الثلاثاء، 14 يونيو 2011

Vaginal Discharge


Overview, Causes, & Risk Factors

Vaginal discharge is a fluid coming from the vagina.
What is going on in the body?
The vagina normally discharges a small mount of fluid that is clear, cloudy, or whitish. There is usually more discharge during exercise or sexual foreplay. A healthy vagina keeps a balance of many bacterial and fungal organisms.
Many factors can affect the delicate balance of organisms within the vagina. These include:
  • antibiotics

  • changes in estrogen levels that occur during menopause, breastfeeding, and pregnancy

  • douching

  • sexual intercourse

  • sexually transmitted diseases (STDs)


  • Vaginitis, a swelling and redness in the vagina, may be caused by mental stress, poor hygiene, and irritants such as:
  • spermicides in foams, jellies, and creams

  • condoms and diaphragms

  • feminine hygiene products, such as perfumed sprays and powders

  • nonabsorbent clothing, such as nylon pantyhose

  • tampons


  • One third of all women have symptoms of abnormal vaginal discharge at some point during their lives.
    What are the causes and risks of the condition?
    The causes of vaginal discharge include:
  • Candida albicans,\ \Candida tropicalis,\ \Candida glabrata,\ and \Candida parapsilosis.\ ',CAPTION,'Vaginal Yeast Infection');" onmouseout="return nd();">yeast infection, caused by the Candida fungus

  • bacterial vaginosis, caused by a change in the normal bacteria in the vagina

  • trichomonas vaginitis, caused by a parasite that is spread through sex

  • atrophic vaginitis, an irritation of the vagina that causes dryness or burning


  • Other possible causes of vaginitis include:
  • a foreign body in the vagina, such as a forgotten tampon or intrauterine device (IUD)

  • Neisseria gonorrhoeae\ bacteria. The infection is usually acquired through sexual contact. ',CAPTION,'Gonorrhea in Females');" onmouseout="return nd();">gonorrhea

  • genital herpes

  • Chlamydia trachomatis\. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. In women, the infection usually occurs in the urinary tract, pelvis, or cervix. The cervix is the opening between the vagina and the uterus. ',CAPTION,'Chlamydia Infection in Females');" onmouseout="return nd();">chlamydia

  • cervicitis

  • pinworms

  • human papillomavirus (HPV)


  • Symptoms & Signs

    What are the signs and symptoms of the condition?
    Symptoms of vaginitis include:
  • irritation or itching of the genital area, inside or outside the vagina

  • swelling or redness of the lips of the vagina or the genital area

  • vaginal discharge that is cottage cheese-like, frothy, yellowish-green or colorless

  • foul smelling vaginal odor, especially after intercourse

  • discomfort or burning with urination

  • dryness, discomfort, or burning with sexual intercourse


  • Diagnosis & Tests

    How is the condition diagnosed?
    Tests that may be done during a pelvic exam include:
  • culture of the vaginal discharge or cervix

  • a lab analysis of the vaginal discharge

  • pH analysis of the vaginal discharge, to check the acidity


  • Prevention & Expectations

    What can be done to prevent the condition?
    Prevention of vaginal discharge depends on the cause. Candida infections can be prevented by avoiding a humid environment around the genital area. This can be done by wearing loose-fitting and absorbent clothing. Women should practice good hygiene methods, such as bathing, showering, wiping front to back after urinating, and frequent handwashing. Practicing safer sex and having fewer sexual partners should reduce the chances of spreading STDs. Hormone replacement therapy can prevent atrophic vaginitis caused by low levels of estrogen.
    What are the long-term effects of the condition?
    Normal vaginal discharge does not need treatment. Feminine hygiene products and douching should not be used. These products can mask the symptoms of an sexually transmitted disease as well as force the bacteria higher into the pelvic organs. These products may cause a contact dermatitis to the vulva and vaginal tissues.
    With proper treatment, there are usually no long-term effects. However, certain causes may not be completely curable. Some of these include herpes, human papillomavirus (HPV), and HIV. If a severe long-standing STD has spread to the pelvic organs, pelvic adhesions may occur. This can lead to long-term pain and infertility.
    What are the risks to others?
    Normal vaginal discharge poses no risk to others. If there is an underlying infection, such as a sexually transmitted disease, the infection may be highly contagious through sexual contact.

    Treatment & Monitoring

    What are the treatments for the condition?
    Treatment of vaginal discharge depends on the particular cause of the infection. Treatment may include the following, in the form of pills or as a cream:
  • antibacterial antibiotics

  • antifungal antibiotics

  • antiviral medication

  • antihistamines to relieve itching

  • cortisone to relieve itching

  • estrogen replacement therapy


  • What are the side effects of the treatments?
    Side effects depend on the particular agent used. Antibiotic pills may cause stomach upset or allergic reactions. Some creams may cause skin irritation.
    What happens after treatment for the condition?
    Most antibiotic treatment is used for 3 to 7 days. Estrogen treatment is usually continued indefinitely. If a sexually transmitted disease has been found, the woman's sexual partner or partners will also need evaluation and possibly treatment.
    How is the condition monitored?
    Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Eva Martin, MD
    Date Written:
    Editor:Smith, Mary Ellen, BS
    Edit Date:09/20/00
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:08/09/01
    Sources
    Understanding Your Body, Felicia Stewart, Felicia Guest, Gary Stewart, and Robert Hatcher, 1987
    Maternity and Gynecological Care, The Nurse and the Family, Irene Bobak, Margaret Jensen, Marianne Zalar, Mosby Co., 1989
    Professional Guide to Signs and Symptoms, Springhouse, 1997

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