- Bacterial vaginosis
The most common cause of pathological vaginal discharge is bacterial vaginosis. It develops when lactobacilli (Dodderlein sticks), normally present in the vagina, are replaced by other bacteria. The factors that provoke the development of bacterial vaginosis have not been fully elucidated. However, it does not occur in patients who have not had sexual intercourse, and is more often noted in women who regularly wash the vagina (apply douching). One of the typical signs of bacterial vaginosis is more abundant discharge from the vagina, which can be transparent or yellowish. They often have a fishy smell and can contain small bubbles. The last symptom arises in connection with the release of gas by bacteria that cause dysbacteriosis. In bacterial vaginosis, there is usually no evidence of inflammation; their presence may indicate another disease. There is no reliable confirmation that bacterial vaginosis is transmitted sexually, so treatment of a partner does not affect the frequency of relapses and the severity of symptoms. Bacterial vaginosis is an unpleasant condition and, with frequent relapses, can depress a woman - but rarely causes any dangerous complications. In many women, it can flow without any symptoms. Subsequently, the pathogenic microflora in them disappears independently, without treatment.
Potential complications
Bacterial vaginosis can become a more serious problem in two cases.
• The relationship between the infection that causes bacterial vaginosis and some cases of premature birth or miscarriage at later stages is established.
• There is also a possible association between bacterial vaginosis and pelvic inflammatory diseases that develop after intrauterine contraceptive use.
Pregnant women are currently undergoing a massive screening for bacterial vaginosis, especially if they have had similar problems during previous pregnancies. Antibiotic therapy gives a good effect. It is possible to diagnose bacterial vaginosis precisely by detecting pathogenic bacteria on the surface of the vaginal cells during a microscopic examination. Bacterial vaginosis can be suspected if the vaginal discharge has a decreased acidity (high pH) or fishy odor, which is enhanced by interaction with potassium hydroxide ("odor test").
- Thrush
The milkmaid can cause several types of yeast-like fungi. All of them are often found in the environment. Just as in the case of bacterial vaginosis, there is no clear indication of a sexual route for infection in the thrush, and partner treatment is not indicated, except when it also has symptoms of the disease. It is assumed that the pathogen of thrush can normally be present on the surface of the body and in the intestine, which is the reservoir of infection. From there, it can spread to the vagina.
Symptoms
Detachable with thrush usually thick, white, cream or yellowish. Often in consistency it resembles cottage cheese. Most women experience itching in the vagina, discomfort and redness of the external genitalia. Most often thrush occurs spontaneously, without an obvious cause, but it is assumed that this may be due to the use of antibiotics. Some diseases, such as diabetes and HIV infection, can also provoke an exacerbation. The disease is easy to diagnose! when yeast cells are detected in a vaginal smear. However, in some cases, the diagnosis is made on the basis of typical symptoms and improvement after the use of antifungal vaginal suppositories.
Treatment
Many women independently diagnose themselves thrush and buy the appropriate drugs in the pharmacy. It should be noted that bacterial vaginosis is more common than thrush and diagnosis without tests is often mistaken. Antifungal tablets, designed for a single or double intake, are very effective. Other methods of treatment include:
• Live yoghurt cultures - some women note improvement and relief of itching after injecting "live" yogurt into the vagina;
• refusal to use soap for genital hygiene, as well as bath foam and intimate hygiene products;
• wearing "breathable" clothing made from natural materials (such as cotton) - helps reduce the severity of symptoms or the frequency of relapses.
A small proportion of patients experience frequent exacerbations, sometimes in the same phase of the cycle. In this case, it may be useful to take regular antifungal medications before the expected exacerbation, within 3-6 months. Some women normally have abundant vaginal discharge, which are clear, odorless and not accompanied by itching. This can continue for several months or years without the effect of antibacterial and antifungal therapy. The causes of this phenomenon are unknown, but the provoking factor may be the use of hormonal contraceptives.
- Cervical erosion
Some women on the cervix can have tissue, which is normally only present in the cervical canal. This condition is called chronic cervical erosion. Since this tissue is less stable than normal vaginal mucosa of the cervix, erosion can produce mucus that goes with vaginal discharge. Treatment consists in elimination of a pathological tissue by means of freezing under local anesthesia (cryosurgery). Taking contraceptive pills at first can cause the appearance of more abundant, but otherwise normal discharges from the vagina. This should not be cause for concern. In cryosurgery, extremely low temperatures are used to destroy unwanted tissues. This technique can be used to treat cervical erosion. Allocations that result from unprotected sex lead to more serious consequences than those associated with non-sexually transmitted infections. It is important to take care of their early diagnosis and treatment.
Trichomoniasis
Trichomoniasis is caused by the simplest type of Trichomonas vaginalis and occurs after unprotected sex. Symptoms usually appear 1-4 weeks after infection and usually include abundant yellowish, greenish or white discharge, which are very similar to those observed with bacterial vaginosis. The secretions also often have a fishy smell and can contain bubbles. Unlike bacterial vaginosis, often there is inflammation of the vagina and external genital organs, in the cavity of the small pelvis may be noted soreness. A significant proportion of women have erased symptoms, and some have no symptoms at all.
Treatment
Diagnosis is carried out using a microscopic examination of the smear. A woman and her sexual partner need a metronidazole course and should abstain from sexual intercourse until the symptoms of inflammation disappear. Very rarely the agent of infection does not respond to specialized treatment. Fortunately, despite the fact that trichomoniasis is a very unpleasant infection, it practically does not cause irreversible complications. If one STD is found, the woman has a risk of having others, so it is desirable for such patients to complete a full urogynecological examination. Condoms help prevent the spread of sexually transmitted diseases. Not latex condoms reduce the risk of allergic reactions. Analysis for trichomoniasis is usually performed in gynecological units. The bacterium can be isolated from a smear in the laboratory. Most women with gonorrhea and chlamydia do not show obvious symptoms of these diseases. They are often complicated by pain in the small pelvis or bleeding after intercourse. Fewer patients have clear or yellowish discharge, possibly with an admixture of blood. This is a consequence of infection of the cervix, which on examination looks red and inflamed. Both infections are transmitted during unprotected intercourse. Symptoms usually appear within 1-3 weeks after infection. In some cases, the doctor may mistakenly decide that the cause of the infection is thrush, and to suspect another infection only if the treatment is ineffective. The diagnosis is confirmed during a thorough urogynecological examination, after which a continuous course of antibiotics is prescribed. Of course, the sexual partner should also undergo a course of treatment. It is necessary to abstain from sexual intercourse before its successful completion. For the diagnosis of gonorrhea and chlamydia, smear analysis is needed, which are taken with gynecological examination.
Primary diagnosis
Timely diagnosis of these infections is extremely important, since in the absence of treatment, perhaps, their progression with the development of inflammation of the fallopian tubes and pelvic organs, as well as infertility. The above reasons for pathological vaginal discharge may also occur in postmenopausal children and women. However, other reasons are more common in these age groups. The low level of production of female sex hormones is a frequent factor.
Level of hormones
Before establishing a regular cycle, the vaginal wall is thinner and has less resistance than adults, due to the lower level of estrogens and progestogens (female hormones) circulating in the blood. One of the causes of inflammation of the vagina in girls can be a reaction to a foreign body, introduced by the child himself. It can be such an inoffensive object, as a fluff or a small toy.
Infections
Inflammation of the vagina can also be associated with poor hygiene. Sometimes it can be caused by helminths. Detection of vaginal secretions in a child can disturb parents due to fear of accusation of lecherous actions, but doctors say that in most cases the cause is different. Usually, a specialist needs to take tests to detect the causative agent of the infection; You may also need a detailed examination of the vagina in case the foreign body is inside. It should be carefully extracted - with minimal discomfort for the child. Successful cure is usually achieved simply by following the rules of hygiene and in some cases with the help of a course of antibiotics. Many post-menopausal women remain sexually active and may continue to be at risk of infection. However, another, more frequent cause of excretions in this period of life is atrophic colpitis.
Causes
Probably, the disease develops due to the thinning of the vaginal wall against the background of a decrease in the level of female sex hormones after menopause. The vagina, thus, becomes more susceptible to infection with microorganisms located on the skin. The number of normal vaginal bacteria that perform a protective function and lactobacilli, which normally increase resistance to pathogenic bacteria, also decreases.
Diagnosis and treatment
A woman can note some discharge, as well as inflammation of the vagina and sometimes bleeding, especially after sexual intercourse. The diagnosis is established by the doctor on the basis of detection during a vaginal examination of typical changes in the vaginal wall. Can be prescribed a course of antibiotics in the form of tablets or creams. Often hormonal vaginal creams are also used. The vaginal wall can become more protected with prolonged use of hormone replacement therapy (HRT). Sexually active older women are also susceptible to sexually transmitted diseases. Hormone replacement therapy (HRT) consists in the appointment of a combination of estrogens and progestogens to compensate for the deficiency of female sex hormones that occurs in postmenopausal women.