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Excessive vaginal discharge

SYMPTOMS

What is excessive vaginal discharge?

Excessive vaginal discharge refers to a higher-than-normal amount of vaginal secretions (normally, daily discharge is about 1–2 mL and does not soak underwear). The volume of discharge is influenced by estrogen levels and various factors, generally categorized into physiological and pathological increases.

  1. Physiological increase: During ovulation, pregnancy, or sexual activity, elevated estrogen levels stimulate increased secretion from cervical glands, leading to more discharge, usually without changes in texture, color, or odor.
  2. Pathological increase: Caused by hormonal imbalances or reproductive system conditions like inflammation or tumors, resulting in significantly more discharge accompanied by changes in texture, color, or odor [1].

What is vaginal discharge?

Vaginal discharge is a mixture of secretions from cervical glands, endometrial glands, and vaginal mucosal exudate, serving to moisturize the vagina.

In healthy conditions, discharge is odorless, white, and thin or egg-white-like, with a slightly acidic pH. The amount is usually minimal, maintaining vaginal moisture. It contains lactobacilli, lysozymes, and antibodies, which help inhibit bacterial growth and preserve vaginal health [1].

What are the symptoms of excessive vaginal discharge?

The main symptom is a noticeable increase in discharge volume. Some patients may also experience color changes (yellow-green, brown, or gray), odor changes (fishy, sour, or foul), or texture changes (watery, cottage cheese-like, pus-like, or frothy) [1].

TREATMENT

How to relieve excessive vaginal discharge?

Physiological increase in vaginal discharge is not a cause for panic, as it usually resolves on its own. Avoid self-medication. Pathological discharge requires prompt medical attention and treatment as prescribed by a doctor. However, whether the discharge is physiological or pathological, the following methods can help alleviate symptoms or improve comfort:

  1. Maintain personal hygiene. Avoid using medications or washes to clean the vagina, as most feminine washes lack therapeutic effects and may disrupt the natural balance of the vaginal environment. Simply wash the external genital area with clean water, and avoid flushing water into the vagina, as it may introduce external bacteria and disrupt the vaginal balance.
  2. Change sanitary pads frequently during menstruation. Avoid using panty liners when not menstruating, as a warm, moist, and nutrient-rich environment promotes bacterial growth.
  3. Wear fewer or no tight pants. Change underwear daily and choose breathable, loose, and high-quality underwear. Avoid drying washed underwear in damp or shaded areas.
  4. When wiping after using the toilet, always wipe from the vaginal opening toward the anus to prevent introducing anal bacteria into the reproductive tract, which could cause infection.
  5. Exercise regularly, strengthen your immune system, ensure adequate sleep, and maintain a healthy diet.
  6. Stay positive and reduce anxiety.
  7. Undergo a comprehensive gynecological check-up annually for early detection and treatment of any issues.

Note: If the above measures fail to relieve excessive vaginal discharge, seek medical attention promptly to identify the underlying cause early.

DIAGNOSIS

When should you go to the hospital for excessive vaginal discharge?

  1. When the increase in vaginal discharge lasts for a long time without cyclical changes;
  2. When increased vaginal discharge is accompanied by vaginal itching;
  3. When increased discharge is accompanied by changes in color, odor, or texture, such as a curd-like white appearance, a fishy smell, pus, or blood. Particularly, bloody or yellowish watery discharge may signal cancer and requires vigilance [2].

Which department should you visit for excessive vaginal discharge?

Gynecology or Obstetrics and Gynecology.

POTENTIAL DISEASES

What are the causes of physiological increase in vaginal discharge?

The amount of vaginal discharge is influenced by estrogen levels and various other factors in the body, so an increase does not necessarily indicate illness. When there is only an increase in discharge without any other discomfort, it is generally referred to as physiological leukorrhea. The causes of physiological leukorrhea include:

  1. During ovulation or pregnancy, elevated estrogen levels, along with changes in the vaginal microenvironment and microbial composition, lead to increased secretion from cervical glands, resulting in more discharge. The discharge at this time is transparent and slightly sticky, resembling egg whites [3].
  2. Taking estrogen medications can raise estrogen levels or increase the viscosity of cervical mucus, also causing an increase in discharge.

What are the causes of pathological increase in vaginal discharge?

Pathological leukorrhea is often accompanied by symptoms such as vaginal itching, burning sensations, or changes in the texture, color, or odor of the discharge, generally referred to as abnormal vaginal discharge. The causes of pathological leukorrhea include:

  1. Infectious diseases:
    1. Trichomonal vaginitis: Increased discharge, thin, purulent, or frothy, with an odor, appearing gray-yellow, yellowish-white, or yellow-green.
    2. Vulvovaginal candidiasis: Increased discharge, resembling tofu dregs or curdled milk.
    3. Bacterial vaginosis: Increased discharge, grayish-white, thin, with a fishy odor.
    4. Vulvar eczema: Discharge may increase, but its appearance is usually normal [1].
    5. Acute cervicitis: Yellowish-green, thick, foul-smelling purulent discharge [4].
  2. Sexually transmitted diseases:
    1. Gonorrhea: Increased discharge, yellow and purulent.
    2. Genital warts: Increased discharge with an odor.
    3. Non-gonococcal urethritis: Increased discharge, yellow or bloody, or with an odor [1].
  3. Gynecological tumors:
    1. Uterine fibroids: Increased discharge, possibly purulent if infected; if the fibroid ulcerates, necroses, or bleeds, bloody or foul-smelling discharge may occur.
    2. Cervical cancer: Increased discharge, white or bloody, thin and watery or foul-smelling. In advanced stages, necrosis and infection may lead to copious rice-water-like or purulent, foul-smelling discharge.
    3. Endometrial cancer: Increased discharge, serous or bloody in early stages; in later stages, local infection and necrosis may produce foul-smelling, bloody-purulent discharge [2].
    4. Fallopian tube cancer: Increased discharge, intermittent clear, yellowish-red, or red watery discharge [4].
  4. High stress levels: Mental state also affects vaginal discharge; endocrine imbalances caused by excessive stress may increase discharge [5].
  5. Others: Well-differentiated cervical adenocarcinoma, ovarian dysfunction, chronic cervicitis, vaginal adenosis, etc., may also cause simple discharge increase, with appearance similar to normal discharge [4].