VAGINAL DISCHARGE - what it means and what you should do.

INTRODUCTION- It is a common complaint in the gynaecological clinic. Its presence and persistence can generate a lot of worries in females experiencing it even when it's not pointing to an underlying disease. However changes in its colour, odour, and consistency (i.e whether it's thick or thin) has been a good indicator as to whether it is normal or abnormal. 
On this note, vaginal discharge can be NORMAL or ABNORMAL.


THE NORMAL VAGINAL DISCHARGE- In the healthy state, the lumen of the vagina is kept moist by a thin fluid which is produced by glands within its walls. This fluid also carries away dead cells and bacteria thus keeping the vagina clean and prevent infection.
Doctors expect this fluid production to be more and thus considering it normal when;

1. You are pregnant,
2. You are breastfeeding,
3. You are sexually aroused,
4. At about 14 days from menstruation (this is the day you ovulate i.e when your ovary releases an egg into your fallopian tube),
5. Shortly after menstruation. 

None of these reasons should be a cause for alarm.

THE ABNORMAL VAGINAL DISCHARGE- Again in the healthy state, the vaginal wall also paradoxically habours some helpful bacteria that help keeps other micro organisms away. These bacteria are known to doctors as the normal vaginal flora. The normal flora help us keep other microbes away by making the vaginal fluid to be acidic which makes the fluid hostile to other micro organisms. These flora bacteria produces the acid themselves each time they feed on the stored carbohydrate (glycogen) in the vaginal wall. The above setting is what doctors calls the vaginal ecosystem.

Any disturbance of this ecosystem would lead to abnormal vaginal discharge and you may have your vaginal ecosystem disturbed if;

1. You take antibiotics indiscriminately- when you take antibiotics that is not prescribed by a doctor, the dose you self administer might in a way destroy the acid-producing bacteria flora and this would now allow any microorganism that stray into your vaginal to flourish, which will irritate your vaginal wall and lead to subsequent vaginal discharge. 
   
2. Immune system suppression (immunosuppression)- your immune system also synergistically function alongside the vaginal acidity to form a microorganism hostile ecosystem. Any condition that will suppress your immune system would allow strayed microorganisms to opportunistically flourish in your vagina, subsequently leading to vaginal discharge. So if you are taking any immunosuppressive drugs like steroids prednisone, some anti cancer drugs, or in a background medical condition like diabetes, HIV.
   
3. Hormonal contraception- especially those whose literature has shown to have contain the hormone called estrogen. Studies have shown a direct relationship in the rate of growth of fungi in the presence of estrogen. Hence, you are more likely to grow fungi in your vaginal when on this contraception for a long time.
   
   
   
   
   
4. Use of feminine hygiene products- vaginal perfumes, soaps, douching has also been implicated.
   
5. Sexual activities- like oral to vaginal sex may actually lead to introduction of microbes from the mouth to the vaginal. 

SYMPTOMS THAT SUGGEST THE PRESENCE OF A PARTICULAR MICRO ORGANISM

FOR FUNGAL INFECTION
If you are experiencing vulva itching which is usually intense before and after menstruating, vaginal sore, pain during sex or while urinating, and a white curdlike, cheesy vaginal discharge, then you are likely to have a discharge due to a fungal infection. 

WHAT TO DO- see your doctor immediately. He would prescribe for you the choiced antifungal medications with the appropriate dose. Attempt to self medicate may worsen the discharge. Although the therapeutic effect of application of yoghurt or gentian violet solution has been documented, however antifungals still remain the treatment of choice. 
PREVENTION

1. Endeavour to wear panties made of cotton and make sure it's not too tight.
2. Change underwear when it is wet especially after a workout or swimming. 
3. Avoid hot tub bath.
4. Endeavours to use antibiotics ONLY when it is prescribed. 
5. Avoid tampons as much as possible.
6. Supplement your diet garlic and yogurt.

FOR BACTERIAL INFECTION

If the discharge has a fishy odour, it is most likely due to a bacterial infection. People with this are usually sexually active with some having multiple sexual partners.

WHAT TO DO

It is important to see your doctor immediately if you are experiencing this or if you've experienced it and it was poorly treated to prevent its fatal complications.

PREVENTION

1. Limit sexual partners.
2. Use femidom or ensure partner uses condom.

FOR PARASITIC (PROTOZOA) INFECTION

If you see a discharge that range from green to yellow to greyish white,  you're likely to have an active parasitic vaginal infection. Other symptoms you may experience may include pain during sex, vaginal bleeding after sex, pain while urinating and frequent urination.

WHAT TO DO

You must know that this is a sexually transmitted disease, so you must present at the hospital with your partner where both of you will be evaluated for other STDs and treated appropriately. 

PREVENTION

Appropriate use of femidom and condoms. 

DOCTOR'S FREQUENTLY ASKED QUESTIONS (FAQs)
Be guaranteed that your doctor will almost always ask you these questions so having the answers ready before your appointment can shorten your consultation time and save you and your doctor a ample time in making your diagnosis and instituting a suitable management plan for you.

1. When your complaint started?.
2. Has it been present since it started or it comes and goes?.
3. Do you think it has progressively worsening or it has remain thesame since it started?.
4. Has it been severe enough to affect your normal daily activities?.
5. What sort of intervention have you taking before you chose to come and see him/her and how did you feel afterwards?
6. How many times have you conceived and how many children are alive?
7. At what age did you start to menstruate? & For how many days do you normally menstruate?
8. How many days makes your menstrual cycle and has it been regular?. Has it been heavy, painful, do you feel pains during sex?.
9. Are you married?, Has anyone in your own family had similar complaint.
10. Do you smoke or drink alcohol. 

Always endeavour to have these details at your finger tips when going to see your doctor, it would make your consultation easy.

PROGNOSIS (the possible outcome of vaginal discharge if not properly treated)

Not presenting at the hospital or self medicating may result in problems like infection of the womb and its tube (fallopian tube) which may increase  the risk of ectopic pregnancy or infertility. Severe blood infection may result (septicaemia)which may sentence the person to untimely death. 

CONCLUSION- Now that a clear margin has been drawn between the normal and abnormal vaginal discharge, the onus is unto us to seek proper medical attention which is always the right thing to do when we are faced with abnormal vaginal discharge.