Discharge from the vagina is common and many of the possible causes do require a doctor. However, the natural secretions can vary considerably in amount and may on occasion give the impression of a discharge. If the discharge is slight, does not hurt or itch, is not cheesy, smelly or bloody, there is no possibility of a venereal disease and the patient is past puberty, the problem may be observed at home – for a time.
If there is also abdominal pain this suggests the possibility of a more serious disease, ranging from gonorrhoea to anpregnancy in the Fallopian tube. Bloody discharge between periods, if recurrent or significant in amount, suggests much the same. Discharge in a girl who has not reached puberty is rare and should be assessed by the doctor.
If sexual contact in the past few weeks might possibly have resulted in venereal disease, the patient must see a doctor. She should either go to her GP or direct to a hospital Venereology Department. No doctor can tell for sure just by an examination if VD is present as special tests are required. If you think you could have VD and you see your GP be certain to tell him, because unless you do, tests for VD will not routinely be carried out.
Monilia is a fungus which can infect the walls of the vagina, causing an irritating thick white cheesy discharge, which is commonly called ‘thrush’. This infection is a little more common in women who have been prescribed antibiotics or who are taking a contraceptive pill. Trichomonas (’TV’) is a common microorganism which can cause a dark yellow or even green frothy discharge and intense itch. A mixture of bacteria may be responsible for a discharge, so called non- specific vaginitis. These infections are not serious and do not spread to the rest of the body, but may be troublesome. They can occasionally go away by themselves, but if the discharge continues for more than a week or if there is marked soreness, make an appointment to see your GP. Sometimes a male partner can carry the germs responsible for these infections and he may need treatment also.
In older women, lack ofcan cause ‘atrophic’ vaginitis. This will respond to hormone creams or tablets which must be prescribed by a doctor. Foreign bodies, particularly a forgotten tampon, are a surprisingly frequent cause of vaginitis and discharge. If the thread of a tampon is ever lost in the vagina and it cannot be removed, make an appointment with the doctor within 24 hours for it to be taken out.
Hygiene and patience are the home remedies. Wash with plain soap and water twice daily. Wear cotton pants and avoid tights or tight fitting trousers. Minipads which stick onto the underwear may be found useful. Do not use vaginal deodorants or bubble baths – these may make the problem worse. If the discharge persists for more than a few days or if it is very irritating, make an appointment to see the doctor.
What the Doctor Will Do
Ask about sexual contacts and possible exposure to venereal disease. Examine the vagina with a speculum and probably take swabs from the discharge for culture. If VD is suspected swabs will be taken from the mouth of the womb (cervix). The usual treatments for the common vaginal infections are pessaries which are large tablets to be inserted into the vagina or creams applied with an applicator rather like a syringe. Trichomonas is treated with tablets by mouth, and VD with tablets or injections. Referral to a gynaecologist is occasionally required.