Vaginal discharge

• atrophic vaginitis (common in older women)
• nonspecific vaginitis
• foreign bodies (such as a forgotten tampon)
• Monilia (white cheesy discharge caused by candidiasis ) a type of yeast infection
• Trichomonas (white, frothy discharge and intense itch )
• sexually transmitted disease (if discharge is cheesy, smelly, or bloody)
• bacterial vaginosis
• drugs (some antibiotics and estrogen-containing drugs)
• irradiation of the reproductive tract
• sexual excitement (normal discharge)
• emotional stress (normal discharge)

Note: There may be other causes of an abnormal vaginal discharge. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for an abnormal vaginal discharge, occurring alone or in combination with other problems.

Home Care:
Good hygiene can help prevent some of the causes of abnormal discharge as well as help get rid of it if it occurs. Sometimes a little bit of extra patience is needed.

Ask your health care provider or gynecologist about the advisability of using a douche. Frequent douching may remove the healthy bacteria lining the vagina (normal flora) that help protect you from infection. Douche recommendations may include: douche daily (and following intercourse) with a Betadine solution (two TABLESPOONS to one quart of warm water), baking soda solution (one teaspoon to one quart of warm water), or with white vinegar (2 TABLESPOONS to one quart of warm water). Do not douche for 24 hours prior to seeing the doctor.

For vaginitis , multipurpose medications (such as AVC creams) may help.

For yeast infections, medications such as Monistat can now be purchased over the counter. Prescription drugs may be necessary for some cases. Use these only if you KNOW that the discharge is caused by a yeast infection (if you have had identical symptoms that were diagnosed by the health care provider as a yeast infection).

If the discharge is caused by a sexually transmitted disease, the sexual partner must also be treated, even if there are no symptoms. Many organisms can harbor themselves without producing symptoms. Failure of the partner(s) to accept treatment can cause continual reinfection which may eventually (if not taken care of) lead to more extensive problems, possibly limiting future reproductivity and effecting overall health.

Call Your Healthcare Provider If:

• the discharge is associated with abdominal discomfort or pain.
• the problem occurs in a child who has not reached puberty.
• the discharge may be caused by taking a drug.
• the problem persists for longer than two weeks or becomes worse.
• a sexually transmitted disease is suspected.

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting the vaginal discharge in detail may include:

• time pattern
  • When did this begin?
  • Does the discharge remain constant throughout the month?

• quality
  • What does the discharge look like (color and consistency)?
  • Is there an odor?
  • Is there pain, itching , or burning?

• aggravating factors
  • Does your sexual partner have a penile discharge?
  • Do you have multiple sexual partners or sexual partners that you do not know very well?

• relieving factors
  • Is there anything that relieves the discharge?
  • Does frequent bathing help?
  • Have over-the-counter creams been tried?
  • Has douching been tried? What kind?

• other
  • What other symptoms are present?
    • abdominal pain ?
    • vaginal itching ?
    • fever ?
    • vaginal bleeding ?
    • rash ?
    • warts ?
    • other lesions?
    • changes in urination?
    • difficulty or pain on urination ?
    • blood in urine ?
    • diarrhea ?

• other important information
  • What medications are being taken?
  • What is the frequency of sexual activity?
  • Do you use condoms ?
  • Do you have any allergies ?
  • Have you changed the detergents or soaps that you use?
  • Do you frequently wear very tight panties or pants?

The physical examination may include a pelvic examination.

Diagnostic tests that may be performed include:

• a culture of the mouth of the womb ( cervix ) (if venereal disease is suspected)
• microscopic examination of vaginal discharge specimen

Intervention:
Suppositories or creams may be ordered and antibiotics may be prescribed. Oral medication for fungus or Trichomonas may be used in difficult cases. The sexual partner(s) may also need treatment.

After seeing your health care provider:
You may want to add a diagnosis related to an abnormal vaginal discharge to your personal medical record.


This is an illustration of the female reproductive system. Both internal and external views are shown here.