Vaginal discharge: norm and pathology

Or what you need to pay attention to a woman

Many women, “obsessed” with the cleanliness of the body, in every possible way strive to get rid of vaginal discharge (or pid discharge women), considering them a manifestation of “not cleanliness”, ill health.

They do not understand that the presence of vaginal discharge is as physiological as the production of saliva, tears, gastric juice and other physiological secretions. Getting rid of these secretions is pointless and unsafe. On the other hand, there are a number of diseases in which a change in the nature of the discharge is the first alarming sign that forces a woman to consult a gynecologist. Let’s try to figure out where the border between the norm and pathology lies.

My name is Mrs. Maria Rudnik, I’m the CEO of the Mami.clinic, a fertility coach and I have been helping women get pregnant for many years. I constantly talk with women, immerse myself in their problems and know what is going on not only in their body, but also in their head.

Normal Vaginal discharge

In the first phase of the menstrual cycle (with a 28-day cycle – from the end of menstruation to the 12-13th day of the cycle, which is counted from the first for menstruation0) – the discharge is not abundant (1-2 ml per day – the spot diameter on the daily pad is 2- 3 cm), watery or slimy in nature, have a homogeneous consistency (or there may be impurities in the form of small (up to 2 mm) lumps), they are colorless or have a whitish or yellowish tint, odorless or with a slight sour smell. During the period of ovulation (1-2 days in the middle of the cycle), the amount of discharge increases to 4 ml per day (the size of the spot on the daily pad increases to 5 cm), they become slimy, viscous, sometimes the shade of the discharge becomes beige.

In the second half of the menstrual cycle, the amount of pid discharge women (compared to the ovulatory period) decreases, the discharge may become creamy or jelly-like in nature. A few days before the onset of menstruation, a repeated increase in the amount of discharge is characteristic. Such a cyclical change in the nature of secretions conditionally persists throughout the entire reproductive period of a woman – from the establishment of a regular menstrual cycle to the appearance of the first signs of extinction of the hormonal function of the ovaries in premenopause.

However, there are many factors that, while not being pathological, change the nature of vaginal discharge.

Factors of Normal Vaginal discharge

Such factors include the onset of sexual activity and the change of sexual partner, the sexual intercourse itself, the use of hormonal contraceptives, the change of means for intimate hygiene or the composition of underwear, pregnancy, the postpartum period.

The onset of sexual activity and the change of sexual partner lead to the fact that a new, alien, unfamiliar, although absolutely normal, non-pathogenic microflora enters the woman’s genital tract. As a result, within a certain period of time (purely individual for each woman), the reproductive system and the whole body of a woman adapt to the “new residents”. During this period, an increase in the amount of discharge, a change in color and consistency is characteristic. The main thing is that there are no unpleasant sensations (discomfort, itching, burning).

Sexual intercourse itself also contributes to the appearance of specific vaginal discharge. Within a few hours after unprotected intercourse (without using a condom), vaginal discharge is in the form of transparent clots, with a white or yellowish tint. After 6-8 hours after intercourse, the nature of the discharge changes: they become liquid, white, and abundant. If sexual intercourse was protected by a condom or the method of interrupted intercourse was used, then after it the secretion of a creamy, white, meager secretion, consisting of “worked out” vaginal lubricant, is characteristic.

Pathological Vaginal discharge

Let’s say right away that, by the nature of the discharge, it is almost impossible to accurately establish a reliable diagnosis, since in most cases there is a combination of two or more pathological processes, and often doctors are faced with atypical manifestations of a particular disease. Therefore, according to the appearance of the discharge, one can only assume the development of a certain pathological process, and data from clinical, laboratory and instrumental examinations must prove its presence.

The most common causes of changes in the nature of vaginal discharge are specific infectious and inflammatory diseases of the reproductive system, namely trichomoniasis, candidiasis, chlamydia, gonorrhea, as well as bacterial vaginosis and nonspecific inflammatory diseases of the genital organs.

Let’s figure out what the pid discharge woman looks like during these pathological processes, and with what methods you can confirm or refute the diagnosis.

Trichomoniasis

Abundant white, yellowish or greenish frothy discharge with an unpleasant odor, accompanied by itching and / or burning, painful urination. For clarification, it is necessary to study a native smear or a smear after staining according to Romanovsky-Giemsa, or a PCR study of vaginal discharge or a cultural method.

Thrush (candidiasis)

Thick discharge, like lumps of yellowish cottage cheese, the amount of discharge is greatly increased. As an accompaniment – exhausting intense itching of the genital organs and irritation (redness, swelling) of the external genital organs. Confirmation – microscopic examination of smears from the vagina, bacterial culture of secretions.

Bacterial vaginosis

The amount of discharge increases significantly, the color of the discharge is grayish-white, an unpleasant odor appears (the smell of rotten fish) and a mild recurring itching of the external genitalia. Symptoms worse after intercourse. With a long existence of the discharge process, they become yellow-green, sticky, when viewed in mirrors, they are evenly “smeared” along the walls of the vagina. To confirm the diagnosis, a bacterial culture of vaginal discharge is performed.

Chlamydia

An increased amount of discharge is rare. The yellow color of the pid discharge woman is characteristic (this sign is especially noticeable to the doctor when examining a woman in the mirrors, since the discharge comes from the cervical canal and flows down the walls of the vagina), often accompanied by pain in the lower abdomen, painful urination, enlargement and soreness of the Bartholin gland. The diagnosis is confirmed with the help of a cultural study and a PCR study of discharge from the cervical canal.

Gonorrhea

Moderate yellowish-white discharge from the vagina, accompanied by pain in the lower abdomen, pain when urinating and, often, intermenstrual bleeding. To confirm the diagnosis, microscopic examination of secretions, bacteriological culture and PCR research are used.
Nonspecific vaginitis (colpitis)
Vaginal discharge is the main symptom. Their characteristics are varied: liquid, watery, sometimes thick, purulent, often fetid, often with an admixture of blood. Acute inflammation is accompanied by itching, burning or heat in the genital area. The diagnosis is confirmed by microscopic examination of vaginal smears.A special place in gynecology is occupied by discharge from the vagina mixed with blood.

In most cases, spotting outside of menstruation indicates the presence of a disease and indicates the need to see a doctor. Some doctors believe that intermenstrual bleeding from the vagina is a harmless phenomenon caused by hormonal fluctuations associated with ovulation. However, such pid discharge woman sometimes occurs in connection with menstrual irregularities, and may also indicate the presence of a sexual infection (for example, gonorrhea), endometriosis, polyposis, chronic inflammation of the uterus (endometritis), etc. and therefore require special attention and examination (consultation of a gynecologist, microscopic and bacteriological analysis of secretions, colposcopy, ultrasound of the pelvic organs).

Any spotting (of any color, in any amount, of any duration) that occurs during pregnancy should be alarming. Even if they are not accompanied by pain. The cause of such discharge may be the threat of abortion, improper location of the placenta (placenta previa), premature detachment of the placenta. A less dangerous cause of bleeding in pregnant women is microruptures of the vessels of the eroded cervix that occur after intercourse. Only a doctor can establish the true cause of bleeding, therefore, with any appearance of such discharge, a visit to the doctor is indicated.

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