Abnormal vaginal discharge
WHAT IS VAGINAL DISCHARGE ?
Discharge is fluid released from the body. Discharge from the vagina is made of mucus from the cervix, secretions from the glands next to the vaginal opening, and from moisture that comes through the vaginal walls.
Many different bacteria, yeasts, and parasites (microscopic forms of life or ‘flora’) normally live in the vagina without causing symptoms. The vagina is usually weakly acidic because normal bacteria (lactobacilli) produce lactic acid. Lactobacilli and the acid help the vagina protect itself from the kinds of bacteria that cause disease.
WHAT DOES NORMAL DISCHARGE FEEL LIKE ?
Normal discharge just feels wet. There is no discomfort.
WHAT DOES NORMAL DISCHARGE LOOK LIKE ?
Normal discharge can be variable but is usually clear or white the first half of the cycle and yellowish during the second half. Infections may cause discharge of varying color, consistency, amount, and odor. Bloody discharge always needs to be checked out.
WHAT IS ABNORMAL DISCHARGE FROM THE VAGINA ?
Abnormal discharge may be caused by the following conditions :
Chlamydia and gonorrhea are sexually transmitted infections. They may cause an infection in the uterus and tubes that can lead to pelvic pain. They may also cause pain on passing urine, bleeding between periods, or bleeding after sex.
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Bacterial vaginosis (BV) is caused by overgrowth of some types of normal bacteria. Bacterial vaginosis does not usually cause discomfort, but can cause mild irritation with sex, and a fishy odor.
Candidiasis is caused by too much yeast. Candidiasis can make the skin and mucosa itchy, swollen, red, and sore.
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Desquamative inflammatory vaginitis is a condition that produces a copious green/yellow discharge. The cause is unknown.
Trichomoniasis (TV) is caused by a sexually transmitted parasite. It can cause itch and pain passing urine as well as a copious yellow/green discharge.
Cervicitis (cervical inflammation) may cause an increase in discharge. While this may come from an STI, or, rarely, a cervical or uterine problem, cervicitis is often an entirely benign, though annoying condition.
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Atrophic vaginitis is caused by low levels of estrogen in the postpartum period or after menopause and may cause a uncomfortable, sticky, yellow discharge.
Abnormal vaginal odor
IS VAGINAL ODOR NORMAL ?
In a word, yes! Even after a shower, a very faint, not-unpleasant, mild odor will be present if vaginal secretions are smelled up close. This mild odor is related to the functionality of the vagina, which is not supposed to smell like flowers, perfume, or fields of freshly mowed grass!
WHAT ARE THE MOST COMMON REASONS FOR STRONGER, MORE UNPLEASANT ODOR ?
Hormonal changes in the menstrual cycle or in menopause
Sweat
Urine
Inadequate cleansing after a bowel movement, fecal incontinence, or chronic constipation
Foreign bodies left in the vagina, such as tampons or pessaries.
Alterations in normal vaginal flora such as bacterial vaginosis
Vulvar and/or vaginal itching
WHAT IS THE CAUSE OF VULVAR AND/OR VAGINAL ITCHING ?
Persistent or recurrent vulvar and/or vaginal itching is relatively common and may have a number of causes, including vulvar skin conditions (e.g., lichen sclerosus, eczema, psoriasis,…), vulvar atrophy, contact sensitivity to irritants or allergens, recurrent vulvovaginal infections (e.g. yeast infections,…), and chronic irritation due to scratching (lichen simplex chronicus).
Vulvar and/or vaginal pain
WHAT IS VULVOVAGINAL PAIN ? WHAT IS VULVODYNIA?
Vulvar pain is divided in two major groups: (1) Vulvar pain related to a specific disorder, such as an infection, dermatological disorder, lesion, and (2) Vulvar pain in the absence of a clear visible or clinically identifiable cause.
This second group is termed vulvodynia. Vulvodynia is divided by location to generalized or localized, depending on where the pain occurs. Generalized vulvodynia means that the pain is present at the whole vulva. Localized vulvodynia is pain confined to a specific area of the vulva. Vulvodynia is further subtyped into provoked, unprovoked, or mixed pain. Provoked pain means that the pain comes on from something that does not usually hurt, such as touch or pressure. Unprovoked pain means that the pain is present without touch or pressure.
WHAT IS THE CAUSE OF VULVOVAGINAL PAIN ?
Some of the known causes of vulvovaginal pain are (in no particular order): candida vaginitis, desquamative inflammatory vaginitis, STI (trichomonas, herpes, …), irritants and allergens, dermatitis or dermatosis, drug reaction, pudendal neuralgia or nerve entrapment, musculoskeletal conditions, low estrogen levels,…
WHAT ARE THE SYMPTOMS OF VULVOVAGINAL PAIN OR VULVODYNIA ?
The most frequent abnormal sensations are aching, burning, knife-like pain, soreness, rawness, stinging, and irritation. The symptoms may involve all or part of the vulva, or be confined to a focal area only.
Vulvar fissures
WHAT ARE VULVAR FISSURES ?
Fissures are fine linear erosions that can occur anywhere on the vulva and/or anus.
WHAT IS THE CAUSE OF VULVAR FISSURES ?
They are related to a great variety of conditions. They are not diseases, but rather manifestations of problems in the vulvar skin. They may be associated with chronic infections (candida, herpes simplex,…), dermatoses (psoriasis, lichen sclerosus, contact dermatitis,…), estrogen deficiency (menopause, postpartum, lactation,…), Crohn disease, etc.
WHAT ARE THE SYMPTOMS OF VULVAR FISSURES ?
Women present recurrent or persistent painful splits in the vulva. Clothing, sanitary napkins, bicycle riding and sexual intercourse may be very uncomfortable.
Vulvar ulcers
WHAT IS THE CAUSE OF VULVAR ULCERS ?
Many conditions can cause vulvar ulcers. Ulcers may be caused by viruses including Epstein-Barr virus (EBV), Cyotomegalo virus (CMV), Coxsackie virus and by sexually transmitted infections like herpes simplex, syphilis, and others. Crohn disease, which can cause vulvar ulcers, may present years before bowel symptoms. Behcet disease is extremely rare and always involves other body sites besides the vulva. A drug reaction may also cause vulvar ulcers.
WHAT ARE THE SYMPTOMS OF VULVAR ULCERS ?
The main vulvar symptom is pain from the ulcerations.
Vulvar and/or vaginal lesions
Other lesions that can occur on the vulva and/or vaginal are kysts, nodules, pustuls, vesicules, patches, erosions, adhesions, scar tissue, … They can be acute or chronic, and associated with or without irritation or pain.