Complications in Vaginal Discharge
* Untreated vaginal infection can spread to the upper reproductive tract. It can cause more serious illness and ultimately infertility.
* Cervical infection is generally harmless although it may cause infertility if it grows very large.
* There are complications associated with infective discharge in pregnancy too.
Cure Rate of Vaginal Discharge
* Bacterial vaginosis has 70-80% cure rate after one course of treatment.
* Candidiasis has cure rate of 80-95%
* Trichomoniasis has a 95% cure rate.
Prevention in Abnormal Vaginal Discharge
Following steps should be taken to prevent abnormal vaginal discharge:
* Keep genital area clean and dry.
* Use infection treatment creams.
* Preferably use condoms to avoid sexually transmitted disease.
* Try to avoid using feminine fragrances, powders or hygiene sprays in the genital area.
* Wearing extremely tight pants may cause irritation, so its better to avoid it.
* Try to use and wear cotton panties and simply stay away and avoid underwear made of silk, nylon or of any other synthetic fibers, synthetic fibers are not so absorbent, in fact they restrict the air flow and increase sweating in the genital area and end result comes is only irritation.
* Don’t use tampons, try to use pads.
* If you are diabetic then try to keep blood sugar level under good control.
Having some amount of vaginal discharge is normal. It may be either due to physiological or pathological reasons. Many cases of vaginal discharge are not caused by sexually transmitted diseases bur still require treatment. Sexually transmitted diseases may also present with the vaginal discharge. So if one observes symptoms of abnormal vaginal discharge like change in color, consistency or in odor of the discharge, doctor must be consulted as soon as possible.
Non infective causes of vaginal discharge:
Foreign bodies
* Most can be manually moved but these may be very small (fibrous material or small beads in child’s vagina, a small piece of torn condom) not visible and require a lavage.
* Large or irregular shaped objects cause muscular contraction of vaginal walls. Anesthesia may also be needed.
* A short course of antibiotics may be needed to treat secondary infection.
* Allergic reactions can be treated by identifying and removing the cause.
Treatment of persistent discharge
* In some cases, repeated examination and screening no positive results and the patients still complain of vaginal discharge.
* It is appropriate to explore the nature of discharge relative to its normal discharge to review personal hygiene habits. Advise to avoid perfumed products, tight synthetic clothing.
* Explore the complaints like depression, anxiety or psychosexual dysfunctions.
* Premenopausal changes may predispose women to vaginal infection which may respond well to hormonal creams.
Epidemiology
* The most common cause of vaginal discharge in childbearing women is bacterial vaginosis.
* 50% cases of bacterial vaginosis are same that its true occurrence is mostly unknown.
Infective cause
The most common infective cause is vulvovaginal infection which affects 75%of women during their reproductive life.
Vaginal Discharge in pregnancy
The quality and quantity of vaginal discharge change during pregnancy. More discharge is produced during pregnancy.
Vaginal discharge during pregnancy is due to miscarriage, preterm labor, and premature rupture of membranes or low birth weight.
Diagnosis of Abnormal Vaginal Discharge
1. A full clinical and sexual history should be sought with the nature of the discharge (what is its color, odor, duration, consistency) and symptoms that includes itching, dyspareunia, abdominal pain, abnormal bleeding.
2. Consider the medications (e.g. antibiotics, steroids) previous treatments used and medical conditions like diabetes.
3. Patients who have the symptoms of bacterial infection can be treated without sampling. Otherwise “Triple Swab” test should be taken.
Triple Swab test consists of following steps
* High vaginal swab to identify bacterial infection.
* Endocervical swab in transport medium to diagnose the disease.
* Endocervical swab for DNA test to diagnose the abnormal discharge.
4. Vaginal pH testing (using narrow range pH paper) is a quick, cheap, simple test for the abnormal vaginal discharge.
