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Female doctor in Durban

Dr H Ganesen( MBCHB, MMed Fam Med) 

Vaginal discharges

Vaginal Discharges

  • Vaginitis is the term for disorders of the vagina caused by infection, inflammation or change in normal flora.
  • Symptoms of vaginitis include: vaginal discharge, odour, itchiness or discomfort.
  • In premenopausal women the skin on the inside of the vagina (epithelium) sloughs frequently.  This releases glycogen rich cells into the vagina. The glycogen is converted to lactic acid by the normal vaginal bacteria called doderlein’s lactobaciili. This makes the vagina acidic.  This acidic environment helps to maintain the normal vaginal flora and prevents the growth of other organisms.
  • Vaginal infections occur when this normal lactobacilli is depleted, the ph of the vagina then increases (becomes more alkaline) and there is an overgrowth of normal and pathogenic flora.
  • Common causes for vaginal discharges
    • Antibiotic or steroid use
    • Bacterial vaginosis, a bacterial infection more common in pregnant women or women who have multiple sexual partners
    • Birth control pills
    • Cervical cancer
    • Chlamydia or gonorrhea (STDs), sexually transmitted infections
    • Diabetes
    • Douches ( washing out the vagina), scented soaps or lotions, bubble bath
    • Pelvic infection after surgery
    • Pelvic inflammatory disease (PID)
    • Trichomoniasis, a parasitic infection typically contracted and caused by having unprotected sex
    • Vaginal atrophy, the thinning and drying out of the vaginal walls during menopause
    • Vaginitis, irritation in or around the vagina
    • Yeast infections.
  • Tips for preventing vaginal infections that can lead to abnormal discharge:
    • Keep the vagina clean by washing regularly with a gentle, mild soap and warm water.
    • Never use scented soaps and feminine products or douche. Also avoid feminine sprays and bubble baths.
    • After going to the bathroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection.
    • Wear 100% cotton underpants, and avoid overly tight clothing.

Infective causes of Vaginitis

  • The most common cause of vaginal discharges in adults are: Bacterial vaginosis, Candida Vulvovaginits and Trichomoniasis

 

 

  1. Bacterial Vaginosis ( BV)
  • BV occurs when there is an overgrowth of vaginal flora and simultaneous loss of lactobacilli.
  • A number of anaerobic organisms are responsible for BV, with the predominant organism being Gardnerella vaginalis.
  • It can occur in both sexually active and sexually inactive women.
  • Most women with the infection do not have any symptoms.
  • The discharge is usually a pale gray, has a distinct fishy odour and there may be associated itchiness of the vagina.
  • Treatment: see you doctor to determine if it is BV and for prescribed medication.
  •  
  1.  Candida Vulvovaginitis ( Thrush)
  • This is not a sexually transmitted disease.
  • The most common organism is Candida Albicans which normally resides in the gut.  If the normal flora of the vagina is disturbed, your immunity is decreased or there are tears in the vaginal skin, candida can then cause an opportunistic infection in the vagina. A small group of infections may be caused by Candida glabrata.
  • The infection is common in diabetic patients.
  • It also occurs frequently during hormonal changes in a female’s life (pregnancy, high levels of oestrogen).
  • There is usually itchiness of the vulva, pain when passing urine and a white thick curd like discharge with minimal odour. The discharge may not always be present.
  • Treatment: There are topical creams, vaginal tablets and oral tablets that can be used to treat the infection.
  •  
  1. Trichomoniasis
  • This infection is caused by a parasite.
  • Most females with the infection have no symptoms.
  • The discharge is usually a yellow frothy discharge which may have an offensive odour.
  • Treatment: Oral medication is prescribed by a doctor.

Non infectious causes of vaginitis

Allergic contact dermatitis

  • This is associated with the use of feminine hygiene products or contraceptive materials.

Atrophic vaginitis 

  • This commonly occurs in association with oestrogen deficiency eg: menopause.
  • Symptoms: vaginal dryness, itching, discharge, irritation and pain during intercourse.