White discharge or Leucorrhoea is a type of vaginal discharge. It varies from whitish to yellowish or sometimes greenish in color and is usually thick in consistency. It is the commonest problem experienced by women of reproductive age. This discharge is usually a secretion from the cervix of uterus but sometimes it originates from vagina, ovaries or fallopian. It consists of normal vaginal bacterial flora and dead skin cells. Women experiencing this condition feel embarrassed to share this problem with their health care provider and as a result they keep worrying over this. They fear that they are suffering from a disease without knowing that white discharge is not a disease it is only a sign of infection. Due to this reason out of 60% of the women suffering from white discharge, only 30% seek medical help.
Types of White discharge
There are 2 types of vaginal discharge:
- Physiological Leucorrhoea: It happens as a reaction of our body’s own defence mechanism to maintain the chemical balance of vagina and to preserve its flexibility. There are few phases in a women cycle where experiencing white discharge is a normal hormonal reaction which goes off on its own without any medical help. These conditions are:
- A few days before menarche (when a woman starts her menstruation for the first time) in adolescent girls.
- A few days before menstruation.
- During sexual fantasy or sexual stimulation.
- During sexual intercourse.
- During Pregnancy.
- During ovulation period: ovulation occurs between 10th to 14th day of menstruation cycle, experiencing white discharge during this time is a normal finding.
- Pathological Leucorrhoea: Here white discharge occurs due to some underlying condition, mainly an infection. And a reproductive tract infection is the main reason for pathological leucorrhoea.
Causes of white discharge or leucorrhoea
Let’s evaluate both the physiological and pathological causes of white discharge.
- Hormonal Changes: Hormonal changes are one of the most common causes of white discharge. Level of female hormone i.e. Estrogen fluctuates rapidly during reproductive phase of a woman and hence leads to physiological leucorrhoea.
- Pregnancy: White discharge is seen more in pregnant women. Main reason behind this is that, during pregnancy the level of estrogen increases which leads to increase of blood flow towards vagina
- Female Infants: Immediately after birth female infants may have white discharge for a few days or months due exposure to estrogen during fetal development. This will go on its own as this is a physiological condition.
- Anemic Girls: Young girls who are starting their menstruation for the first time and are having low haemoglobin level are at high risk of developing leucorrhoea. Anemia suggests malnourishment and other nutritional deficiencies which is also a cause of white discharge in young menstruating girls.
- Poor Hygienic Condition: Poor genital hygiene is one of the commonest causes of white discharge in women. Women who are not following good hygiene practice especially during menstruation are more prone to develop leucorrhoea. It may also cause genital tract infection.
- Keeping vaginal area moist: Wetness of vaginal area especially during menstruation leads to fungal infection and thus causes white discharge. Using tight and synthetic undergarments also keeps the vaginal area moist and prone to infection.
- Improper use of Sanitary napkins: Not changing sanitary napkins on a timely manner is an important cause of vaginal infection and leucorrhoea. And also not using clean and hygienic sanitary measures during menstruation is a reason of infection and white discharge.
- Excessive Sexual Activity: Increased sexual activity can lead to reproductive tract infection and thus causes white discharge. Here some ineffective pathogens like Trichomonas vaginalis or Chlamydia gets active and cause vaginal infection.
- Excessive Sexual Desire: Increase in sexual desire leads to masturbation and thus causes infection and white discharge. Overuse of vaginal sprays, lubricants or jellies can also cause white discharge.
- Sexually Transmitted Disease: Many sexually transmitted diseases such as gonorrhea, which causes transmission of bacteria, viruses, yeast or some other microorganisms and hence leads to infection of cervix of uterus. This infection causes irritation of the mucus glands of cervix and hence leads to excessive secretion of mucus from cervix. These diseases are the common most reason of gynecological disorders and pathological white discharge.
- Vaginitis: Inflammation of vagina which is caused by infection with fungus Candida albicans or protozoan parasite Trichomonas vaginalis is also a reason for white discharge in women. This type of infection is quite resistant to treatments.
- Foreign Bodies: Some foreign objects such a tampon, diaphragm, intrauterine device or chemical contraceptives etc if left in vagina for a longer time can lead to infection which give rise to an irritating white discharge.
- Stress: Excessive mental stress is also a known reason for hormonal imbalance in women. So the women who are in depression or going through some stressful situations in her life are more prone to have white discharge.
- Injury to female genital tract: Sometimes white discharge occurs as a result of some injury or trauma to the female genital tract. Here white discharge may accompany with blood stains.
- Dietary stimulation: Excessive use of tea, coffee, oily, spicy and unhealthy food causes vaginal irritation. And also smoking as well as over use of alcohol can causes white discharge.
- Sedentary lifestyle: No regular exercise or least physical activity may also leads to leucorrhoea.
Symptoms of white discharge or leucorrhoea
- Vaginal Discharge: There is thin or thick sticky discharge from vagina which is white, yellow or greenish in color. This is present almost in all the cases of leucorrhoea.
- Foul Smell: White discharge occurs as a result of infection is yellowish or curd like and is extremely foul smelling. It might smell like a fish.
- Intense itching or pruritus of vulva.
- Soreness and swelling of vulva.
- Intense burning sensation.
- Increased and painful urination.
- Rashes around vagina.
- Frequent mood swings
- Headache and sometimes vertigo
- Pain in legs.
- Abdominal pain and cramps.
- Pain during and after sexual intercourse.
- Bleeding during and after sex.
- Metrorrhagia i.e. abnormal uterine bleeding in-between two menstrual cycles.
Diagnosis of white discharge
Diagnosis of pathological leucorrhoea is based on following factors:
- Clinical History: A detailed history of symptoms is required to confirm the diagnosis of leucorrhoea which includes:
- Duration of the symptoms
- Frequency of symptoms
- Color and consistency of discharge
- Odour of discharge
- Type of fungal infection
- Frequency of sexual intercourse
- History of exposure to venereal disease in patient or in her husband
- History of obstetric status
- Use of contraceptives
- Physical Examination: Physical infection is also required to confirm the severity of inflammation.
- Blood Tests: Blood tests are required to confirm the type of infection i.e. bacterial or fungal etc.
- Speculum Examination: To see directly into the cervix to check for any signs of inflammation.
- Swab Test: To check the number of pus cells as well as to check ph. It also helps in identifying the exact cause of infection.
Risks if neglected
White discharge, as we already discussed can be a result of infection. And if it remains untreated for a long time it leads to complications as well. Few of them are as follows:
- Miscarriage – Spontaneous abortion
- Premature birth or pre-term labour
- Ectopic pregnancy – A pregnancy where eggs get fertilized outside the uterus and get implanted into the fallopian tube.
- Difficulties in conceiving
- Cervical erosion – A condition where cervical cells are present also on the outer surface of cervix
- Endometriosis – A condition where uterine tissue start growing outwards.
- Scarring of Fallopian tube
- Persistent lower abdominal pain
- Females infected with Trichomonas vaginal is are at high risk morbidity which includes infertility, preterm labour, pelvic inflammatory disease etc.
Foods to eat and avoid
Foods to eat:
- Drink plenty of water: it helps to flush out the toxins
- Rice water: drink a glass of rice water every morning.
- Fenugreek seed: boil 1 liter of water with 3 tablespoons of fenugreek seeds. Drink this water daily in morning.
- Coriander seeds: soak a tablespoon of coriander seeds in 1 glass of water at night. And drink that water in morning.
- Apple cider vinegar: 2 teaspoons mixed with water
- Indian gooseberry: mix one teaspoon of Indian gooseberry powder with honey and take it empty stomach in morning.
- Complex Carbs: like whole grain, oats, brown rice etc.
- Lean Protein: like fish, sprouts, nuts, yoghurts etc.
- Ripe banana, Orange, Cranberry juice, Lemons, Black plums,
- Lady finger, Onions, Ginger, Garlic, Fresh fruits and green leafy vegetables
Foods to avoid: Tea or coffee, Alcohol, Aerated drinks, Oily or fried food, Spicy and sour food, Sugar, Egg, Meat, Bread, Mushrooms, Fermented food
- Maintain a good genital hygiene.
- Do not let moisture retained in genital area.
- Always use wipes after going to the toilet.
- Wear loose and cotton undergarments rather than tight and synthetic one, which have the ability to retain moisture.
- Wash undergarments with antibiotic soap or solution
- Practice a safe sexual intercourse
When to see a doctor
Visit your doctor if you have following symptoms:
- Gray, green or yellowish discharge
- Burning and irritating pain around vagina
- Offensive odour of the discharge
- Intense itching with frequent and painful urination
- Thick vaginal discharge during pregnancy
- Severe abdominal pain
- Pain during and after sexual intercourse
- Visible signs of infection around genitals like rashes, sores or blisters.
- Bleeding in between periods
Treatment of white discharge
Vaginal infections can be treated with antibiotics as well as antifungal medicines based on the type of infection. These medicines can be administrated orally by mouth or can be administered through vaginal route. These antibiotics can also be used in the form of vaginal creams or gel to provide soothing to the sore and inflamed vaginal lining.
- If your physical examination suggests a sexually transmitted disease, your doctor may give you antibiotics by injections under his supervision.
- For a recurrent yeast infection, only a local application of antifungal cream is sufficient to produce cure.
- If the reason of leucorrhoea is hormonal imbalance, then estrogen therapy is required which can be administered orally as well as through vagina. For a mild case of infection, just a water based lubricant is enough.
- If contraceptive pills are the reason of white discharge in a woman, than your doctor may change the type of contraception which will help in improving the symptoms.
- If the reason for your white discharge is sexually transmitted disease and no other factor seems applicable on you, than your sexual partner should also be evaluated and being treated under a doctor’s guidance.
Do’s & Don’ts
- Keep yourself hydrated
- Maintain good genital hygiene
- Use proper sanitation
- Change sanitary pads after every 6 hours
- Apply pulp of mango to vaginal area and wash it off after keeping it for few minutes
- Clean the vaginal area with lemon water
- Wash genital area with neem water, twice a day
- Eat healthy nutritious food
- Do regular exercise
- Do not smoke
- Do not drink alcohol
- Do not eat sugar
- Do not take stress
- Do not use vaginal sprays or jellies
Risks for specific people
Pregnant women, infertile women and the women suffering from frequent lower genital tract infections such as cervicitis and endometritis are more prone to develop leucorrhoea. Women with HIV infection are more prone to yeast infection which further leads to leucorrhoea. Obese women having high intake of carbohydrates especially alcohol and sugar are also at risk of developing white discharge. Diabetic women and the women at menopausal age are also at great risk of developing leucorrhoea.