What causes UTI discharge in women. How does abnormal vaginal flora contribute to UTIs. What are the symptoms of UTI-related discharge. How can you prevent UTIs and maintain healthy vaginal flora.

Understanding Urinary Tract Infections (UTIs) and Vaginal Discharge

Urinary tract infections (UTIs) are a common health concern for women, with research indicating that approximately half of the female population worldwide will experience a UTI at some point in their lives. While UTIs primarily affect the urinary system, they can often be linked to changes in vaginal health and discharge. This article explores the relationship between UTIs, abnormal vaginal flora, and discharge, providing essential information for women’s health.

What is a UTI?

A urinary tract infection is an infection that can occur in any part of the urinary system, including the kidneys, ureters, bladder, or urethra. UTIs are more common in women due to their shorter urethra, which provides an easier route for bacteria to enter the urinary tract.

Common Symptoms of UTIs

• Discomfort or burning sensation during urination
• Cloudy or bloody urine
• Frequent urge to urinate with small volumes
• Pelvic pain and lower abdominal tenderness
• Urine leakage
• Strong-smelling urine
• In severe cases: fever, nausea, chills, and vomiting

The Link Between Vaginal Flora and UTIs

The relationship between vaginal health and UTIs is complex but significant. While a UTI itself may not directly cause changes in vaginal discharge, the conditions that lead to a UTI can often affect vaginal flora as well.

How does vaginal flora impact UTI risk?

Vaginal flora refers to the community of microorganisms that naturally inhabit the vagina. When this flora is balanced, it helps protect against infections. However, disruptions in vaginal flora can increase the risk of both vaginal infections and UTIs.

Conditions such as bacterial vaginosis or yeast infections can alter the vaginal environment, making it easier for harmful bacteria to proliferate and potentially travel to the urinary tract. This is why maintaining healthy vaginal flora is crucial in preventing UTIs.

Understanding Normal vs. Abnormal Vaginal Discharge

To recognize potential UTI-related issues, it’s important to understand what constitutes normal vaginal discharge.

What is normal vaginal discharge?

• Clear, white, or off-white in color
• Odorless or with a mild musky scent
• Varies in texture and amount throughout the menstrual cycle
• May be thin and elastic or thick and gooey

Signs of abnormal discharge potentially related to UTIs

• Unpleasant or strong odor
• Foamy or cottage cheese-like texture
• Greenish hue or pus-like appearance
• Accompanied by vaginal itching, burning, or swelling
• Unusual vaginal bleeding or spotting

Risk Factors for UTIs and Abnormal Vaginal Flora

Several factors can increase a woman’s risk of developing UTIs and experiencing changes in vaginal flora:

1. Previous history of UTIs
2. Certain contraceptive methods (e.g., diaphragms, spermicides)
3. Changes in vaginal pH
4. Diabetes and other chronic illnesses
5. Use of urinary catheters
6. Kidney or bladder stones
7. Incomplete bladder emptying
8. Menopause and post-menopausal changes
9. Poor hygiene practices
10. Pregnancy
11. Sexual activity
12. Improper wiping technique after bowel movements

Bacterial Culprits Behind UTIs

UTIs are typically caused by bacteria entering the urinary tract. The most common bacterial culprits include:

• Escherichia coli (E. coli)
• Klebsiella pneumoniae
• Staphylococcus saprophyticus

These bacteria can originate from the vaginal or rectal area and ascend the urethra, causing infection. Understanding the source of these bacteria is crucial for prevention strategies.

Prevention Strategies for UTIs and Maintaining Healthy Vaginal Flora

While it’s not always possible to prevent UTIs entirely, there are several steps women can take to reduce their risk and maintain healthy vaginal flora:

Hygiene practices

• Wipe from front to back after using the toilet
• Urinate before and after sexual activity
• Avoid holding urine for long periods
• Keep the genital area clean and dry

Lifestyle choices

• Stay hydrated by drinking plenty of water
• Wear breathable, cotton underwear
• Avoid tight-fitting pants or synthetic materials that trap moisture
• Consider switching from baths to showers

Dietary considerations

• Incorporate probiotic-rich foods into your diet
• Consider cranberry products, which may help prevent UTIs
• Limit intake of sugary and processed foods

Vaginal health maintenance

• Avoid douching and scented feminine hygiene products
• Use gentle, unscented soaps for cleansing
• Consider probiotic supplements designed for vaginal health

When to Seek Medical Attention

It’s important to consult a healthcare provider if you experience symptoms of a UTI or notice changes in your vaginal discharge. Prompt treatment can prevent complications and provide relief from uncomfortable symptoms.

When should you see a doctor?

• Persistent urinary symptoms lasting more than a few days
• Fever, chills, or back pain accompanying urinary symptoms
• Blood in the urine
• Significant changes in vaginal discharge color, odor, or texture
• Recurrent UTIs (3 or more in a year)

Treatment Options for UTIs and Vaginal Flora Imbalances

Treatment for UTIs and vaginal flora imbalances typically involves addressing the underlying cause and managing symptoms. Here are some common approaches:

Antibiotics for UTIs

UTIs are usually treated with a course of antibiotics. The type and duration of antibiotic treatment depend on the severity of the infection and the patient’s medical history. It’s crucial to complete the entire course of antibiotics as prescribed, even if symptoms improve before finishing the medication.

Probiotics for vaginal health

Probiotics can help restore and maintain healthy vaginal flora. These beneficial bacteria can be taken orally or applied topically in the form of suppositories. Probiotics may be particularly helpful in preventing recurrent UTIs and maintaining overall vaginal health.

Addressing underlying conditions

In some cases, recurrent UTIs or persistent vaginal flora imbalances may be symptoms of underlying health issues. Your healthcare provider may recommend additional tests or treatments to address any contributing factors, such as hormonal imbalances or immune system disorders.

Lifestyle modifications

Your doctor may suggest specific lifestyle changes based on your individual risk factors. These might include adjustments to your hygiene routine, dietary changes, or recommendations for managing chronic health conditions that may increase your susceptibility to UTIs.

The Role of Hormones in UTIs and Vaginal Health

Hormonal fluctuations throughout a woman’s life can significantly impact urinary tract and vaginal health. Understanding these relationships can help in managing and preventing UTIs and vaginal flora imbalances.

How do hormones affect UTI risk?

Estrogen plays a crucial role in maintaining the health of the urinary tract and vaginal tissues. As estrogen levels decline, particularly during menopause, women may become more susceptible to UTIs and changes in vaginal flora. This is due to several factors:

• Thinning of the urethral and vaginal tissues
• Decreased production of protective vaginal secretions
• Changes in the pH balance of the vagina
• Alterations in the types of bacteria that colonize the urogenital area

Hormonal treatments for UTI prevention

For postmenopausal women experiencing recurrent UTIs, hormonal treatments may be recommended. These can include:

• Topical estrogen creams or vaginal suppositories
• Low-dose systemic hormone replacement therapy (in select cases)

These treatments can help restore the vaginal environment to a more protective state, reducing the risk of UTIs and improving overall vaginal health.

The Impact of Sexual Activity on UTIs and Vaginal Flora

Sexual activity is a common trigger for UTIs in women. Understanding the connection between sexual practices and urinary tract health can help in developing effective prevention strategies.

How does sexual activity contribute to UTIs?

During sexual intercourse, bacteria can be introduced or pushed into the urethra, increasing the risk of infection. Additionally, certain sexual practices or contraceptive methods can alter the vaginal environment, potentially disrupting the balance of flora.

Prevention strategies for sexually active women

• Urinate before and after sexual activity to flush out bacteria
• Use water-based lubricants to minimize irritation
• Consider alternative contraceptive methods if using spermicides frequently
• Practice good hygiene before and after intimate contact
• Stay hydrated to promote frequent urination

Emerging Research and Future Directions

The field of urogenital health is continually evolving, with new research shedding light on the complex relationships between UTIs, vaginal flora, and overall women’s health. Some exciting areas of current and future research include:

Microbiome studies

Researchers are delving deeper into understanding the urinary and vaginal microbiomes. This research aims to identify specific bacterial strains that may be protective against UTIs and explore ways to promote a healthy microbial balance.

Novel prevention strategies

Scientists are investigating new approaches to prevent UTIs, including:

• Development of UTI vaccines
• Use of bacteriophages (viruses that target specific bacteria)
• Creation of antimicrobial coatings for medical devices

Personalized treatment approaches

As our understanding of individual differences in urogenital health improves, there is a growing focus on developing personalized prevention and treatment strategies. This may involve tailored probiotic formulations, individualized hygiene recommendations, and targeted hormonal treatments based on a woman’s specific risk factors and microbiome profile.

Conclusion: Empowering Women’s Urogenital Health

Understanding the intricate relationship between UTIs, vaginal flora, and overall urogenital health is crucial for women of all ages. By recognizing the signs of UTIs and abnormal vaginal discharge, implementing preventive strategies, and seeking timely medical attention, women can take control of their urogenital health and reduce the impact of these common but potentially serious conditions.

Remember that maintaining a healthy lifestyle, practicing good hygiene, and staying informed about your body’s needs are key components of preventing UTIs and maintaining optimal vaginal health. If you experience recurring UTIs or persistent changes in vaginal discharge, don’t hesitate to consult with a healthcare provider to develop a personalized management plan.

As research in this field continues to advance, we can look forward to even more effective strategies for preventing and treating UTIs while promoting overall urogenital health. By staying informed and proactive, women can ensure they are well-equipped to maintain their health and well-being throughout all stages of life.

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.

Urinary Tract Infection (UTI) – Symptoms & Treatment Options

A urinary tract infection (UTI) occurs when bacteria get into your urinary system. Urinary tract infections usually begin in the bladder and urethra. If left untreated, they can spread to the ureters and kidneys.

UTIs can cause very uncomfortable symptoms including:

• Pressure or pain in your lower pelvis or abdomen
• Frequent or urgent need to urinate
• Need to urinate but only a small amount of urine comes out
• Foul-smelling urine
• Urine leakage
• Pain or burning when urinating
• Urine that looks cloudy or milky
• Blood in urine
• Penis discharge (in men)

Your urinary tract can usually protect itself from infection, but certain factors increase your risk of developing a UTI.

• Being female. Women get more UTIs than men because bacteria and other infection-causing organisms (from the anus or vagina) can easily reach the urethra. Then they travel quickly to the bladder, which is only a short distance away. A man’s urethra runs to the end of his penis so bacteria have to travel further to reach the bladder.
• Menopause and post-menopause, which  cause the lining of the urethra to get thinner as estrogen levels decrease.
• Diabetes and other chronic illnesses or medications that affect your immune system and make it harder for your body to fight infections.
• Conditions that make it difficult to completely empty your bladder, such as enlarged prostate and bladder and kidney stones.
• Long-term use of catheters

Your provider may use a variety of tests to diagnose a urinary tract infection, including:

• Urinalysis
• Urine culture
• Cystoscopy of the bladder (a camera placed into the urethra for direct visualization) may be used to inspect the bladder.
• Kidney ultrasound
• Cat scan of kidneys, ureters, and bladder.

Usually doctors prescribe antibiotics to treat UTIs. Once you start taking medication, your symptoms should go away in a few days, but this doesn’t mean you can stop taking the medicine. While you are on the mediation, drink plenty of water to help flush the bacteria out of your system.

To help ease the pain of a UTI, you can take an over-the-counter pain reliever and try putting a heating pad on your lower abdomen.

If you have recurrent UTIs (three or more in a year), your doctor may recommend additional treatments.

You can reduce your risk of developing urinary tract infections with these steps.

• Drink plenty of water (enough that your urine is clear or a light yellow)
• Urinate when you first get the urge. Holding urine can increases bacteria growth in your bladder.
• Wipe from front to back after a bowel movement to avoid germs from the anus getting into the urethra
• After sex, urinate and drink a glass of water to help flush bacteria that may have been pushed into the urethra during intercourse
• Avoid genital cleansing products such as douches and deodorants. These remove your body’s natural protective secretions and oils
• Take showers instead of baths
• Wear cotton underwear

Does drinking cranberry juice cure UTIs?
You can’t treat an active UTI by drinking cranberry juice, but substances in cranberries may help prevent UTIs by making it harder for bacteria to stick to the bladder wall. Keep in mind that fruit juices have a lot of sugar and consider cranberry pill instead.

How can I tell the difference between a urinary tract infection and a yeast infection?
Pay attention to when the burning or itching feeling occurs. A yeast infection causes vaginal itching or burning with a white discharge. In contrast, a urinary tract infection causes a burning sensation during or shortly after urination.

Vaginal discharge: types, causes, diagnosis and treatment

Normally, every healthy woman should have vaginal discharge. Whites are produced by the cells of the gonads and are a protective barrier against infection. Vaginal discharge in women should be taken calmly, just like the production of saliva or digestive juice, but only if they are of a normal nature and there are no accompanying symptoms.

In the last few years, the number of patients complaining of atypical leucorrhoea has increased. Women notice changes in the quantity and quality of discharge. Violation of the physiological process causes not only hygienic inconvenience, but also the fear of being rejected by your man, getting complications during pregnancy and childbirth. The reason for this prevalence of the problem is the frequent disruption of the vaginal microbiota. Women wear tight synthetic underwear, take antibiotics without a doctor’s prescription, use soaps with fragrances and dyes to wash. These and many other factors affect intimate health.

Doctors at the MedEx clinic will help you distinguish between normal and abnormal. If you are concerned about atypical vaginal discharge, come see our gynecologist.

Where do secretions in the genital tract come from

The female reproductive system has a very complex structure. The walls of the organs are composed of muscles, and the inner surface is covered with a mucous membrane with glandular inclusions. The epithelium is constantly updated, old cells die and are separated from the surface. These “spent” tissues are part of the light-colored vaginal discharge. They are mixed with the mucus of the cervical canal, which is produced by the glands, and the microorganisms that inhabit the vagina.

A healthy woman has vaginal discharge with a slight sour smell. The reason is that the normal microflora consists mainly of lactobacilli and Dederlein sticks. E. coli, fungi, streptococci and other microbes may appear in small quantities. A single presence of microorganisms such as ureaplasma and even gardnerella is allowed – their presence in a smear does not mean a disease. Lactobacilli form an acidic environment in the vagina that is detrimental to pathogens. Pathogenic microorganisms die in the external genital tract without penetrating the uterus and ovaries, and the discharge acquires a characteristic odor.

Types of vaginal discharge in a healthy woman

The type, color and amount of discharge change in different phases of the life cycle. Girls before puberty should not face such a phenomenon at all. If any liquid is released from the baby’s genitals, this is an occasion to consult a doctor. The doctor examines the girl for anatomical disorders.

Early school age

If a child aged 10-12 years has vaginal discharge without signs of early puberty, a comprehensive examination is necessary. This may be a sign of pathology in the urinary or digestive system.

Adolescence

The first normal vaginal discharge occurs a year before the first menstruation. During this period, many hormonal processes take place in the girl’s body, the body is preparing for the transition to a new phase of the life cycle, in which motherhood becomes possible. In different cases, it can be liquid, watery, transparent, white, mucous discharge from the vagina without an unpleasant odor. A slight acidity is considered normal. A protective barrier forms in the girl’s vagina.

Puberty

After the onset of menstruation and the stabilization of the cycle, the nature of the discharge changes, not only with age, but also within one month. In the first phase, leucorrhoea is scarce, light. Normally, the spot diameter on a daily pad during this period should not exceed 2-3 cm per day. A slight discharge of mucus from the vagina, the presence of small colorless lumps or impurities with a faint yellow tint are allowed.

In the middle of the cycle, when ovulation occurs, the amount of leucorrhea approximately doubles. The discharge does not smell, but becomes thicker. It is possible to change the color of the whites from transparent to beige.

The second half of the cycle is the time of light vaginal discharge. Beli acquire a creamy texture. As the period approaches, the amount of discharge increases.

What determines the nature of leucorrhea

The signs listed above are not an absolute dogma. The nature of the discharge can vary greatly under the influence of external factors, but at the same time remain within the normal range.

What can affect the natural processes in the genitals:

· Beginning of sexual activity. When entering into intimacy with a man, a woman receives a lot of bacteria that were previously absent in the microflora of the vagina. These microorganisms may be harmless, but the immune system needs time to adapt. During this period, the previously clear vaginal discharge becomes thicker, darker. It is important that the change in whites is not accompanied by the appearance of itching and other unpleasant sensations;

• Sexual intercourse. If a couple does not use a condom, then within a few hours after intercourse, mucous yellow discharge from the vagina in the form of clots may appear. Gradually whites become more liquid, plentiful. After protected intercourse, scanty white discharge from the vagina appears, which is a lubricant secret;
• Taking combined oral contraceptives. Drugs in this group strongly affect the process of ovulation. While taking COCs, scanty, odorless vaginal discharge appears, but immediately after the pills are canceled, the volume of leucorrhoea is restored to its previous level;
• Pregnancy. During the period of gestation, a woman’s body undergoes serious hormonal changes. The blood supply to the internal genital organs is increased. A small amount of plasma can enter the vaginal lumen, resulting in a watery vaginal discharge. In the last trimester of pregnancy, mucus is abundantly discharged from the cervical canal, which indicates an impending birth. The future mother should carefully monitor her condition. The appearance of an unpleasant or unusual aroma, blood impurities in the secretions of a pregnant woman is a reason for an urgent visit to a doctor;
• Postpartum period. Vaginal discharge after childbirth is called lochia. They consist of mucus, dead tissues of the inner lining of the uterus, bloody clots. In the first days after childbirth, the discharge is abundant, bloody, similar to normal menstruation. Lochia stand out within 3-8 weeks with a gradual decrease in volume and clarification. After about 2 months, strong vaginal discharge stops, the usual whites of a yellowish-beige hue appear;
• Breastfeeding. Within a few months after childbirth, the nature and volume of discharge return to normal. The fact of lactation does not have a significant effect on leucorrhoea;
• Postmenopausal. From the moment the menopause begins and until the reproductive function is completely suppressed, the amount of leucorrhoea decreases until the vagina is completely dry. Microorganisms predominate in the composition of the secretions and there is almost no vaginal secretion.

All of the above situations do not require treatment and are considered normal. But this is provided that there are no other alarming symptoms. If you suddenly have abundant vaginal discharge, your health has changed, it is better to see a doctor. The doctor will dispel doubts.

Types and causes of abnormal vaginal discharge

Discharge during sexual infections

Reproduction of infectious agents is manifested by yellow or greenish vaginal discharge with an odor. Leucorrhea becomes frothy, irritates the skin of the perineum, accompanied by burning, pain during urination. The symptoms are consistent with a trichomoniasis infection, but may be a sign of another sexually transmitted infection.

With chlamydia, frothy discharge from the vagina is also accompanied by an increase in the Bartholin’s gland, pain in the lower abdomen.

Gonorrhea presents with yellowish-white discharge with intermenstrual bleeding.

Discharge in thrush (candidiasis)

The disease develops with the active growth of fungi of the genus Candida. These microorganisms live in the microflora of a healthy person, but normally do not cause concern. Under the influence of various factors, fungi begin to grow, affect the mucous membrane of the genital organs. Candidiasis is characterized by itching in the vagina and discharge of a curdled structure. The external genital organs of a woman turn red, swell. Excessive amount of Candida is found in the smear.

Bacterial vaginosis discharge

Leucorrhea becomes copious. With vaginosis, a woman complains of a foul-smelling gray discharge from the vagina and mild periodic itching, which intensifies after intercourse. The long course of the disease is manifested by sticky, green whites that do not drain from the vaginal wall and are clearly visible when speculums are inserted.

Discharge from nonspecific vaginitis

The leucorrhoea can be anything from watery to cloudy purulent. A woman complains of unpleasant vaginal discharge that irritates the skin, causes itching and burning in the perineum. In the presence of pus, an increase in temperature is possible. Often, blood is found in the whites.

Vaginal bleeding not related to menstruation

Intermenstrual bleeding is not normal. Such secretions always indicate disorders in the body. Anxiety should be caused by the appearance of blood in any form and quantity. It can be bright pink or dark brown, almost black discharge, abundant or smearing.

The main causes of blood in the whites:

• latent course of sexually transmitted infection;
• chronic inflammation of the uterus, vagina;
• polyposis;
• ectopic pregnancy;
• mechanical damage to internal genital organs, etc.

Bloody discharge from the vagina during pregnancy is a direct threat of miscarriage. A woman should see a doctor as soon as possible.

Diagnosis of vaginal discharge

The primary diagnosis can be made by a doctor after a standard gynecological examination. The doctor at the reception collects the patient’s history, finds out the presence of provoking factors, hereditary predisposition, chronic illness. Of great importance for diagnosis is information about the onset of menstruation, sexual activity, the number of pregnancies and their outcome.

To determine the exact cause of vaginal discharge, additional tests may be required:

• General and biochemical blood tests. The study is necessary to determine the general condition of the patient. For example, elevated ESR and leukocytosis are a sign of inflammation. Deviations in biochemistry indicate diseases of the thyroid gland, kidneys, liver;
• Colposcopy. The mucous membrane of the vagina and cervix is ​​examined under multiple magnification. At colposcopy, the doctor makes test samples with iodine, acetic acid to determine visually invisible pathologies. The study allows to exclude precancerous conditions and oncopathology;
• Ultrasound of the pelvic organs. An ultrasound examination is prescribed for severe pain, deviations in the results of a smear and a blood test. The results of ultrasound display the anatomical structure and location of organs, changes in the fallopian tubes, ovaries, uterus, and adjacent tissues. If necessary, dopplerography is performed – this method allows you to assess the intensity of blood flow;
• Bacteriological culture of discharge from the mucous wall. The analysis is prescribed for purulent discharge from the vagina, viscous, like snot, with an unpleasant odor. Based on the results of bakposev, it is possible to determine the causative agent of the disease and answer the question of why a woman has certain symptoms. According to the analysis, targeted therapy is also selected;
• Laparoscopy. This is a minimally invasive study that helps determine the cause of vaginal discharge and pain in an unclear clinical picture. Using a miniature video camera, the doctor visually examines the internal organs of the patient. During laparoscopy, you can do a hysteroscopy and take tissue samples for a biopsy;
• Consultation of narrow specialists. Joint work of a gynecologist, endocrinologist, surgeon, therapist may be required.

Depending on the clinical manifestations, the doctor also prescribes a test for tuberculosis, a Wassermann test to rule out syphilis, CT or MRI with a clarifying purpose.

Treatment of vaginal discharge

It is not necessary to treat all types of leucorrhea, but only obviously pathological ones. If cloudy vaginal discharge is accompanied by pain in the lower abdomen, the appearance of dirty smearing spots on linen and other alarming symptoms, the doctor will prescribe therapy.

Conservative treatment

The regimen is selected individually. If an infection is detected, both partners should be treated.

For the treatment of abnormal discharge, the doctor may prescribe:

• Antibacterial drugs in injections or tablets. Antibiotics destroy pathogens, suppress inflammation;
• Antihistamines. Means are effective in the presence of an allergic reaction;
• Non-steroidal anti-inflammatory drugs. Medicines help to quickly stop pain, reduce swelling, and alleviate the general condition of a woman;
• Antimycotics. The drugs are used in the treatment of candidiasis, with milky curdled discharge from the vagina;
• Topical drugs. The doctor prescribes suppositories and creams to normalize the microflora, accelerate the healing of the mucosa, and form local immunity.

Diet

In the treatment of thrush and a number of other vaginal dysbiosis, diet is very helpful. A woman is recommended to give up sweet, flour products, kvass, alcoholic beverages. In the diet, limit the amount of smoked, spicy foods.

Surgery

Purulent green vaginal discharge may require surgery. During the operation, the doctor eliminates the cause of the disease: a cyst, an abscess of the Bartholin gland, a focus of inflammation in the uterine cavity, etc. A complete sanitation of the internal genital organs is performed. The operation is also indicated for various forms of oncopathology, benign formations.

Expert advice

Once again, I want to remind you that discharge is the norm. If you develop a rash in the perineum, the skin itches, itches or smells, the whites become cloudy, then go to the doctor. No need to drink decoctions of herbs and use other dubious recipes. Modern medicine easily solves most problems. In the case of a serious pathology, self-medication can lead to sad consequences. Take care of your health. We recommend that mothers bring their daughters to the doctor’s appointment when the first questions about physiology appear. The doctor will explain intimate moments to the child in an accessible way and teach the rules of hygiene.

Bani Odekh Elena Yuryevna

Obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostician, Candidate of Medical Sciences
Experience 23 years

Possible complications

infection. Inflammation can spread to the uterine cavity, fallopian tubes, ovaries. The formation of abscesses leads to blood poisoning, the formation of adhesions, and infertility. In pregnant women, ignoring atypical secretions is fraught with spontaneous abortion, premature birth, intrauterine infection of the fetus, and the birth of a small child.

Prevention

Preventive measures are limited to the prevention of vaginosis and genital infections – these are the main causes of atypical vaginal discharge.

It is enough to follow a few simple recommendations:

• adhere to the principles of proper nutrition;
• control weight and engage in feasible physical activity;
• wash properly with neutral soap;
• wear loose underwear made from natural fabrics;
• use a condom when having sex with a non-regular partner;
• visit a gynecologist at least once a year.

Women with endocrine disorders and a predisposition to cancer are recommended to be screened twice a year. Early diagnosis is the key to successful treatment.

At the MedEx clinic you can have a complete gynecological examination. We will tell you if your condition is normal or pathological, what to do with vaginal discharge and when to sound the alarm. Appointments can be made by phone.

Sources

Expert Council of the Russian Society of Obstetricians and Gynecologists. Clinical guidelines for the diagnosis and treatment of diseases accompanied by pathological discharge from the female genital tract.

· Radzinsky VE A review of foreign clinical guidelines for the treatment of women with complaints of vaginal discharge – Journal of Obstetrics and Gynecology: News. Opinions. Education, 2013.

Vaginal discharge (leucorrhoea): types, causes, treatment

How do you know how much vaginal discharge is normal and how much 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.

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

The nature of the discharge, as a rule, changes during the menstrual cycle, but in the absence of diseases, they never lose the properties characteristic of normal discharge.

Signs of abnormal 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.

The following signs are typical for pathological discharges that occur in various gynecological diseases:

• 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, as a rule, 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.

Diagnosis of the cause of vaginal discharge

When a pathological discharge appears, every woman should make an appointment with a gynecologist. 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 the 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 discharge are prescribed after the final diagnosis is 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: for oral administration (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 the fact 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 suppositories Betadine ^® 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 for the use of Betadine ^® containing an iodine compound, there are 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 prescribed0203 ® 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
• Maintain 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
• 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 spotting 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.

Read on topic

Bacterial vaginosis

Almost 90% of cases of pathological discharge in women are diagnosed with bacterial vaginosis. Why does this disease occur and how is it treated?

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Vaginitis suppositories

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

Characteristics and properties of povidone-iodine. What is povidone-iodine used for? Instructions for use of the solution, ointment, suppositories Betadine ^® with 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” from 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.
9. Clinical guidelines “Menopause and climacteric condition in women”// ROAG 2021.