Vaginal Discharge: Causes, Symptoms, and Solutions

Vaginal discharge

Hello Dr.
Lu: For a long time, I have been troubled by vaginal itching.
After switching to cotton underwear, the situation has improved significantly, but I still feel uncomfortable and continue to have discharge that resembles cottage cheese.
Recently, I noticed that the discharge has been flowing out like condensed milk when I use the restroom, although the color is not very dark and it is not very thick.
Occasionally, when I feel extremely uncomfortable, I go to an external gynecology clinic to apply medication and get something to take.
I find this very frustrating! The situation fluctuates between good and bad.
What should I do? Please give me some advice, Dr.
Lu!

Bai Xue, 20~29 year old female. Ask Date: 2002/03/14

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
The cheese-like discharge is characteristic of fungal (Candida) vaginitis, which is difficult to completely cure, as you mentioned, with symptoms fluctuating between improvement and worsening.
2.
Fortunately, this inflammation is generally confined to the vagina and vulva, causing localized itching without harming internal organs such as the uterus or ovaries, and does not pose further health risks.
Studies have found that more than half of healthy women can culture Candida in their vaginas, and symptoms of itching only occur when there is an overgrowth of Candida.
3.
So what should be done? First, treatment must be thorough.
Using medication for only two or three days is insufficient; vaginal suppositories should be used for at least one week, daily.
Some patients with stubborn inflammation may need to use medication for two weeks or combine it with oral antifungal medications.
Second, fungi thrive in a warm, moist vaginal environment, so breathable cotton underwear is recommended, and outer clothing should be loose or made of breathable fabrics like skirts.
It is advisable to minimize the use of non-breathable garments, such as tight-fitting pants or tampons, and to limit swimming or soaking in hot springs.
A drier, more ventilated vaginal environment can help prevent flare-ups.
Third, local immunity is also important; using contraceptive devices or douching can lower vaginal resistance, making it more susceptible to inflammation, so these should be avoided.
Fourth, individuals with diabetes or those on dialysis may have weakened immunity, making them more prone to infections.
Fifth, those who experience chronic stress or have a habit of staying up late may also have reduced immunity and should take measures to avoid this.
Sixth, the use of antibiotics can decrease the normal bacterial flora in the vagina, allowing fungi to proliferate unchecked, so antibiotics (anti-inflammatory medications) should not be taken casually unless necessary.
Seventh, the types of bacteria causing vaginal inflammation can change; if treatment is ineffective, further examination at a larger hospital may be required.

Reply Date: 2002/03/14

More Info

Understanding vaginal discharge and its associated symptoms can be quite complex, as there are numerous factors that can contribute to changes in discharge, itching, and discomfort. Based on your description, it sounds like you are experiencing a combination of symptoms that may be indicative of a few different conditions. Let's break this down into manageable parts.

Causes of Vaginal Discharge
1. Normal Physiological Discharge: It's important to note that some vaginal discharge is normal and varies throughout the menstrual cycle. It can be influenced by hormonal changes, sexual arousal, and even diet.

2. Infections: The presence of a cheese-like discharge could suggest a yeast infection (candidiasis), which is often accompanied by itching and irritation. On the other hand, a discharge that resembles milk or is more watery could indicate bacterial vaginosis or a sexually transmitted infection (STI) such as trichomoniasis.
3. Allergic Reactions or Irritants: Sometimes, the materials in clothing (like synthetic fabrics), soaps, or hygiene products can cause irritation leading to discomfort and changes in discharge.

4. Hormonal Imbalances: Hormonal fluctuations, particularly those related to menstrual cycles, pregnancy, or contraceptive use, can also affect the nature of vaginal discharge.

Symptoms to Monitor
- Color and Consistency: Pay attention to the color, consistency, and odor of the discharge. A strong, fishy odor may indicate bacterial vaginosis, while a thick, white discharge often points to a yeast infection.

- Associated Symptoms: Note if there are any additional symptoms such as burning during urination, pain during intercourse, or significant itching.

Recommendations for Management
1. Consult a Healthcare Provider: Since you have been experiencing ongoing discomfort, it is crucial to consult a healthcare provider, preferably a gynecologist. They can perform a thorough examination and possibly run tests (like a pelvic exam or cultures) to determine the exact cause of your symptoms.

2. Maintain Hygiene: Continue wearing breathable cotton underwear and avoid douching or using scented products in the genital area, as these can disrupt the natural flora and lead to infections.

3. Medications: If an infection is diagnosed, your healthcare provider may prescribe antifungal medications for yeast infections or antibiotics for bacterial infections. Over-the-counter treatments may also be available, but it’s best to use them under the guidance of a healthcare professional.

4. Lifestyle Adjustments: Consider dietary changes, such as reducing sugar intake, which can help manage yeast infections. Staying hydrated and maintaining a balanced diet can also support overall vaginal health.

5. Follow-Up: If symptoms persist despite treatment, or if you notice any new symptoms, follow up with your healthcare provider. Persistent issues may require further investigation to rule out other underlying conditions.

Conclusion
Vaginal discharge can be a normal part of female physiology, but changes in its characteristics can indicate underlying issues that may require medical attention. Your symptoms of itching and unusual discharge warrant a thorough evaluation by a healthcare professional. By taking proactive steps and seeking appropriate care, you can find relief and better understand your body’s signals. Remember, open communication with your healthcare provider is key to addressing any concerns you may have regarding your reproductive health.

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