Vaginal Discharge Solution
In 1959, investigators examined a group of 113 New York City women, an unknown number of whom showed evidence of cervical or vaginal infection (19). The researchers quantified the discharge by swabbing the entire vagina during the course of an examination and measuring the weight change in the swab. The mean vaginal discharge was 0.76 g for all patients, 1.0 g for women with vaginal infection, and 0.50 g for women who had douched the day before the examination. The mean weight of vaginal discharge increased among women who were periovulational. The observation that variation in cervical secretions was associated with changes in vaginal discharge led the Australian physician John Billings to study vaginal secretions as a way of predicting ovulation (22,23). Billings studied several hundred women using self-report, often correlated with biochemical markers of ovulation, and described a typical pattern of vaginal discharge based on the changes in cervical mucus. The pattern began with a...
Bacterial vaginosis one of three major causes of vaginal discharge. (The others are Candida and Trichomonas species.) Bacterial vaginosis produces a change in the normal bacterial flora of the vagina. The direct cause of the change is not known, and it is unclear whether it is contagious. The condition is called vaginosis instead of vaginitis because there is no apparent inflammation. Bacterial vaginosis causes a discharge that is often malodorous but does not typically cause itching. This problem has led to slang terms that refer to women as fish or statements about fishy odors of the vagina. Treatment typically employs metronidazole.
Physiological leukorrhea A normal but persistent whitish vaginal discharge that is not a symptom of infection. Usually white or yellow mucous discharge from the cervical canal or the vagina. It may constantly be present but somewhat increased preceding and following menstruation, and during sexual excitement. Leukorrhea may be abnormal if it is increased in amount, has a change of color, is malodorous, or contains blood.
Vaginal discharge Abnormal vaginal secretions. Healthy vaginal secretions are made up of aging cell cast off from the vaginal walls, secretions from the cervix that help protect the uterus from infection and aid in fertility, and chemicals produced by vaginal bacteria and fungi. Normal vaginal secretion is clear and or white. Different conditions can cause the discharge to become different colors. If a color change from what is normal for an individual occurs, a doctor should perform an examination to determine the cause. Any abnormal aromas of the vaginal area also need to be investigated by a doctor. Abnormal discharge can be due to infection and is frequently associated with pain, burning, itching, and painful urination. pelvic inflammatory disease (PID), herpes genitalis, other STDs, infection of the inside of the uterus, and inflammation of the vagina due to lack of estrogen are other possible causes of vaginal discharge.
Stratified squamous epithelium high in glycogen content Lactic acid-producing microbes colonize the vagina shortly after birth White or blood-tinged vaginal discharge may be present (3) The vaginal epithelium thins, is less stratified, and has a low glycogen content The vulva and vagina of the newborn exhibit the effects of residual maternal estrogens (Fig. 1). At birth, the labia majora appear plump. The labia minora are well developed and may protrude beyond the labia majora. Similarly, the clitoris may appear disproportionately large. The vaginal introitus is visible but small (typically 4 to 5 mm in girls under the age of five). The hymen may appear thick and fibriated, a hymenal configuration common in girls under the age of three years. Bartholin's glands are visible and Skene's (paraurethral) glands are well formed. The urethral opening is not easily discerned. The vaginal epithelium is glycogen-rich and is colonized with lactic acid-producing microbes, such as Lactobacillus...
Also, decreasing moisture to the irritated area is helpful. Patients should avoid wearing synthetic fabric clothing and wear cotton undergarments to help promote air circulation and, thus, decrease the effects of perspiration and moisture on the vulvar skin. Normal vaginal discharge,
C. (Torulopsis) glabrata is a vaginal yeast infection that causes vulvar burning. Typically, women describe constant vulvar burning without an associated increase in vaginal discharge. Usually, these women have seen multiple providers and tried many over-the-counter as well as prescription medications without relief. On vulvar examination, the genitalia can appear normal or there can be generalized erythema. Microscopic evaluation of the vaginal discharge may be normal or numerous budding yeasts may be present. A yeast culture is necessary to identify that C. (T.) glabrata is present. Treatment can be challenging, as it is resistant to all azoles used typically for Candidal infections (8-11). Boric acid
There is a wide variation in what women and physicians consider normal vaginal discharge. Many of the symptoms associated with vaginal abnormality are present in healthy women, and healthy women experience vaginal discharge. The quantity of discharge appears to vary from woman to woman, as well as throughout an individual woman's menstrual cycle. Normal vaginal fluid may have an unpleasant odor. There is some evidence that healthy women can experience irritative symptoms. Although vaginal discharge, odor, and irritation may be normal, they may also be legitimate indicators of disease. Given the prevalence of vaginal symptoms, it is important for primary care researchers to develop clinically useful ways of making the distinction between normal and pathologic discharge and establish some criteria for normality. Existing studies typically classify women as normal if either they had been examined thoroughly and no disease was found ( clinically normal ) or if they declared themselves...
Most girls have no symptoms in the early stages. As the disease progresses, symptoms may include burning during urination, pelvic pain, heavy menstrual flow with severe cramps, bleeding between periods, pain during sex, unusual vaginal discharge, fever, low backache, nausea, and vomiting. The cervix is tender if palpated. The very youngest girls tend to have the most severe symptoms.
In the past, androgens and progesterones have been used widely. Andro-genic side effects are common and include clitoral enlargement, hirsutism, amenorrhoea, increased libido, and voice changes (25). Side effects of progesterone include changes in vaginal discharge. Placebo-controlled trials have demonstrated that testosterone (26) is no more effective in the treatment of lichen sclerosus. Clinical trials have also indicated that prednisolone is not an effective treatment (27).
C. albicans is the most common strain of Candida to cause infection in the vulvovaginal area (8). Women complain of vulvar itching and or vaginal discharge. On examination, the vulvar skin and associated affected skin have an irregular or asymmetrical pattern, mild to intense erythema, edema of the labia minora (usually), and edema of the labia majora (possibly). If the C. albicans infection spreads to the adjacent skin in the genitocrural folds, as well as to the perianal area, satellite pustules occur frequently in these skin areas as well. Excoriations can be present and there may or may not be vaginal discharge. Vaginal discharge can be scant to heavy, thin and milky, clumpy and curdy, or cottage cheese-like. In addition, the woman may describe a foul, sweet, or strong odor associated with the discharge. Microscopic evaluation of the vaginal discharge usually documents the presence of hyphae and budding yeast. If the concentration of yeast is low, a yeast culture is useful to...
Next, the vaginal discharge should be evaluated microscopically. This is accomplished with a wet-smear preparation of the vaginal discharge. From this sample, a maturation index is performed to identify maturity of squamous cells to determine whether an atrophic or erosive condition is occurring. The sample should be evaluated microscopically for the presence or the absence of white blood cells (WBCs), red blood cells, Lactobacilli, budding yeast, hyphae, or Trichomonads. A yeast culture of vaginal discharge is useful either for identification of a subclinical yeast infection or for yeast strain identification.
Examination of the vulvar tissue demonstrates a pale to erythematous mucosa. A urethral caruncle can be present (Fig. 5). The maturation index from microscopic evaluation of vaginal discharge demonstrates a decrease in the number of mature squamous epithelial cells and an increase in the number of basal and parabasal epithelial cells. Frequently, there is an increase in WBCs seen microscopically in the wet preparation sample.