Vaginal discharge is released from several types of glands located in the external female genital organs, the vagina and vulva. The criteria for normal vaginal discharge are very flexible, as different women have different patterns of vaginal secretion. Additionally, the amount and properties of vaginal discharge vary depending on the stage of the menstrual cycle, age, sexual arousal, hydration level, and other factors. Here are some general properties of normal vaginal discharge, and an overview of pathological conditions during which the vaginal discharge can be changed.
Normal Vaginal Discharge
Normal vaginal discharge is transparent or white. It has a certain odor, which should not be offensive. The amount of discharge can be increased during ovulation, in certain intervals during pregnancy, and during sexual arousal. The smell can also slightly vary with these changes, but all of that is perfectly normal. Vaginal discharge has an important role to keep the vagina moist and to help the elimination of dead cells, thus making the vagina clear and protected from infections.
As a woman enters the perimenopause, the transition towards the menopause, she will not only notice changes such as less regular periods, hot flashes, and mood swings, but she is also likely to experience increasing vaginal dryness. This vaginal dryness is caused by reduced estrogen production and can lead to unpleasant genital sensations, especially during intercourse. Vaginal dryness is also associated with other conditions that lead to lower estrogen levels, such as breastfeeding, cancer and chemotherapy drugs, and using estrogen-blocking medications for conditions such as uterine fibroids. Non-estrogen related causes can also be to blame, and they include autoimmune disorders as well as simple things like vaginal douching or exposure to irritants, which upsets the normal vaginal flora.
Infections As A Cause Of Abnormal Vaginal Discharge
Infections of the genitourinary tract are the most common causes of abnormal vaginal discharge. There is a difference between non-sexually transmitted and sexually transmitted infections.
Non-sexually transmitted infections are caused by the disturbance in vaginal pH, or normal vaginal bacterial flora. If there is some imbalance of these protective factors, some microbes use that as a good opportunity to initiate the infection.
Some of these are bacteria, which cause a condition called bacterial vaginosis. Bacterial vaginosis is very common, and it presents with a large amount of vaginal discharge with a bad odor (usually smells like fish). In some women, bacterial vaginosis does not cause any symptoms and consequences, but in a certain amount of women, this condition increases the chances for the development of pelvic inflammatory disease, which can affect fertility. This condition is treated with the appropriate antibiotics, according to the results of bacterial culture with an antibiogram.
Vulvovaginal candidiasis is caused by a fungus called Candida albicans. Unlike with bacterial vaginosis, women with this infection have a lower amount of thick and white discharge with no specific odor. This condition often causes itching in the vulvovaginal area. Topical antifungal creams, as well as oral antifungal drugs, are used in order to eliminate candidiasis.
Sexually transmitted infections which cause abnormal vaginal discharge include infections with bacteria, such as Chlamydia trachomatis and Neisseria gonorrhoeae, and and parasites, such as Trichomonas vaginalis. Chlamydia Trachomatis is the most common sexually transmitted bacteria which causes infections in the female genitourinary tract. It produces symptoms only in 20% of cases, while in the rest, it is asymptomatic. Chlamydia, as well as Neisseria gonorrhoeae can produce a large amount of purulent vaginal discharge with a bad odor, while Trichomonas usually produces yellowish discharge. Antibiotics are used to treat bacterial infections, and antiparasitic drugs to treat Trichomonas infection.
Available Tests And When To Perform Them
There are many tests available to detect vaginal infections, but you should first make sure that your condition requires examination and treatment. If you notice an increased amount of vaginal discharge, or even a slightly changed odor, that is not a cause for alarm. These things happen and usually resolve on their own within a few days. However, if the symptoms are more pronounced and persistent, and especially if there are other associated symptoms, then you should visit your doctor in order to schedule necessary tests. The most commonly performed test is the so-called Triple swabs. During this test, three swabs are taken:
- High vaginal swab to detect bacterial vaginosis, Trichomonas vaginalis, and fungal infections.
- Endocervical swab for the detection of Neisseria gonorrhoeae.
- Endocervical swab for a DNA test to detect Chlamydia trachomatis.
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