyperplasia can be of different nature. Most often, this pathology develops due to hormonal imbalances, as well as carbohydrate, lipid and other types of metabolism. An important role may be played by hereditary predisposition, the presence of uterine fibroids, cancer of the genital organs and breast, hypertension and other diseases, manifestations of damaging effects during the prenatal period of development, diseases during puberty and the disorders of menstrual and subsequently reproductive function caused by them. The appearance of hyperplasia in adulthood is often preceded by previous gynecological diseases, abortions, and genital surgeries.
Treatment for pathology
If we are talking about pathology, then therapy should begin after passing the following examination:
- blood and urine tests;
- taking a smear;
- conducting an ultrasound examination of the reproductive system organs.
A gynecologist will conduct a consultation, prescribe examinations and make a diagnosis. In some cases, you will need to visit an endocrinologist, urologist and other specialists. This is due to the fact that increased secretion can be triggered by disruptions in other systems of the human body. Therapy for odorless and itchy leucorrhoea consists of prescribing antifungal, antiviral or anti-inflammatory drugs. The type of remedy depends on the cause of the pathology. You will also need antibiotics and drugs that restore normal vaginal microflora.
Bibliography
- Gynecology textbook. IV edition ed. Academician of the Russian Academy of Medical Sciences, Professor G.M. Savelyeva; prof. V.G. Breusenko 2012
- Urogenital candidiasis. Clinical recommendations. Moscow, 2016 – 22 p.
- Vulvovaginal candidiasis: pathogenesis, diagnosis and treatment tactics. Bayramova G.R., Amirkhanyan A.S., Chernova V.F. //Doctor.Ru 2018. No. 10 (154). pp. 32-36
- Sherry L., Kean R., McKloud E., O'Donnell LE, Metcalfe R., Jones BL et al. Biofilms formed by isolates from recurrent vulvovaginal candidiasis patients are heterogeneous and insensitive to fluconazole. Antimicrob. Agents. Chemother. 2017; 61(9): e01065-17
- Prilepskaya V.N. Vulvovaginal candidiasis. Clinic, diagnosis, principles of therapy: manual / V.N. Prilepskaya, G.R. Bayramova - M 2008 - 50s
- Atlas of pathogens of fungal infections/E.N. Moskvitina and others - Moscow GEOTAR-Media, 2022 208p
- Zordan R., Cormack B. Adgesis on opportunistic fungal pathogens In: Calderone RA, Clancy CJ, ed Candada and candidiasis/ Washington: ASM press; 2012: 243-259)
- Zhang Y., Li W., Chu M., Chen H., Yu H., Fang C. et al. The AAA AT Pase Vps4 plays important roles in Candida albicans hyphal formation and is inhibited by DBeQ. Mycopathology 2016; (5-6) 329-39
- Murciano C., Moyes DL, Runglall M., Yobouti P., Islam A., Hoyer LL et al. Evaluation of the role of Candida albicans agglutinin-like sequence (Als) proteins in human oral epithelial cell interactions. Plos one 2012.
- Center for Disease Control (CDC) Sexually Transmitted Disease Treatment Guidelines, 2015.
- Donders GG, Bellen G., Mendling W. Management of recurrent vulvovaginal candidosis as a chronic illness. Gynecol. Obstet. Invest 2010 70(4):306-21
- Ankirskaya A.S. Muravyova V.V. Microbiological characteristics of vaginal infections caused by fungi of the genus Candida // sexually transmitted diseases 2001. pp. 12-14
- Eschenbach DA Chronic vulvovaginal candidosis N Engl. J Med 2004; 351(9)
- Tikhomirov A.L. Oleinik Ch.G. Optimization of treatment of recurrent vulvovaginal candidiasis // effective therapy in obstetrics and gynecology. 2007 No. 3 from 22-27
- Bayramova G.R. Recurrent vaginal candidiasis. Clinic, diagnosis, treatment. dis. Doctor of Medical Sciences M. 2013 (46s)
- Prilepskaya V.N. Bayramova G.R. Vulvovaginal candidiasis, modern ways to solve the problem. Difficult patient 2006 (from 33-36)
Classification
Vaginal discharge is divided into physiological, associated with the reaction of the epithelium of the reproductive organs to natural changes in hormonal levels, and pathological, caused by various diseases. In terms of thickness and consistency, vaginal discharge can be watery, thick and viscous, dense, cheesy, and sometimes foamy leucorrhoea is observed. To make a diagnosis and choose a medical tactic, it is important to classify discharge by color, according to which the following types of leucorrhoea are distinguished:
- Transparent.
The discharge is mucous, thick or very thin, watery. Such odorless leucorrhoea appears when there are disturbances in the absorption of excess fluid into the vagina, which is caused by changes in the normal microflora and fluctuations in the level of sex hormones. - White.
Thick, curdled or viscous 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 leucorrhoea can be ichorous, the color of “meat slop”, often with a smell. Sometimes scarlet or dark red blood may be discharged. Bleeding is associated with endometrial dysfunction, damage to the vaginal or cervical epithelium. - Gray.
Such leucorrhoea is the result of a disturbance in the vaginal microflora, which is accompanied by a decrease in the number of beneficial Doderlein bacilli and the colonization of the vagina by pathogenic bacteria. The discharge is thick, foul-smelling, or has a fishy odor. - Yellow.
Such discharge is typical for infectious lesions of the reproductive system. The symptom develops as a result of an intense inflammatory reaction in the vagina, disruption of the exocrine glands. Leucorrhoea can be either thick or watery and foamy. - Purulent (yellow-green
). Thick, often creamy vaginal discharge indicates a bacterial infection. The characteristic color is due to dead leukocytes. Abundant leucorrhoea with a specific purulent odor occurs when the uterus, its appendages are damaged, abscesses and cysts are opened.
Vaginal discharge is also classified by smell - in a number of patients, leucorrhoea has a sour, putrid, fetid aroma. Quite often there is a discharge with the smell of fish, sometimes the stench of rotten meat is felt. Taking into account the localization of the pathological process that caused leucorrhoea, they are divided into vestibular, vaginal, and cervical (cervical). With discharge that forms in the uterus and appendages, they speak of corporal and tubal leucorrhoea.
