Dr Meera Sethi's Clinic

I’m Dr Meera Sethi, I’ll be telling you something very important topic which is the most common factor in women of all age group that is vaginal discharge.

Vaginal discharge serves an important housekeeping function in the female reproductive system. From where the fluid comes, where the discharge comes, the fluid is made by the glands inside the vagina and cervix, and this carries dead cells and bacteria. This keeps the vagina clean and helps to prevent infection. Most of the time, vaginal discharge is perfectly normal. Girls complain I am having the discharge, I am having the discharge, this discharge may be normal, this can vary in odour as well as hue, colour, depending on the time of your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding or sexually aroused. It will be different if you are pregnant or if you are not keeping your personal hygiene properly. However, the colour, smell, consistency seems significantly different and if it is associated with vaginal itching or burning, there can be some infection.

What causes abnormal discharge?

Any change in the vaginal balance of vaginal flora affects the smell, colour or consistency of the discharge. There are few things that can upset the balance like a fungal infection, bacterial vaginosis which is common in pregnancy or in women who have multiple sexual partners. Trichomoniasis, which is typically contracted after unprotected sex, pelvic inflammatory diseases, diabetes, sexually transmitted diseases like gonorrhoea or Chlamydia, can be by the use of antibiotics. If the girl or woman is taking antibiotics for a throat infection, or urinary infection, she might have added symptoms of vaginal itching, because of the change in the vaginal flora, the fungal infection can be there. By use of douches, scented soaps, bubble bath, there can be an infection. During the menopausal period, vaginal atrophy leads to infection.

What are the types of abnormal discharges and their possible causes?

Cloudy or yellow discharges seen in gonorrhoea, frothy yellow or greenish discharge with a bad smell is seen in trichomoniasis. There can be symptoms associated such as pain and itching while urinating. Thick, white cheesy discharges are seen in fungal infection with symptoms like swelling and itching around the vulva. There will be painful sexual contact also. A white, grey or yellow discharge with vicious odour is seen in bacterial vaginosis with symptoms like itching and swelling of the vagina and vulva. Bloody or brown discharge is seen in irregular menses, cervical erosion, or there can be a polyp.

How to make a diagnosis of abnormal discharges?

You will be asked by the doctor of the abnormality of the discharge, that when does the abnormal discharge begin, what is the colour of the discharge, what is the smell if there is any if you have any itching, pain or burning in and around the vagina.

Do you have any sexual partner? Do you douche?

And the doctor may take a sample of the vaginal discharge for testing. So it is mandatory not to take any self-medication because the type of the discharge varies from person to person, and from time to time, and the treatment will depend on the type of infection you are having.

So how is abnormal discharge is treated?

Your treatment will depend on your causative problem. Like if there a is fungal infection, you will be treated with oral anti fungals, vaginal pessaries into the vagina and cream outside the vagina and your vulva. Bacterial vaginosis is treated with anti biotics orally and vaginal creams to be applied inside the vagina. Trichomoniacal infection is treated with oral metranedazole or tinidazole and vaginal pessaries are supplemented with it. If the patient is diabetic, it is very important to control the blood sugar levels, otherwise the patient will not be cured of the symptoms. In menopausal ladies, we give estrogen creams for local application to make the atrophic vagina very healthy.

Now, I’ll be giving you some important tips to prevent the vaginal infection, which is a very common problem. So you have to keep your vagina clean by washing regularly with mild, gentle soap and warm water or hygienic washes. You should not use scented soaps and feminine douches. Do not use bubble bath or feminine sprays. It is important while going to washroom, always wipe from front to back to prevent bacteria from getting into your vagina and causing any infection. Wear 100% cotton undergarments and avoid overly tight clothing. It is very important to keep your perineal area or private parts dry.

I think this talk will help you in the prevention of a major problem that is vaginal discharge.

Thank you.
 

I am Dr Meera Sethi, senior consultant at Kirat Ram hospital.I will be taking about PCOS which is a common disease these days in reproductive age group in girls. Coming to the syndromic approach, PCOS comprised of triad of an evolution, that is, excess of male hormone and can be diagnosed by ultrasound. Two of the 3 symptoms should be there to come confirm PCOS. Cause of PCOS is unknown, it could be genetic or environmental. If one of the siblings is effected then chances are high for the other child as well. There are prolonged and delayed cycles. Girls menstruate upto to 9 times in a year. The could be missed periods for upto 2 months or heavy periods at other times. Scanty flow could also be there. There could be excessive weight gain, unusual hair growth especially facial hair and acne. The scalp hair get sparse and thin.

Examination is done with detailed history BP, BMI are all taken into account. Depression and anxiety are also a sometimes present in PCOS patients, the long term effect includes unable to get pregnant.

Treatment is done with proper diagnosis like blood test, serum level test, TSH, LFH and accordingly treatment plan is decided. Pelvic ultrasonography might be required in some cases to check for cyst in the ovaries. Lifestyle changes are also suggested like losing weight. Atleast 10 pounds of weight is list to bring hormones in balance.

Diet should include green veggies, fat free food avoiding cheese and oily and fried food. Medical treatment is also required in some cases to curb excessive hair growth and acne. It takes time for acne and excessive growth to come in check as hormonal balance requires time. The patient should take regular follow-ups and undergo lab tests and sonography to avoid long term problems.

Thank you so much