Vaginal Infections: Symptoms, Risks, and Treatment Options - Obstetrics and Gynecology

Dr. Chen Fuhao reply Obstetrics and Gynecology

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Dear readers: Vaginal discharge, commonly known as leukorrhea, refers to the fluid that flows from a woman's genitalia.
Normal female genitalia secretes various fluids.
Typically, this fluid is clear or milky white and odorless, with increased volume around ovulation (approximately fourteen days before menstruation).
If the amount of this discharge becomes excessive or its characteristics change—such as turning yellow or pink and developing an odor—it indicates a problem with the genitalia, and it is essential to seek assistance from a gynecologist to resolve the issue.
Statistics show that many women suffer from leukorrhea, with approximately one in three women experiencing this condition.
Inflammation of the genitalia is the primary cause of leukorrhea, but postmenopausal women with pink vaginal discharge must be cautious about the possibility of cancer.
Additionally, conditions such as anemia, tuberculosis, hormonal imbalances, and poor ovarian function leading to menstrual irregularities can also increase leukorrhea, which should be taken into consideration.
Any issue affecting the female genitalia can lead to increased leukorrhea, but problems with the vagina and cervix should be prioritized.
Generally, the main factors contributing to increased leukorrhea are infections caused by various microorganisms, primarily Candida, Trichomonas vaginalis, and Neisseria gonorrhoeae.

Candidiasis is caused by Candida, a type of fungus that is normally present in the human mouth.
When it invades the female genitalia (especially the vagina and vulva), it can result in a discharge resembling cottage cheese, with a mildly sweet odor, along with severe itching in the vulvar area and grayish-white membrane-like or granular attachments.
Women who are pregnant, using oral contraceptives, have diabetes, or are on long-term antibiotic treatment are more susceptible to Candida infections.
Therefore, women with increased discharge and severe vulvar itching under these conditions should consider a Candida infection.
The medical community has developed effective antifungal medications for this type of infection.
While following the physician's instructions for treatment, women should avoid wearing tight jeans or non-breathable tights and refrain from prolonged exposure to water while wearing swimsuits, as these conditions can worsen the situation.
Proper management of diabetes and careful consideration when using antibiotics and contraceptive pills are also necessary.
Trichomoniasis is caused by Trichomonas vaginalis, a flagellated protozoan that, although invisible to the naked eye, is significantly larger than typical bacteria under a microscope.
Statistics indicate that one in ten women may have a Trichomonas infection, but only ten percent of those will exhibit increased discharge and vulvar itching.
Trichomonas tends to reside in the vagina, causing vaginitis, which presents as a thin, milky discharge with a foamy consistency.
Sometimes, this discharge may appear yellow and foul-smelling, accompanied by vulvar itching.
Trichomonas is primarily transmitted through sexual intercourse, leading some physicians to classify it as a sexually transmitted infection, with couples often reinfecting each other, referred to as "ping-pong infection." Therefore, both partners must receive treatment simultaneously.
However, some women may also contract the infection through bathing.
The medication used to treat Trichomonas is called Metronidazole (Flagyl), which is highly effective; after a few days of treatment, the protozoa lose their motility, but complete eradication may take ten days to two weeks.
The medications for treating Candida and Trichomonas are entirely different, so it is crucial to accurately identify the type of microbial infection before treatment.
Some women may experience simultaneous infections from both microorganisms, necessitating the use of both medications concurrently.
Thus, accurate diagnosis is vital.
Neisseria gonorrhoeae primarily targets the cervix.
Patients with gonococcal cervicitis are often young women.
After the discovery of penicillin, gonorrhea was relatively quiet for a time, but appropriate treatment is essential; otherwise, it can lead to chronic cervicitis or antibiotic resistance, making treatment difficult and potentially resulting in lifelong leukorrhea.
Gonorrhea can also further invade the fallopian tubes, leading to infertility in women.
Chlamydia infection has become the most common sexually transmitted infection in recent years.
Infected women may also experience foul-smelling discharge.
Penicillin is ineffective against it; treatment requires tetracycline or erythromycin to see results.

Other factors that can lead to increased discharge include cervical lacerations during childbirth, miscarriage, or abortion, improper care during menstruation, and prolonged use of intrauterine devices (IUDs) like the Copper T, which can lead to secondary bacterial infections.
In such cases, in addition to using oral antibiotics and vaginal tablets, daily rinsing of the vagina and cervix with warm water two to three times for fifteen minutes can be very helpful.
Typically, symptoms will resolve within two weeks of treatment.

The presence of foreign objects in the vagina or cervix (such as cotton gauze or a pessary) can also result in copious and foul-smelling discharge, which can be resolved by removing the foreign object.
Furthermore, endometritis, uterine fibroids, cancer, or retained products of conception can also increase discharge.

Thus, while leukorrhea is a common issue, it may also indicate serious conditions, including potentially fatal cancers, especially when blood-streaked discharge (commonly referred to as "red discharge") appears in older women, warranting increased vigilance.

In summary, leukorrhea is one of the most common hidden ailments among women.
As the saying goes, "nine out of ten women have leukorrhea," leading many to believe it is not a significant issue.
Additionally, the conservative views in Chinese society often lead to unintentional neglect of women's health issues.
The tendency to avoid discussing health problems is a common issue.
However, ignoring or avoiding these discussions is not a solution; what may start as a minor issue can escalate to infertility if left unaddressed.
Moreover, women suffering from leukorrhea may experience psychological distress, leading to emotional instability or poor mood.
Therefore, women must confront this minor issue and bravely seek help from a gynecologist.
Do not allow this small problem to evolve into a major, unmanageable issue.

Pap smears are necessary for all sexually active women or those over 30 years old, who should undergo this routine screening annually.
It is essential to pay attention to one’s body; the principle of "prevention is better than cure" holds true.
Trust in your physician's diagnosis and treatment; if there are any uncertainties, discuss them with your doctor.
The doctor-patient relationship should be based on trust, and doubts should not be allowed to cause unnecessary distress.
Wishing you a speedy recovery.

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Reply Date: 2003/03/09