Date: 23rd December 2010
Author: Dr. Swati Allahbadia
About: Dr. Swati Allahbadia is a Consultant Gynaecologist practicing in Mumbai since the last 19 years. She has wide ranging experience in every aspect of Gynaecology having worked in the Family planning area for two years, as Lecturer and then Associate Professor at the Sion Hospital-a teaching Hospital in Mumbai. She currently practices at: Rotuna Hospital, Brach Candy Hospital and Wadia Hospital.
Doc, I wish I had come to you earlier. I just didn’t know who to talk to this about’-is a common refrain of many women to their Gynaecologist. Most of my patients come to me after suffering a while, because they are too shy to talk about their illnesses even to their mothers or daughters. A common ailment across age groups is white discharge from the vagina. The medical term used is ‘Leucorrhoea’ but commonly referred to as Whites. Excessive discharge is normal during the middle part of the menstrual cycle-when a sticky strand may stretch even outside the vagina-this disappears soon after the egg bursts from your ovary.
It is also normal to have discharge at time of sexual arousal and in pregnancy. In late pregnancy, excess vaginal discharge may be a sign of onset of labour or may be a break in the ‘bag of waters’ that surrounds your baby-warranting a visit to the hospital. In young girls prior to onset of periods, excessive discharge may be due to a foreign body-beads, toy parts or grains in the vagina-this needs to be checked out by a doctor who can telescopically remove the same. In women of reproductive age group, the commonest cause of whites is a vaginal infection. Three types of usual infections are – fungal, trichomonal or bacterial. Thrush/yeast/fungal/ candidiasis/moniliasis is the commonest.
This occurs when the normal bacteria in the vagina which maintain acidic environment die out -as following antibiotic therapy. This also occurs if vaginal acids are neutralised by alkaine semen [after frequent sexual intercourse] or taking alkalinisers for urinary infections. Yeast thrives in a moist, sugary environment that happens after exercise, in summer or the monsoons or after binging on sweets or in diabetics. Tight clothes, synthetic materials & excessive pubic hair, trap moisture, create friction, damage skin and encourage fungal growth.
Thrush is seen a curd like discharge that doesn’t smell too much and is accompanied by itching and soreness and burning while urinating. Trichomoniasis is sexually transmitted, accompanied by profuse greenish, frothy discharge and dyspareunia-pain during sexual intercourse.[though this can occur in any vaginal infection-its severity isgreater in Trichomoniasis.] Partner treatment is important here else chances of a recurrence are high. Bacterial vaginitis may cause a foul smelling, greyish or yellowish discharge and needs local and/or oral antibiotics. The cervix which is the mouth of the uterus may have an ulcer, a growth or an erosion[ overgrowth of mucus producing inner lining] which causes the discharge or may be elongated and herniated-this needs to be thoroughly checked and surgically treated .
Sometimes a fibroid in the uterus or a swollen fluid filled fallopian tube may also cause vaginal discharge and would show up on sonography.The treatment options for these would be put before you by your gynaecologist. To reduce the spread of HIV, which either partner is more likely to get, if there is unprotected intercourse in the presence vaginal infection, doctors or sometimes nurses adopt a ‘syndromic approach’ to treatment-they treat all three types of infection with a combined vaginal tablet or a kit of oral medicines. Worms migrate from the bowel to the vagina, carrying with them germs that may cause an infection. This is common in India and sometimes, deworming helps relieve the infection. It also helps improve your nutrition and resistance in general.
Other sexually transmitted diseases like gonorrhoea, herpes or syphilis may also present as a white discharge. Your doctor may order tests before starting treatment.
Older women who lose hormonal support and hence have thin vaginal skin, may need short term or local hormonal therapy besides treating their infection. Even a mild vaginal infection can spread to the uterus, pelvis and blood and have serious consequences especially in pregnancy or after a surgery. Vaginitis also makes you prone to other infections. Hence it needs to be treated quickly, and completely.
Some simple things you can do to avoid repeated infections are:
Cut the sugars from your diet
- Trim your nails-fungal spores and worms eggs get caught under long nails, and reinfect you by an itch-scratch cycle.
- Keep you hair trimmed down there for hygiene-to avoid trapping moisture and germs
- Use cotton inners-natural fibres breathe and keep you dry avoiding frequent infections.
- Use tissues to gently dab yourself dry after passing urine, instead of washing with water.
- Wash after intercourse if you are not trying for a baby and dab yourself dry.
- Loose clothes like skirts, Parallels, or Salwars or Sarees are better than tightly fitted trousers or Churidars. Jeans, Jeggings and Tights are totally unsuited to Indian weather-put them away till you’re fine.
If possible, sleep without a panty so that your parts stay aerated and you avoid infection.
Douching your vagina is not a good idea. Let your natural defense mechanism take over.
Eating yoghurt and pro-biotics colonises your bowel with friendly bacteria which migrate to the skin and vagina and protect you from future infection.
Use a mild soap or a special pH controlled perineal wash for your privates-that keeps the natural resistance mechanisms going.
Using condoms protects against infections –so insist on it.
Some panty liners contain chemicals that may causes irritation and allergies-avoid these.
Sterilise your panties by soaking them in half a bucket of water into which a cap full of dettol or similar antiseptic solution is added, for a couple of hours. Wash thoroughly with detergent before use. You need to do this only once, not daily.
During your periods, change sanitary pads every few hours and wash atleast thrice a day. The glue from some makes of pads and panty liners doesn’t wash off. It traps germs and re infects you. Change the make or keep a separate set to use only during your periods[with a pad]
Above all, your vaginal discharge may just be the symptom of something more serious-see your doctor and get things cleared.
Asking your partner to go for a check and maybe adopt some of the measures mentioned above-might help both of you.
Severe Infections may need long term oral treatment -follow your doc’s advice and try not to give up half way.
Let there be White no more!