Vaginal Discharge

What is vaginal discharge?

• Drawing of the female abdomen
• Vaginal discharge is the same as mucus or fluid (secretions), which is secreted from the vagina
• It is normal that there is discharge from the vagina
• The normal vaginal discharge is slimy, milk-white or clear. Once the general discharge comes into contact with oxygen in the air, it will be colored yellowish
• Usually smells discharge not uncomfortable, and normal vaginal discharge does not often give itching

Occurrence

• The sheath is kept moist due to the formation of mucus, and it is this mucus, which shows up as vaginal discharge. The amount of secretions in the vagina may vary from one woman to another and thus the amount of discharge can also vary
• The amount and appearance of udflådet varies during the menstrual cycle. Normally udflådet more thin and clear around the time of ovulation. This variation does not occur in women who take the pill
• The amount of secretions in the vagina is also affected by other factors, for example, is formed more secretions in the vagina during sexual arousal
• The amount of discharge depends, among other woman’s hormones, and generally younger women more discharge than older. During pregnancy are also formed more discharge
• It usually occurs many different bacteria in the vagina. In most dominating lactic acid bacteria, and these make sure to maintain a healthy balance in the vagina. The lactic acid results in that the sheath has an acidic environment (low pH), and an acid environment inhibits the growth of pathogenic bacteria
• The vagina is self-cleaning, and the sheath should not be washed or rinsed, since the environment can be changed hereby
• For abnormal amounts of vaginal discharge or foul-smelling vaginal discharge, there is a risk that there is an inflammation
• In some situations, an increased amount of discharge go by itself

What can be the reason?

Common causes

• bacterial vaginosis
  • Due to a change in the microbial community of the vagina, wherein the lactic acid bacteria is replaced by a mixed flora of bacteria
  • Is the leading cause of bothersome vaginal discharge
  • Half of the women who have vaginosis have no symptoms, while others can feel the sudden appearance of gray, watery, frothy discharge in moderate amount
  • The bacterial vaginosis is often accompanied by a characteristic fishy smell. The smell is especially evident after sexual intercourse. This is because the semen is alkaline, and when the basic seed is mixed with the organisms present at vaginosis, the odor compounds released
  • Bacterial vaginosis is not considered a sexually transmitted disease, but as a sexually associated disease
  • Drug therapy with metronidazole tablets or suppositories in the vagina or rectum is rapidly and effectively
• Fungal infection (Candida)
  • Is a frequent condition
  • Characterized by white, thick discharge with a consistency like cottage cheese, often only a small amount of vaginal discharge
  • Is accompanied an irritation, burning, itching, and redness around the vagina and possibly burning on urination
  • At between 10 and 25% of healthy women can be detected fungus in the vagina, and it must be processed only if there are genes
  • States where there are high concentrations of sex hormones that predispose to fungal infections (for example, in young people, in COC users, in pregnancy), diabetes predisposes also to fungal infection
  • Not considered a contagious disease and partner must not be treated
  • Can be treated with antifungal drugs over the counter (creams, suppositories). In some cases, the prescription medication (tablets or agents to the vagina) necessary
  • For recurring fungal infections are advised to avoid tampons
  • In cases where there are a fungal infection every month after menstruation, a preventive treatment may be indicated
• Trikomonasvaginit
  • Sexually transmitted disease
  • Yellow-green, watery, frothy discharge in large quantities. Accompanied by tenderness
  • The mucosa is irritated, swollen and stinging
  • Due to infection with a flagellate (Trichomonas), a small organism with a moveable tail
  • Treated with metronidazole
  • Is today infrequent
• chlamydia Infection
  • Is the most common sexually transmitted bacterial disease
  • Infection with chlamydia can give puslignende vaginal discharge without a special smell
  • Most of chlamydia (80%) have no symptoms
  • Between 5 and 10% of sexually active women under 24 have Chlamydia infection
  • Chlamydia infection can spread and cause pelvic inflammatory disease
  • Chlamydia detected by grafting to the doctor
  • Chlamydia infection is treated with antibiotics – also partner be treated
• Inflammation of the cervix
  • Due to different types of infection – chlamydia. trichomonas, Possibly. gonorrhea (rare), herpes or genital mycoplasma
  • There are increased vaginal discharge, which can sometimes be bloody
• Pelvic inflammatory disease (salpingitis)
  • Most common among sexually active young women
  • Often insidious onset, nagging pain or tenderness at the bottom of the stomach, increased vaginal discharge, bleeding disorders, fever
• endometritis
  • Caused by an inflammation of the lining of the uterus
  • Can occur in the wound surface of the uterus by curettage, miscarriage, birth and after setting up the spiral

Rarer causes

• Foreign bodies in the vagina
  • Forgotten tampon or foreign body in the vagina
  • Usually accompanied by strong smelling vaginal discharge
• Age-related changes (atrophic kolpit)
  • Vulnerable mucous membranes due to estrogen deficiency is seen especially after menopause
• Cancer of the uterus
  • As a rule, women over 50, usually after menopause
  • Turns out typically by small bleedings without accompanying pain
• Cancer of the cervix
  • As a rule, women aged 40-60 years
  • Symptoms are initially few and often atypical: bleeding during intercourse and bleeding with exertion, irregular bleeding, striking discharge
  • In the majority of cases (199 of 200) due to bleeding associated with intercourse benign lesions not cancer, but the symptoms by, you should check with your doctor
  • If you have followed the normal smearprogram with cell samples every 3 years, it is unlikely to bleeding during sexual intercourse due to cancer

• General advice on pelvic hygiene:
  • The vagina is self cleaning
  • The external genitalia is washed once a day with mild soap or a special agent for abdominal hygiene
  • Wash cloths should be used only once
• Women with frequent fungal infections are advised not to use tight clothing or underwear made of synthetic materials. Recommended cotton underwear, which can be washed at high temperature
• Treatment partner is at more of the infections are important in order to prevent re-infection

• If you suspect to be infected with a venereal disease
  • A sexually transmitted disease like chlamydia can spread and cause pelvic inflammatory disease
  • Venereal disease is contagious and can be transferred to other
  • Do you have a venereal disease your partner must be examined and treated, otherwise rubs In other or each other again
• By bothersome vaginal discharge, especially if there is a sudden change in your vaginal discharge
• If you have so much discharge, it is necessary to use volume outside menstruation time
• If the discharge is accompanied by slight smell, itching or stinging

• In acute severe pain and discomfort, and if there is excessive bleeding

What does the doctor do?

Medical history

What the doctor will want to know:

• How long have you had the genes?
• How is udflådet?
  • The color, smell, amount?
  • Is there a link with the menstrual cycle?
• Is there a burning or itching?
• Do you have pain?
• Have you had a sexually transmitted disease / illnesses?
• Do you have multiple partners, a new partner?
• Have partner symptoms such as irritation or discharge from the penis?
• Do you use chemical means or another in the vagina?
  • Spermicide, washes, soaps, suppositories?
  • Diaphragm?
  • Tampon?
• Have you received antibiotics in the last time?
• Do you use birth control pills?
• Have you been the victim of sexual assault?

medical examination

• The doctor will make a gynecological examination, look at the vaginal wall and udflådet
• The doctor may take a sample of udflådet and examine it under the microscope to see if there are specific disease-causing organisms. With a test strip the doctor may also measure the acidity of the vagina
• In many cases, your doctor make a diagnosis of hearing about your genes and see and smell the udflådet
• In other cases, a sample is taken from the abdomen, which is sent for culture. The sample is taken with the swab from the cervix or udflådet. If there is suspicion of a sexually transmitted disease like chlamydia or gonorrhea, grafted also from the urethra and possibly. from elsewhere. The sample from the urethra can cause a little pain – remember to drink plenty of rest of the day, so urethra flushed

other studies

• If a suspected pelvic inflammatory disease, may need to take blood samples

Referral to a specialist or hospital

• In most cases, the practitioner will be able to handle the problem
• If you are unclear diagnosis or repeated cases can be referred to specialist
• In acute pelvic inflammatory disease, it may be necessary to hospitalize you at hospital

Do you want to know more?

Ask solu- a guide for you to be interviewed at the hospital

• “Ask loose” is a guide that helps prepare you for the conversations you have at the hospital. See what questions others in the same situation have benefited from and make your own list that you can take. read more on  www.sikkerpatient.dk