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Vaginal discharge

Summary/Definition

Vaginal discharge is often referred to as “thrush,” and although the amount of vaginal discharge varies from person to person, it usually appears in women of childbearing age. However, abnormal vaginal discharge may appear. The characteristic causes of pathological vaginal discharge are bacterial vaginitis, candidiasis vaginitis, trichomonas vaginitis, atrophic vaginitis. Abnormal vaginal discharge is caused by infection, changes in the normal vaginal microflora, or a decrease in the level of female hormones. Changes in the infectious and normal bacterial flora include bacterial vaginosis, candidiasis vaginitis, trichomonas vaginitis, etc., and a decrease in the level of female hormones includes natural menopause, chemotherapy treatment of cancer, bilateral ovarian resection, etc. Other causes include foreign bodies in the vagina in children and vulvar cancer in adults.

Symptoms

Normally, vaginal discharge is transparent or light, odorless, increases in volume during ovulation, pathological vaginal discharge becomes thicker, dark gray or yellow-green with an unpleasant odor, accompanied by symptoms of itching, pain when urinating, hot flashes, etc.

Diagnostics

During the consultation, the doctor finds out the nature and symptoms of vaginal discharge, examines the vagina, vulva and cervix, determines the acidity of the vagina, conducts a microscopic examination of a Gram-stained smear, a nucleic acid amplification test (PCR) and an analysis for bacterial culture to diagnose major diseases. With bacterial vaginosis, gray cloudy discharge is observed on the vaginal wall, the acidity of the vaginal discharge is more than 4.5, microscopic examination of vaginal discharge reveals more than 20% of key cells, this means that the result is positive (the result is positive if a few drops of a 10% solution of potassium hydroxide (OHKZ) are added to the vaginal discharge, it appears sharp fishy smell). The diagnosis is made when three or more of these tests are confirmed. Candidiasis vulvovaginitis can be diagnosed clinically when symptoms such as pain during urination, itching of the vulva and white vaginal discharge with flakes similar to cottage cheese are observed. Trichomonas vaginitis is characterized by abundant foamy discharge from the vagina of yellow-green color, pain when urinating, pain in the lower abdomen, swelling of the vaginal mucosa, bright red spots are observed in the vagina and cervix. The diagnosis is confirmed when mobile flagellated protozoa are detected in the smear and the number of leukocytes increases. Atrophic vaginitis is diagnosed when the vaginal mucosa is pale, wrinkled and atrophied with a decrease in the level of sex hormones, and the acidity in the vagina is increased to 5-7.

Treatment and course of the disease

It is necessary to eliminate the causative agent of the disease. For bacterial vaginitis, metronidazole gel, oral medications or antibiotics are used, and for candidiasis vaginitis, antifungal vaginal tablets of the azole group, vaginal cream or oral antifungal drugs are used. With trichomonas vaginitis, drugs such as metronidazole or tinidazole are used, and with atrophic vaginitis, vaginal pills or hormonal creams are used.

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