UTI discharge in women due to abnormal vaginal flora

The relationship between vaginal discharge and UTI is confusing to many. Since UTI is an infection of the ureter, it should technically not induce any changes in normal vaginal discharge. However, one of the main causes of UTIs could be due to the vaginal bacteria reaching the ureter. In such cases, a clinical diagnosis of UTI is accompanied by abnormal or excessive vaginal UTI discharge.

According to research studies, around half of the female population over the world is likely to develop UTI at some point in their life. Of these women, most are susceptible to recurrent UTIs and are required to take extra care of their hygiene. With increased age and sexual activity, the incidence of UTI increases. However, sexual activity is not the sole reason for the development of UTIs.

What is a UTI?

Short for urinary tract infections, UTIs are infections of the kidney, ureter, urinary bladder, or urethra due to any external or internal causes. Women with UTIs present with the following symptoms:

• Discomfort during peeing, commonly characterized as a burning sensation
• Cloudy urine or discolored with traces of blood
• Frequent urge to urinate accompanied by extremely small volumes of urine excreted
• Pelvic pain with tenderness at the sides or lower abdomen
• Urine leakage
• Urine with a strong odor

In severe cases, UTI may even present with fever, nausea, chills, and vomiting.

Vaginal pH imbalance or poor vaginal health could be a predisposing factor to the development of UTI. If you notice abnormal vaginal discharge due to a yeast infection or bacterial vaginosis, you are likely to develop an infection if your vaginal condition goes untreated.

Risk Factors of UTI

Either of the three bacteria types to be entering the urinary tract could cause a UTI.

• Escherichia Coli
• Klebsiella pneumonia
• Staphylococcus saprophyticus

They may enter the urinary tract via the following means:

• A history of previous UTIs
• Certain contraceptive methods including diaphragms or spermicide
• Change in vaginal flora, such as a change in vaginal pH makes it prone to infections
• Diabetes and other chronic illnesses
• Having a urinary catheter attached to you
• Having stone(s) in your kidney or urinary bladder
• Incomplete urination, that is urinating without completing the bladder
• Long-term use of catheters
• Menopause and post-menopause
• Poor hygiene
• Pregnancy
• Sexual activity
• Wiping from back to front after a bowel movement, causing bacteria from fecal matter to enter the vagina

The prevalence of UTI is more common in women than in men. This is because the female urethras are shorter and closer to the rectum. This allows a shorter and easier route for bacteria to enter the urinary tract in females than in males.

What is Normal Vaginal Discharge?

Vaginal discharge is the fluid that comes out of your vagina after puberty. Your normal vaginal discharge should be clear, white, or off-white. Different periods of the menstrual cycle account for the different textures or amounts of the discharge. Generally, the vaginal discharge lubricates the vaginal wall and prevents infections. It may be thin, elastic, and sticky or thick and gooey. One of the characteristics that make it easiest to differentiate between normal and abnormal vaginal discharge is the odor. Normal vaginal discharge will always be odorless or have a mild musky odor, which can only be smelled from a close distance. Vaginal discharge in UTI or other bacterial diseases produces a bad, pungent odor.

Vaginal Discharge in UTI

In some cases, however, your vaginal discharge may change appearance. If it is because of UTI, it may be referred to as UTI vaginal discharge. Any of the following appearances of vaginal discharge are concerning and may be categorized as UTI vaginal discharge symptoms.

• An unpleasant odor
• Foamy or cottage-cheese-like texture
• Greenish hue to the vaginal discharge, which looks something like pus
• Vaginal bleeding or spotting apart from the menstrual period
• Vaginal itching, dryness, burning, redness, or swelling

While an increased amount of vaginal discharge is considered an abnormality, it is not the best criteria to determine whether someone has UTI discharge. Out of a group of perfectly healthy women, a few may present with little to no amount of vaginal discharge. Whereas, others may present with moderate and a few with even heavy vaginal discharge. Some people may even have to wear pantyliners to prevent getting their underwear wet from the excessive amounts of normal vaginal discharge.

Prevention

There is not much you can do to specifically prevent UTI vaginal discharge but you may take a few steps to reduce the possibility of developing UTI associated with vaginal infections. Some of these include:

• Avoid unnecessary douches and scented feminine hygiene products, such as vaginal sprays.
• Changing out of swimsuits or gym clothing as soon as you can
• Regularly changing sanitary pads or other menstrual products
• Staying hydrated
• Urinating pre and post sex
• Urinating fully whenever you feel the need to
• Wearing breathable and soft underwear
• Wiping from front to back after defecating

Diagnosis

Doctors have a wide range of testing methods to choose from when it comes to UTI diagnosis. Hence, you may see each one of them using a different set of markers for urinary tract infections. They include, but are not limited to:

• Bladder Cystoscopy
• CT scan of kidneys, bladder, and ureter
• Kidney ultrasound
• Urinalysis
• Urine DR
• Urine Culture

Treatment of UTI Vaginal Discharge

Antibiotics generally suffice as UTI treatments, effectively clearing up any bacterial infections. The symptoms of UTI vaginal discharge tend to go away within a few days into the course of medication if the UTI is caused by bacterial infections in the vagina. Unsweetened cranberry juice, natural cranberry juice, or cranberry extract are one of the best at-home remedies for UTIs. Aside from treating urinary tract infections, they even improve UTI discharge and may resolve abnormal vaginal discharge. OTC pain relievers and the use of a heating pad on the lower abdomen have also shown significant improvement in the pelvic pain and tenderness associated with UTI and vaginal discharge.

Other causes of vaginal discharge, such as yeast infections, may also predispose the occurrence of UTI. It is relatively easier to treat mild yeast infections by using over-the-counter or OTC antifungal medications. They are available in the market in the following forms:

• Creams
• Ointments
• Oral supplements
• Suppositories

Mild UTIs and mild changes in the vaginal discharge are easy to treat and sometimes may even resolve on their own. However, regardless of how mild your condition seems to you, speak with a doctor before experimenting with self-medication.

See Also: Uti Vs Yeast Infection: How To Not Confuse The Two

Conclusion

Vaginal discharge is normal for women above the age of puberty and before menopause and those who are pregnant. The changes in vaginal discharge are consistent with your menstrual cycle and are not always alarming. However, if you are concerned that you may be developing symptoms of UTI or extremely abnormal vaginal discharge, see a doctor.

While some people resort to medications to find a treatment for their UTI discharge, others may resort to at-home remedies. Regardless of whichever method you choose to treat yourself, make sure you visit a doctor and get yourself checked for any other medical conditions that may be associated with your UTI-associated vaginal discharge. At Family Medicine Austin, we offer comprehensive preventive and diagnostic disease management care for you and your family! Reach out to us today and avail our full spectrum of healthcare.

Differences in symptoms and treatment

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Both a yeast infection and a urinary tract infection (UTI) can cause pain and discomfort, but there are some differences. For instance, a yeast infection produces a white discharge, while a UTI leads to cloudy urine.

People should seek professional medical attention if they believe that they have either type of infection.

In this article, we discuss the differences between yeast infections and urinary tract infections (UTIs), including their symptoms, duration, causes, diagnosis, treatment, and prevention.

Share on PinterestYeast infections and UTIs may both cause pain when urinating.

Yeast infections and UTIs cause distinct symptoms that affect different parts of the body.

Yeast infections usually cause pain and itching of the genitals and a thick, curd-like discharge.

UTIs specifically affect the lower urinary tract, which includes the urethra and bladder. Without treatment, a UTI can spread to the kidneys, causing more severe symptoms and potential complications.

In severe cases, a UTI can also cause fever, chills, nausea, and vomiting.

The duration of both infections depends on two factors: the severity of the infection and the choice of treatment.

In general, the symptoms of an uncomplicated UTI — one that has not spread to the kidneys — go away 1–2 days after starting antibiotic treatment. However, a complicated UTI can take several days to a couple of weeks to treat.

A mild yeast infection is likely to clear up more quickly than a severe one. The duration of treatment for yeast infections varies from just a few days to up to 6 months, although the latter is rare.

Learn more about how long a yeast infection can last here.

Yeast infections and UTIs have distinct causes and risk factors.

UTIs

According to a 2015 article, UTIs are most common among older males, young boys, and females of all ages.

An estimated 60% of females and 12% of males will have at least one UTI during their lifetime, according to the Urology Care Foundation.

UTIs occur when bacteria, such as Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus, enter the urinary tract.

Risk factors for a UTI can include:

• having sex
• using certain contraceptive methods, such as diaphragms or spermicide
• wiping from back to front after a bowel movement
• having kidney or bladder stones
• urinating without emptying the bladder
• having a urinary catheter

Females develop UTIs more often than males because the female urethra is much shorter, which allows bacteria near the vagina to enter the bladder more easily.

UTIs in children

According to the Urology Care Foundation, up to 8% of girls and 2% of boys develop UTIs. They also state that young children have a higher risk than adults of kidney damage from UTIs.

Young children may experience UTIs due to a condition called vesicoureteral reflux, which is most common among infants and children, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Vesicoureteral reflux can occur as a result of structural abnormalities of the ureters.

Normally, urine flows through the ureters from the kidneys into the bladder. A small piece of tissue called the flap valve blocks urine from flowing backward from the bladder to the ureters.

In vesicoureteral reflux, urine from the bladder may reenter one or both ureters and even flow back into the kidneys.

Vesicoureteral reflux rarely causes long term complications for children.

Yeast infections

Share on PinterestA person may be at risk of a yeast infection if they are pregnant, taking antibiotics, or have a weakened immune system.

Yeast infections occur when there is an overgrowth of Candida, a type of fungus that lives inside the body, in a moist area of the skin. Typical areas where yeast infections may develop include:

• the mouth
• the throat
• the gut
• the vagina

Vaginal yeast infections are very common. According to the Office on Women’s Health, about 75% of all females will have at least one yeast infection during their lifetime.

Risk factors for yeast infections include:

• having a weakened immune system
• taking antibiotics or having recently completed a course
• being pregnant
• having uncontrolled diabetes
• using hormonal birth control that contains high doses of estrogen
• using douches or vaginal sprays
• wearing tight underwear and clothes that create a warm, moist environment

During pregnancy

Pregnant women may have an increased risk of developing both types of infection. They should contact their OB-GYN immediately if they believe that they may have a UTI or yeast infection.

Untreated UTIs and yeast infections can harm the fetus and may result in complications during and after delivery.

Learn more about infections during pregnancy here.

UTIs and yeast infections require a medical professional to diagnose and treat them.

If a person leaves either infection untreated, it can progress, causing worse symptoms and additional complications. For example, an untreated UTI may result in a severe kidney infection.

Doctors use different diagnostic methods for yeast infections and UTIs.

The diagnosis of a UTI requires a urine sample. At the doctor’s office, a person will fill a small cup with urine. The doctor will send this to a laboratory where technicians will test it for the presence of bacteria.

A doctor can diagnose a yeast infection by carrying out a physical examination of the affected area and a culture test.

During a culture test, a doctor will use a cotton swab to collect a sample from the affected area and then send it to a laboratory for testing. The lab technicians will examine it for the Candida fungus.

UTIs and yeast infections require different treatments.

UTI treatment usually involves antibiotics, which clear up bacterial infections. The class and dosage of antibiotic treatment depend on the type of infection and the person’s medical history.

Although symptoms usually go away shortly after a person starts taking antibiotics, they should complete the entire course of medication that the doctor prescribed.

People can treat yeast infections in several different ways. Mild yeast infections may respond to over-the-counter (OTC) antifungal medications, which are available in the following forms:

• creams
• ointments
• suppositories
• oral tablets

OTC antifungal medications are available to purchase in stores or online.

Severe yeast infections might require a prescription-strength antifungal oral tablet called fluconazole.

Although OTC and prescription medications can successfully treat UTIs and yeast infections, some people may choose alternative or natural therapies instead.

Eating natural, unsweetened yogurt that contains Lactobacillus acidophilus may help prevent yeast infections.

Unsweetened cranberry juice is a common home remedy for UTIs. However, in a 2013 article, researchers reviewed 24 studies and concluded that cranberry juice is less effective than earlier research indicated and that it demonstrates a limited ability to prevent UTIs.

Mild UTIs and yeast infections are easily treatable and may even resolve on their own. However, people should still consult a doctor before attempting to treat either infection at home.

Currently, not enough scientific evidence exists to support the exclusive use of natural remedies for treating UTIs or yeast infections.

Share on PinterestStaying hydrated may help prevent UTIs and yeast infections.

Steps that people can take to prevent UTIs and yeast infections include:

• staying hydrated
• urinating when the need arises and not holding it in
• wiping from front to back after a bowel movement
• urinating before and after sex
• avoiding the use of douches, vaginal sprays, and scented feminine hygiene products
• changing out of swimsuits and exercise attire as soon as possible
• changing female sanitary products regularly
• avoiding tight fitting or restrictive clothing

Although UTIs and yeast infections are common, they cause symptoms that are similar to those of other conditions. As a result, people may sometimes mistake one condition for another.

Conditions that cause symptoms similar to those of UTIs and yeast infections include the following:

• Interstitial cystitis (IC) is a bladder condition that causes frequent urination and chronic pain near the bladder.
• Ovarian cysts are benign growths that develop on the ovaries. Ovarian cysts can cause uncomfortable bloating, pain in the lower back, and a frequent urge to urinate.
• Bacterial vaginosis refers to an overgrowth of bacteria in and around the vagina. It can cause painful urination, itching, and odor.

UTIs and yeast infections affect the lower pelvic and genital regions. However, these conditions have distinct causes, symptoms, and treatments.

Yeast infections occur due to an overgrowth of the Candida fungus, while UTIs result from bacterial infections in the urinary tract.

Yeast infections cause itching, pain, and odorless vaginal discharge. UTIs, on the other hand, cause urinary symptoms, such as a frequent urge to urinate and painful urination.

Both types of infection require medical attention, but they are easily treatable. Treatment typically involves antifungals for yeast infections and antibiotics for UTIs.

People can often prevent yeast infections and UTIs by staying hydrated, urinating frequently, and using proper hygiene techniques.

Vaginal discharge – types, causes and treatment

What is vaginal secretion

The vagina, or vagina, is the part of the female reproductive system that connects the external genitalia (vulva) and uterus. It is an elastic hollow tube consisting of muscles, mucous membranes and various glands that secrete a secret.

Like the vulva, each woman’s vagina has individual differences in structure. So, the presence and shape of the hymen, the length of the vagina and its angle in relation to the entrance to the uterus (cervix) are individual. On average, the length of the vagina in an adult woman varies from 7 to 12 cm.

Vaginal intercourse, fertilization and childbirth occur through the vagina. Due to the elasticity of the tissues, the vagina can stretch, adapting to the size of the penis or head of the fetus during childbirth, and then shrink again, returning to its original shape.

The microflora is normally well developed on the vaginal mucosa. It consists of beneficial lactobacilli, which maintain the acidity of the environment and protect the internal organs of the reproductive system from pathogens.

The body also removes various biological fluids through the vagina: menstrual flow, vaginal secretion, and at the beginning of labor, amniotic fluid.

Vaginal discharge is a mixture of fluid (secretion) secreted by the glands of the vagina, cervical mucus, dead cells of the mucous membrane and bacteria that are part of the normal microflora. The composition and amount of secretions are individual. In addition, their color, consistency and intensity depend on the woman’s age and the phase of the menstrual cycle.

Types of vaginal discharge

Since the vagina is permeated from the inside with glands and lined with a moist mucous membrane (epithelium), densely populated by microorganisms, it constantly secretes mucus with various impurities. This is normal: this is how the vagina maintains the microflora, self-cleanses itself from unnecessary bacteria and epithelial cells that have died during renewal. But if the discharge causes discomfort, accompanied by itching, burning, pain and inflammation of the vulva and vagina, this is a sign of pathology.

Thus, vaginal discharge can be physiological (normal) or pathological (abnormal).

Physiological vaginal discharge

Physiological vaginal secretions are normal secretions characteristic of a healthy vaginal microflora. They are mucus of various consistency – from liquid to thick, creamy. Color – from transparent to yellowish white. On underwear and panty liners, the vaginal secretion leaves white spots, sometimes with a slight yellowish tint.

Normal discharge consists of cervical mucus produced by the cervix, dead mucosal cells, vaginal secretions, bacteria and lactic acid.

The amount of vaginal secretion depends on the phase of the menstrual cycle. So, at the beginning of the cycle, there are few discharges, and they are liquid. Abundant viscous discharge is characteristic of the middle of the cycle – ovulation. In women of reproductive age, the average amount of discharge can reach 2 ml per day – this is about half a teaspoon.

However, vaginal discharge is not exclusive to women of reproductive age. Girls have practically no discharge, or they are minimal and not particularly noticeable. The amount of discharge increases along with the onset of puberty, when secondary sexual characteristics begin to develop (for example, the mammary glands grow, the figure changes). Under the influence of hormones, the vaginal microflora changes – this is a sign of the maturation of the reproductive system, its preparation for the onset of the menstrual cycle and a possible sexual life.

Adolescent girls often worry about vaginal discharge but are embarrassed to ask about it. This can lead to self-doubt.

In the first days of menstruation, the discharge becomes profuse, liquid, with a lot of blood and clots. This is due to the active rejection of the endometrium – the layer of mucous membrane that lines the uterine cavity and prepares it for a possible pregnancy. On average, on the 4th-5th day, bleeding becomes less, they thicken, darken, and then stop altogether.

In pregnant women, the volume of regular vaginal discharge increases due to increased blood supply to the organs of the reproductive system, an increase in the level of sex hormones estrogen and progesterone. According to the chemical composition, the discharge may become more acidic – this is how the vagina protects the fetus from pathogens – but this does not cause discomfort.

During pregnancy, the volume of discharge increases, but this usually does not cause discomfort

In menopausal women, the amount of discharge is significantly reduced – to almost imperceptible. This is due to a decrease in the level of female sex hormones and the gradual extinction of the function of the reproductive system. The vagina becomes less elastic, there is a feeling of dryness, sometimes pain during vaginal intercourse.

Abnormal vaginal discharge

Normal vaginal discharge without a strong odor is a sign of a healthy reproductive system. But if the discharge has become unusual in color, smell and volume, and also causes discomfort, you should consult a doctor for medical help.

When infected with a pathogen, the vaginal microflora changes: some microorganisms become more, others less. The acid-base balance is disturbed, the protective functions of the mucous membrane are reduced.

In addition, pathogen activity can lead to inflammation of the vagina, vulva, and reproductive system. This can affect reproductive function, in severe cases, provoke infertility, and during pregnancy, lead to spontaneous abortion (miscarriage) and irreversible pathologies of fetal development.

Main signs of abnormal vaginal discharge:

• offensive smell – musty, putrid, reminiscent of the smell of raw fish;
• unusual color – green, grayish, yellow, gray-white;
• unusual consistency – cheesy, lumpy, foamy;
• profuse discharge – the volume of vaginal secretion is greater than usual;
• itching, burning, inflammation, redness in the vagina and vulva;
• pain when urinating;
• pain during vaginal intercourse.

Causes of abnormal vaginal discharge

In the vast majority of cases, the cause of pathological discharge is foreign pathogens that penetrate the vagina, attach to the mucous membrane and disrupt the normal microflora with their vital activity.

The most common diseases that affect the nature of vaginal secretions include bacterial vaginosis, vaginal candidiasis, trichomoniasis, chlamydial infection and gonorrhea.

It is important to note that it is impossible to make an accurate diagnosis by the nature of the discharge alone. This requires laboratory tests of a scraping from the vagina, in some cases, a blood test. However, the presence of atypical discharge is a clear signal of the reproductive system that its health is at risk.

Vaginal candidiasis is one of the causes of atypical vaginal discharge

Bacterial vaginosis

Bacterial vaginosis is a non-inflammatory disease of the vagina in which the concentration of lactic acid bacteria is greatly reduced. They are part of the normal microflora and maintain the acid-base balance.

Increased acidity inhibits the growth of opportunistic pathogens, which also live in small numbers in the vagina and provide some benefit. But if the number of lactobacilli decreases, the environment in the vagina becomes more alkaline – and, therefore, comfortable for life and active growth of opportunistic and pathogenic microorganisms.

The causative agents of bacterial vaginosis can be opportunistic bacteria that are part of the normal microflora – Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Veillonella spp. and others.

Epithelial cells of the vaginal secretion are covered with rods of an opportunistic organism – Gardnerella vaginalis (pink pips)

Common causes of bacterial vaginosis:

• frequent change of sexual partners;
• non-observance of intimate hygiene;
• frequent douching, use of antiseptic drugs (eg, miramistin) without a doctor’s prescription;
• injuries of the vaginal mucosa;
• antibiotic treatment;
• hormonal disorders.

Symptoms of bacterial vaginosis – profuse, fishy-smelling discharge that is white or light gray, sometimes frothy, itching and burning at the entrance to the vagina, as well as discomfort in the vulva and pain during intercourse (dyspareunia) .

In bacterial vaginosis, vaginal discharge is profuse, whitish-gray and thick, and smells like rotten fish.

Diagnosis of bacterial vaginosis includes measurement of the acidity of the vagina – pH-metry, aminotest, as well as the study of the microflora of the vagina by laboratory methods. Preventive studies for various sexually transmitted infections are assigned at the discretion of the gynecologist as part of the differential diagnosis.

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The main goal of the treatment of bacterial vaginosis is to normalize the microflora of the vagina, reduce the population of opportunistic microorganisms and compensate for the deficiency of lactobacilli. For this, the doctor may prescribe antibacterial drugs and vaginal suppositories.

Vaginal candidiasis

Candidiasis, or thrush, is an infectious disease that occurs due to the active growth of the opportunistic fungus of the genus Candida. This fungus is part of the normal microflora of the vagina, but if the number of lactobacilli decreases or the immune system weakens, candida begins to grow rapidly.

Approximately 80-90% of cases of thrush are caused by Candida albicans. Other types are less common: for example, with a long course of thrush, diabetes mellitus, as well as in patients with immunodeficiency. Can be sexually transmitted.

Microscopic fungi Candida albicans in 80-90% of cases are the causative agent of thrush

Common causes of candidiasis:

• weakening of immunity, including local;
• diseases of the endocrine system affecting metabolism – diabetes mellitus, thyroid pathology;
• wearing tight clothing – tight trousers, synthetic leggings;
• regular use of sanitary napkins;
• taking antibiotics, corticosteroids, immunosuppressants;
• prolonged use of intrauterine devices, vaginal diaphragms, spermicides;
• frequent douching;
• hormonal disorders.

The main manifestations of candidiasis include white cheesy discharge, itching and burning in the vulva and vagina, pain during urination (dysuria), and sometimes pain during intercourse (dyspareunia).

With candidiasis, vaginal discharge is white, unusually thick, and cheesy.

A gynecologist can diagnose thrush. After examining and collecting complaints, the specialist may prescribe laboratory tests for the fungus of the genus Candida and a general study of the vaginal microflora.

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The main goal in the treatment of thrush is to restore the normal microflora of the vagina. The dosage of antifungal drugs and the duration of treatment are calculated by the gynecologist based on the results of laboratory tests.

Trichomoniasis

Trichomonas vaginitis, or trichomoniasis, is an infectious disease transmitted primarily through sexual contact (STI). Less commonly, trichomoniasis is transmitted from mother to child during childbirth. The infection, as a rule, affects not only the reproductive system, but also the urinary tract.

The incubation period of the disease lasts from 3 days. In 20–40% of people, the disease is asymptomatic.

The causative agent of trichomoniasis is a pathogenic unicellular microorganism Trichomonas vaginalis. The source and spreader of the infection can be both a woman and a man.

Trichomonas vaginalis – a species of unicellular protozoa, the causative agent of trichomoniasis

Factors that can lead to the development of trichomoniasis:

• unprotected sexual intercourse with an infected partner;
• casual sex;
• the presence of other infections of the genital tract – for example, bacterial vaginosis or candidiasis.

Symptoms of trichomonas vaginitis include a gray-yellow vaginal discharge, often frothy, with an unpleasant odor. There is also itching and burning in the genital area, pain may appear during urination and sexual intercourse. The mucous membrane of the vulva turns red and swells.

Vaginal discharge in trichomoniasis is gray-yellow, often frothy, with an unpleasant odor.

Diagnosis of trichomoniasis includes microscopy of scrapings from the urogenital tract and cervical canal, seeding for bacteria, as well as targeted analysis for Trichomonas vaginalis.

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The most common treatment for trichomoniasis involves the administration of an antimicrobial drug by both partners.

Chlamydia infection

Urogenital chlamydia infection (chlamydia) is one of the most common sexually transmitted diseases. Newborns can become infected with chlamydia from their mother in utero or during childbirth.

The causative agent of chlamydial infection is the bacterium Chlamydia trachomatis.

The incubation period of the disease lasts 7-14 days, after which the first symptoms may appear. However, most women (70-95%) and half of men do not have chlamydia, which contributes to its spread.

Factors that can lead to the development of chlamydial infection:

• unprotected sexual intercourse with an infected partner;
• casual sex;
• the presence of other infections of the genital tract.

Symptoms of urogenital chlamydial infection, if present, include atypical mucopurulent discharge, intermenstrual bleeding, pain and discomfort during urination and intercourse, pain in the lower abdomen.

Mucopurulent discharge from the vagina with chlamydial infection.

A gynecologist deals with the diagnosis of chlamydia. He can prescribe a laboratory general examination of a scraping from the urogenital tract, as well as a targeted analysis for chlamydia.

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Chlamydia infection is treated with antibiotics.

Gonorrhea

Gonococcal infection (gonorrhea, or gonorrhea) is a sexually transmitted disease, as well as during childbirth. The disease does not spread through the home.

The causative agent of gonorrhea is the gonococcal bacterium Neisseria gonorrhoeae.

The incubation period of gonococcal infection lasts from 1 to 10 days. During this period, the symptoms of the disease do not appear, but the carrier of the bacteria can infect other people.

Factors that can lead to the development of gonorrhea:

• unprotected sexual intercourse with an infected person;
• casual sex;
• the presence of other infections of the genital tract.

In women, gonorrhea in most cases (more than 70%) is asymptomatic. Less commonly, symptoms appear in the form of mucopurulent discharge from the urethra and vagina, itching and burning, painful urination, pain during intercourse (dyspareunia), and sometimes pain in the lower abdomen.

With gonorrhea, purulent-mucous discharge from the vagina of a yellow or green tint may appear.

Laboratory diagnosis of gonorrhea involves the study of scrapings from the urogenital tract for microflora and analysis for sexually transmitted infections, including targeted – for gonococcus.

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Gonococcal infection is treated with antibiotics.

Diagnosis and treatment of abnormal vaginal discharge

Abnormal vaginal discharge is not an independent pathology, but a sign of an infectious disease of the reproductive system. As soon as the root cause of the discharge is diagnosed and treated, the vaginal microflora returns to normal and the symptom disappears.

As a rule, diseases accompanied by vaginal discharge are treated with antibiotics or antifungals. The period of therapy and restoration of microflora can last up to 2-3 weeks. However, you should not prescribe treatment yourself: each pathogen is sensitive to a certain type of antibiotics and only a doctor can choose them correctly after examination and familiarization with the results of laboratory tests.

Which doctor to contact for unhealthy vaginal discharge

A gynecologist deals with the diagnosis and treatment of diseases of the reproductive system in women. The specialist will collect an anamnesis – ask about sexual contacts, contraceptive methods, past infectious diseases, as well as about symptoms and their duration.

A gynecologist deals with the treatment of diseases of the vagina.

After the interview, the doctor will examine the vagina on the gynecological chair and, if necessary, take a scraping.

At the end of the appointment, the gynecologist will prescribe additional tests or, if the diagnosis is clear, will tell you about the treatment plan and prescribe medications.

What tests are prescribed for pathological vaginal discharge

To speed up the treatment process, you can take a comprehensive analysis for the most common pathogens on your own and come to the doctor with a ready-made result.

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However, it is important to understand that many infections of the genital tract are similar in nature of discharge and symptoms. Only a specialist can make a more accurate guess after examining the mucous membrane of the vagina and cervix.

How to prevent unhealthy vaginal discharge

Most cases of abnormal vaginal discharge are caused by sexually transmitted infections. To prevent infection, it is recommended to avoid contact or use barrier contraception (condoms) when having sex with potentially infectious people.

In addition, adolescents and sexually active women should visit a gynecologist regularly, once a year, for preventive examinations and monitoring of the health of the reproductive system.

Women who are sexually active are advised to visit a gynecologist once a year.

Girls and women should also follow the rules of intimate hygiene:

• Daily wash the vulva – external genitalia. To do this, you can use special means for intimate hygiene. You need to wash from front to back – from the vulva to the anus, not vice versa.
• Wipe the vulva with a separate towel. It must be washed at least once a week.
• On long trips or if regular washing is not possible, special wet wipes for intimate hygiene should be used.
• Do not douche unless advised by a doctor. Especially before visiting the gynecologist. The procedure can disrupt the natural microflora and harm beneficial bacteria or distort the clinical picture on examination. The vagina copes with cleaning itself with the help of natural secretions.
• Change sanitary pads, tampons and menstrual cups every 3-4 hours. In heat and moisture, various microorganisms grow and develop well. Contact of the vulva and vagina with them can cause an infectious disease.
• Wear underwear made of natural fabrics more often – synthetic materials do not pass air well and can create a greenhouse effect in the crotch area. The combination of moisture, heat, and limited air circulation are good conditions for bacteria to thrive.

Vaginal discharge (leucorrhoea): types, causes, treatment

How to understand how much vaginal discharge is normal and what is not? What should a normal discharge look like? And are there signs by which a woman can immediately understand that it is time for her to make an appointment with a gynecologist?

Starting from the period of menarche (the arrival of the first menstruation) and ending with the postmenopausal period, leucorrhoea is normally present in all women ¹ .

Vaginal secretions are a way to protect against infections by moisturizing and “cleansing” the vagina of germs, old cells and mucus. The nature of the discharge depends on both internal and external factors: age, phase of the menstrual cycle and fluctuations in the level of sex hormones, pregnancy, menopause, sexual activity, taking antibiotics or hormonal drugs, the presence of chronic diseases and stress ^1.2 .

It is known that the main signs of disease in the vagina begin when pathogenic microorganisms infect its epithelial cells. One of the protective mechanisms on the part of the vagina is the formation of a so-called physical barrier on the surface of epithelial cells – a layer of mucus and secretions rich in immunoglobulins – protective proteins that are produced by immune cells and other components ^1-3 .

Types of vaginal discharge

Normal vaginal discharge

There are a number of signs that a woman can be sure that her discharge is normal.

The amount of discharge: is normally insignificant. Almost throughout the entire cycle, the volume of secretions approximately corresponds to 1 tsp. (up to 5 ml). In the middle of the cycle, the amount of discharge can be increased, but this is of a short-term nature.

Discharge color: transparent, translucent in the first phase of the cycle or whitish (sometimes with a slight yellowish tint) in the second phase of the cycle closer to menstruation.

Consistency: normal discharge is homogeneous, without any impurities and components (no large lumps, streaks or traces of blood). Most often they are mucous, in the middle of the cycle (during the period of ovulation) the mucus can acquire viscous properties (similar to raw egg white). By the end of the cycle after ovulation, the discharge may become thicker and creamy in consistency.

Odour: normal leucorrhoea has a slightly acidic odor or no odor at all ^{1. 4} .

Discharge tends to change during the menstrual cycle, but in the absence of disease, it never loses the properties of normal discharge.

Signs of pathological discharge in the intimate area

Any vaginal discharge should always be compared with the standard of normal discharge. This is convenient for both the doctor and the woman herself.

Pathological discharges that occur in various gynecological diseases are characterized by the following symptoms:

• The amount of discharge: in a number of gynecological diseases, the discharge often becomes abundant, their number increases and does not change throughout the menstrual cycle (more than 5 ml). Sometimes the discharge becomes so much that you have to change daily pads several times. At the same time, a woman is haunted by a feeling of constant moisture in the genital area, which brings significant discomfort.
• There are infections, such as chlamydia, where the amount of discharge can change throughout the cycle. In this case, you should pay attention to additional signs: pain during urination, discomfort or pain during sexual intercourse, pain in the lower abdomen.
• Discharge color: the color of abnormal leucorrhoea may vary. Whites with the presence of blood in them have a bright scarlet, dark or brown color. If such discharge appears outside the scheduled days of menstruation, then this may be due to a gynecological disease (endometriosis, a polyp in the uterus or cervix, cystic formations on the ovaries). Other reasons may be taking hormonal pills (including contraceptives) or setting up an intrauterine device, as a rule, this is temporary.
• Yellow or green vaginal discharge may be associated with sexually transmitted infections (STIs). For bacterial vaginosis – an infectious disease of the vagina – a dirty gray color is characteristic. Allocations with white large lumps, resembling cottage cheese, are characteristic of thrush.

The appearance of bleeding outside of menstruation always requires specialist advice and additional examination.

• Consistency: pathological secretions acquire a different consistency: watery, thick creamy, “curdled”.
• Smell: discharge from various diseases usually has an unpleasant, sometimes pungent odor ^1,4,5 .

Additional signs of the disease along with pathological discharge can be: itching, burning sensation, pain during urination or during sexual intercourse, redness, swelling in the vulva.

Diagnosing the cause of vaginal discharge

Every woman should make an appointment with a gynecologist when abnormal discharge occurs. In addition to subjective signs that a woman herself can evaluate, there are also objective signs of the disease that the doctor reveals during the examination, as well as the results of mandatory laboratory diagnostics confirming a specific diagnosis.

Diagnosis of diseases of the vagina begins with an assessment of complaints at a doctor’s appointment. Already according to characteristic complaints, the doctor may suspect a particular disease.

Second stage of diagnostics

Examination by a gynecologist on a chair. The doctor can assess the degree of inflammation and the nature of the discharge, if any. Also, during the examination, the doctor takes a vaginal discharge for further laboratory diagnosis.

Third diagnostic step

Laboratory examination of vaginal discharge. Using a microscope, the number of cells and the nature of the microflora of the vagina are determined. Additional laboratory tests may be performed to confirm an accurate diagnosis.

In addition, according to the doctor’s prescription, in case of pathological discharge, instrumental examination methods can be recommended – colposcopy (examination of the cervix and vagina under magnification using a colposcope) and ultrasound (ultrasound examination) of the pelvic organs ^5.6 .

Treatment of abnormal vaginal discharge

Complaints about vaginal discharge are the most frequent complaints at a gynecologist’s appointment.

Specific drugs for the treatment of abnormal discharges are prescribed after a final diagnosis has been made.

Often there is a combination of pathogens of various diseases that cause pathological discharge from the vagina ^1,6,7 .

Preparations for the treatment of abnormal discharge are available in various forms: oral (capsules or tablets) or topical (vaginal suppositories or tablets, gels, creams, solutions).

The most common treatment for abnormal vaginal discharge is topical agents that are inserted into the vagina. When using local preparations, the medicine enters directly into the focus of inflammation.

Given that vaginal discharge is often a sign of a combination of several diseases (for example, a combination of bacterial vaginosis and thrush caused by fungi), it is preferable to consider drugs with a wide spectrum of action, that is, those that can cause the death of several types of microorganisms at once.

Betadine® Suppositories in the treatment of diseases with pathological discharge

Betadine ^® is a drug that acts on a wide range of microorganisms: fungi (cause of thrush), gram-positive and gram-negative bacteria (cause of inflammation in the vagina ( vaginitis) and bacterial vaginosis) and a number of other microorganisms.

For abnormal vaginal discharge, use Betadine ^® in the form of vaginal suppositories. With the introduction of one suppository from the main active ingredient (povidone-iodine), from 18 to 24 mg of active iodine is released, which has a strong effect on pathogenic microbes, contributes to their destruction. Most pathogens die within 1 minute after being exposed to iodine ⁸ .

Indications for the use of Betadine ^® suppositories are acute or chronic vaginitis, bacterial vaginosis (caused by Gardnerella vaginalis), candidiasis, infection caused by Trichomonas vaginalis (trichomoniasis). Vaginal infections after antibiotic or steroid therapy. Another indication is the prevention of various infections during surgical interventions in gynecology.

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It should be remembered that Betadine ^® containing an iodine compound has a number of restrictions: the period of bearing a child and the period of breastfeeding, the presence of any dysfunction of the thyroid gland, a also hypersensitivity to the components of the drug.

In acute vaginitis, as a rule, 1 suppository Betadine 9 is prescribed0618 ® overnight in the vagina for 7 days. In more severe situations, treatment can be continued for another 7 days ⁸ .

Prevention of pathological vaginal discharge

Many infectious and inflammatory diseases are accompanied by pathological discharge and disturbance of the vaginal microflora. It is important to observe the following prevention rules:

• Refuse casual sex and frequent change of sexual partners
• Observe proper intimate hygiene
• limit the uncontrolled use of antibiotics, glucocorticoids and hormonal drugs without existing indications
• do not wear close synthetic clothing
• to treat the exacerbations of chronic diseases in a timely manner (for example, control the level of blood glucose in diabetes)
• to treat any gyneco Logical pathology
• Regularly attend preventive examinations by a gynecologist

Frequently asked questions

Is it necessary to treat a sexual partner if a woman has abnormal leucorrhoea?

If any pathological discharge occurs in a woman, it is necessary to consult a gynecologist. Depending on what specific disease is detected during the examination of a woman, it is recommended for her partner to consult an andrologist and conduct the necessary examination. Treatment of both sexual partners does not occur in all cases of the appearance of pathological discharge in a woman. This is decided individually depending on the clinical situation.

Can spotting appear in the middle of the cycle? And repeat almost every month?

The appearance of bleeding in the middle of the cycle is sometimes a normal sign of completed ovulation (the release of the egg from the ovary and its readiness for fertilization). At the same time, a woman, as a rule, also feels other signs of ovulation – more abundant mucous secretions (similar to raw egg protein), minor pains in the lower abdomen (sometimes only on one side), an increase in sexual desire. The discharge itself is not abundant, but rather streaks of blood or slight spotting, which are not accompanied by pathological signs, do not have a pungent odor and are short-lived (literally 1, maximum 2 days). In any case, the appearance of bloody discharge from the vagina outside of menstruation requires a full-time visit to the doctor.

Bloody discharge only after intercourse what can it indicate? Is this the norm?

The appearance of blood can be observed after the first sexual intercourse in a woman’s life. If we are talking about a different situation, then such spotting is not the norm. Often this is associated with inflammatory processes, in particular with cervicitis (inflammation in the cervix). A woman with similar symptoms should see a doctor.

Molchanov Oleg Leonidovich

Gynecologist, reproductive specialist, doctor of medical sciences.

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Bacterial vaginosis

In almost 90% of cases of abnormal discharge in women, bacterial vaginosis is diagnosed. Why does this disease occur and how is it treated?

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Treatment of vaginitis with local preparations in the form of vaginal suppositories. How to choose suppositories for inflammation in the vagina?

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Povidone iodine

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References

1. Savelyeva G. M., Sukhikh G. T., Serov V. N., Radzinsky V. E. National guide “Gynecology” // GEOTAR-Media 2020, Moscow.
2. Clinical guidelines “Inflammatory diseases of the cervix, vagina, vulva”// ROAG, 2021.
3. Petersen E.E. Infections in obstetrics and gynecology // MEDpress inform, Moscow 2007.
4. Clinical recommendations “Chlamydial infection” dated 17.02.2021.
5. Clinical guidelines “Gonococcal infection” 2021.
6. Clinical guidelines “Urogenital trichomoniasis” 2021.
7. Clinical guidelines “Anogenital herpetic viral infection” 2021.
8. Clinical guidelines for the diagnosis and treatment of diseases accompanied by pathological discharge from the female genital tract, 2019.