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Vaginal discharge: vaginal discharge


Vaginal discharge is a relatively normal side effect for many women during the course of their monthly cycle, but the increased secretion from the vagina can also be due to a serious illness that urgently needs medical treatment. Changes in consistency, smell and the amount of secretion released are to be assessed as possible warning signals.

Definition

Vaginal discharge is the secretion secreted by the vagina. The medical terms are called fluor vaginalis or fluorine genitalis. Sometimes there is a further differentiation of vaginal discharge according to the location of secretion formation (for example vestibular fluorine, formation in the vaginal atrium or cervical fluorine, formation in the cervix). There are also special names for certain forms of vaginal discharge, such as secretion delivery shortly before ovulation (fluorine albus or white flow).

Function of the vaginal secretion

The mucous membranes inside the vagina are constantly covered with vaginal secretions, which take on an important protective function against invading bacteria, viruses, fungi and other pathogens. Countless useful microorganisms live in the secretion or colonize the vagina and form the so-called vaginal flora here. The majority of them are special lactic acid bacteria, the so-called Döderlein bacteria, which provide an acidic vaginal environment through the production of lactic acid. This, in turn, is important for the defense against invading pathogens, because the latter can only reproduce with difficulty in the acidic environment. With the vaginal secretion, the germs are also transported towards the vaginal opening. If the bacterial milieu of the vagina is disturbed, for example, by excessive or improper hygiene or the use of antibiotics, the natural protective function deteriorates and pathogens can spread more and more. Bacterial vaginal infections or a vaginal yeast infection are common consequences here. The mucous membranes swell and react with an increased secretion of secretions.

Symptoms

Vaginal discharge usually occurs in the form of a clear, odorless, rather thin liquid secretion in healthy women, but depending on possible diseases and hormonal changes, the consistency as well as the smell and color can vary significantly. If the discharge shows, for example, malodorous, grayish and fluid, this is an indication of bacterial vaginosis and a corresponding vaginal infection (colpitis). Brownish, bloody vaginal secretions occur, for example, with internal injuries and malignant tumors (malignancies). Which particular form of vaginal discharge takes on the various triggers and which accompanying symptoms are to be expected is explained in more detail in connection with the explanations on the causes of vaginal discharge. In general, those affected by the diseases that can lead to vaginal discharge are often accompanied by a violent burning sensation in the genital area and an itchy vagina. But sometimes these conspicuous disease features are completely missing, so that those affected are initially not aware of any illness.

Causes of vaginal discharge

The possible causes of vaginal discharge range from hormonal fluctuations in the course of the monthly cycle or menopause to mycogenic, viral, bacterial or parasitic infections of the vagina to possible cancers such as vaginal cancer (vaginal cancer), cervical cancer (cervical cancer) or endometrial cancer (uterine cancer) (uterine cancer) . The nature of the outflow can often be used to draw conclusions about its cause.

Vaginal / vaginal fungal infection

One of the most common triggers for pathological changes in vaginal secretions are vaginal yeast infections, which are associated with inflammation of the vagina (vaginitis or colpitis). The discharge appears whitish to yellowish, odorless and with a slightly viscous consistency. When rubbed, the secretion looks crumbly, crumbly. White, non-wipeable deposits can sometimes be observed on the mucous membrane of the vagina. If the course of the infection is severe, these so-called thrush deposits can also be seen in the area of ​​the vulva. The vaginal yeast infections are often accompanied by severe itching and massive skin irritation, which not only affects the genital area itself, but sometimes also the inside of the thighs. A large-scale itchy rash is the result. The damage to the skin can sometimes cause pain during sexual intercourse and when urinating.

Vaginal mycosis is usually caused by the yeast Candida albicans, which is a normally harmless part of the vaginal flora. However, if the vaginal environment is impaired, a pathological multiplication of the fungus can begin. Disorders of the vaginal milieu can be attributed, for example, to a general weakening of the immune system, hormonal fluctuations, mechanical irritation due to unsuitable clothing (too tight, air-impermeable), errors in intimate hygiene or the use of antibiotics. Sexual intercourse is also considered a risk factor here.

Bacterial vaginosis

Bacterial vaginal infections can also cause vaginal inflammation and increased vaginal discharge. Bacteria of the Gardnerella vaginalis genus, genital mycoplasma and chlamydia are common triggers. With an infection caused by Gardnerella vaginalis or other anaerobic bacteria, the vaginal discharge is often thin, greyish-yellowish with an unpleasant fishy smell. Infection with chlamydial or mycoplasma is not associated with comparable noticeable changes in vaginal secretion. The discharge is slightly whitish and remains odorless. Skin irritation, itching and burning sensations can also occur with bacterial vaginosis, but are significantly less common and less pronounced here than with vaginal infections. If the inflammation passes to the vulva, this is known as vulvovaginitis. In such cases, it is not uncommon to see bacterial inflammation of the glans of the partners of the women concerned.

Trichomoniasis

Vaginal discharge can also result from so-called trichomoniasis caused by certain flagellates (Trichomonads). This sexually transmitted disease causes inflammation of the vagina, which causes a yellowish greenish, thin to foamy, unpleasant smelling discharge. Vaginal itching is also a common symptom that can be observed here. Sometimes the infection spreads to the urethra, uterus and urinary bladder, causing inflammation here. The flagellates cause long-term tiny damage to the mucous membranes, which persist even after successful therapy and pose a permanently increased risk of HIV.

Herpes virus infections

Another possible cause of vaginal discharge is vaginal herpes infections, also called genital herpes. These are among the most widespread sexually transmitted diseases. Triggers are usually viruses of the genus herpes simplex type 2. A typical feature of genital herpes is the painful, itchy cold sores in the genital area. The herpes infection can also lead to inflammation of the vulva and vagina, which is associated with increased vaginal discharge. In addition, in the worst case, those affected are at risk of spreading the herpes infection to other organs, which can take life-threatening forms, for example, if the brain is affected. The herpes viruses remain in the organism even after they have survived the disease and can theoretically lead to an acute infection at any time, although the causes of the reactivation of the viruses have not yet been conclusively clarified.

Cancer

Various cancers are also associated with increased vaginal discharge. Vaginal carcinomas, cervical carcinomas and endometrial carcinomas are particularly worth mentioning here. What is particularly critical about cancer is that when the first symptoms appear, they are often already at an extremely advanced stage. Spotting and bloody discharge are often the first signs of the disease. Recurrent abdominal pain can also indicate cancer. At a later stage, flesh-colored, watery discharge with a slightly sweet smell can be observed in cervical or cervical cancer.

Other causes of vaginal discharge

Another potential trigger of vaginal discharge is gonorrhea (gonorrhea). This sexually transmitted disease caused by gonococci causes inflammation of the cervix in women and possibly inflammation of the fallopian tubes and ovaries (adnexitis), which leads to severe purulent discharge. The pathogens can also affect other organs via the bloodstream and, in the worst case, cause life-threatening meningitis or inflammation of the heart (endocarditis).

In rare cases, adnexitis and the corresponding discharge can also be observed in the context of a tuberculosis disease. These so-called urogenital tuberculoses form a secondary form of tuberculosis, which is caused by the spread of the pathogens via the bloodstream. Previously, the disease usually manifested itself in the form of pulmonary tuberculosis with symptoms such as loss of appetite, cough, fever and swelling of the lymph nodes.

For some women, vaginal discharge is due to physical rather than physical causes. For example, those affected show an increase in vaginal secretion in the event of excessive persistent stress or other mental stress. This so-called functional fluorine can be uncomfortable, but initially it does not pose any health threat. However, if the vaginal environment is affected, the risk of other infections increases.

If a tampon is forgotten in the vagina, after some time this also causes an increased vaginal discharge, which is colored brown and has an extremely unpleasant smell. Contraceptives that have been introduced, such as a spiral, can be mentioned as further possible causes of the increased vaginal discharge. In addition, an increased vaginal discharge can be observed with a latex allergy after the use of condoms during sexual intercourse.

Vaginal discharge is also observed during pregnancy and as a so-called weekly flow after the birth of the child. The latter is formed from wound secretions and appears in the first few days as thin, reddish, later as brownish and thin, and in the end as watery-white. The discharge during pregnancy and after childbirth is - like the increased secretion formation in the course of hormonal fluctuations during the monthly cycle - a perfectly normal process and usually not an indication of a pathological event.

Due to the hormonal changes and the corresponding impairment of the vaginal milieu, many women suffer more from vaginal inflammation accompanied by vaginal fluorine during the menopause. Their vagina is rather too dry overall, but they show an increased vaginal discharge in the course of the recurring inflammation.

Diagnosis

After a thorough medical history, in the context of which the affected persons report the symptoms, and an initial examination of the genital area, there are usually already indications of a possibly existing pathological event as the cause of the vaginal discharge. A measurement of the ph value in the vaginal milieu and a subsequent smear provide further important diagnostic information. If the pH value is significantly higher than 4.5, this indicates a disorder of the vaginal flora due to an infectious event. With the help of the smear and its subsequent evaluation in the laboratory, the underlying pathogens can be determined. There is also the possibility of a so-called colposcopy, in which the inside of the vagina is examined with a special microscope. It is used, for example, to diagnose vaginal cancer. However, these usually require a biopsy (tissue sampling) to confirm the diagnosis. Ultrasound examinations are also used more frequently for cancer to determine the extent of the tumorous event. Computed tomography and magnetic resonance imaging, which are used less frequently here, serve the same purpose. The imaging procedures may also provide important information about inflammation or cancer of the fallopian tubes, ovaries, cervix and uterus. A blood test is recommended for the various possible inflammations in the genital area, since it is relatively easy to determine increased inflammation levels in the blood in this way.

Treatment for vaginal discharge

The therapy for the causes of an altered vaginal secretion can vary significantly according to the different triggers of the symptoms. If there is a bacterial infection in the vaginal area, antibiotics are given, which are either taken orally or applied as a vaginal cream. As a rule, the patient can be completely cured within a relatively short time. The rarer diseases of urogenital tuberculosis are also preferably treated with antibiotics, although these must be taken as a combination therapy of various antibiotics over a period of several months (usually half a year). In the case of an infection with flagella (trichomoniasis), the standard therapy is also based on the administration of special antibiotics (metronidazole, tinidazole); the disease is usually over after a few days. Gonorrhea (gonorrhea) is also treated with antibiotics, which are taken over a period of up to one month in the event of complications.

If the vaginal discharge is due to a vaginal infection, the standard therapy provides for the use of antifungals (anti-fungal agents), which are available as tablets, ointments and also as vaginal suppositories. As a rule, the fungal infection disappears within a few days if treated accordingly. However, it is not uncommon for the women affected to suffer repeatedly from vaginal mycoses, which can be caused by the partner being infected again or by a generally weakened vaginal milieu. Numerous over-the-counter preparations are said to help stabilize the vaginal milieu and thus improve infection control. However, whether lactic acid bacteria in capsules or vaginal suppositories actually have the desired effect against vaginal infections remains a matter of debate.

The acute phase of genital herpes can be treated with so-called virostatics (antiviral drugs), both oral intake and external use in the form of ointments being considered. After a little more than a week, the acute outbreak is usually over with the appropriate treatment. However, the viruses remain in the body and the disease can theoretically break out again at any time. Mild forms of genital herpes usually heal on their own after some time, even without medical care.

If the vaginal discharge is based on cancer, more extensive medical measures are required. Smaller tumors can often be completely removed as part of a surgical intervention; larger ulcers often require additional radiation therapy. If the cancer takes a particularly severe course or metastases have already formed, chemotherapy treatment may also be necessary.

With functional fluorine, psychotherapeutic treatment can sometimes provide significant relief to the patient, but treatment here is not absolutely necessary as long as the patient does not feel too much affected by the discharge. Because functional fluorine does not have an organic impairment or disease.

Naturopathy with vaginal discharge

Naturopathy offers promising treatment approaches for some causes of vaginal discharge, such as vaginal infections or fungal infections. For example, homeopathic remedies such as Acidum chloratum, Acidum nitricum, Creosotum, Mercurius solubilis and Pulsatilla are successfully used for vaginal infections. The selection of suitable homeopathic medicinal products depends on the type of discharge and the accompanying complaints. According to the German Central Association of Homeopathic Doctors (DZVhÄ), the intravaginal introduction of a peeled clove of garlic, which is changed every 24 hours over a period of four to five days, has proven to be a naturopathic home remedy for bacterial vaginal infections. The only disadvantage is the sometimes unbearably penetrating smell that occurs during use.

From the field of phytotherapy (herbal medicine) extracts of marjoram, calendula and coneflower are said to have a positive effect against bacterial vaginal infections. These are mostly used as vaginal gel or as vaginal tablets. Envelopes and hip baths made of lady's mantle, yarrow and dead nettle are also said to have a soothing effect on bacterial vaginal infections. According to the DZVhÄ, sitting baths with various additives such as chamomile flowers, oak bark and witch hazel leaves are also suitable for naturopathic treatment of vaginal infections.

A well-known home remedy for vaginal yeast infections is treatment with yoghurt or buttermilk, which today, however, often fails to work, since in this country heat-treated products are almost exclusively sold, the bacterial content is so low that they can no longer have a positive effect on the vaginal flora. Natural yogurt, which is inserted into the vagina using a so-called yogurt tampon or with a finger, for example, has a soothing effect on many patients, even if the treatment method is controversial among medical professionals. Most gynecologists today advise against yogurt treatment and recommend rather special lactic acid bacteria preparations to strengthen the vaginal milieu. However, their effects are not clearly proven either.

Naturopathy also uses vinegar baths and vaginal douching with fruit vinegar to combat vaginal infections, which are said to have an antifungal effect. In addition, various herbal medicinal substances are used for external use, with tea tree and lavender oil, for example, but also the essential oils of thyme, which have a particularly positive effect. Mother tinctures made of lady's mantle, walnut and pansies with geranium, lavender and yarrow oil, which are processed into vaginal cream, also have a promising effect against the vaginal fungus, according to DZVhÄ. If the symptoms are to be observed primarily in the external genital area, hip baths with mother tinctures of marjoram, walnut, chamomile or dead nettle are recommended. According to the DZVhÄ, geranium oil can also have an antifungal and antibacterial effect, using a tampon that has been soaked in a mixture of geranium oil and: olive oil in a ratio of one to no.

Although naturopathy can often help to relieve or heal vaginal infections and vaginal fungal infections in a relatively simple way, especially with complaints such as trichomoniasis, tuberculosis, gonorrhea or cancer, there is usually no way around conventional therapy. (fp)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

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