Normal vaginal secretion is dependent on the endogenous estrogen level. With the rising of the estrogen level, there is abundant secretary activity of the endocervical glands and the superficial vaginal epithelium becomes rich in glycogen. The glycogen loaded epithelium sheds.
The mucoid secretion from the cervical glands is normally small in amount. If however, the mucus is secreted in excess, it pours out at the vagina.
The excessive secretion is due to
The normal secretion is expected to increase in conditions when the estrogen levels become high. Such as,
- During puberty- Increased levels of endogenous oestrogen lead to marked over-growth of the endocervical epithelium which may encroach onto the ectocervix producing congenital erosion which leads increased secretion.
- During menstrual cycle- [1] around ovulation- peak rise of estrogen, increase in secretary activity of cervical glands.
[2] Premenstrual pelvic congestion and increased mucus in the hypertrophied endometrial glands.
- Pregnancy- There is hyperoestrinism with increased vascularity. This leads to increased vaginal transudation and cervical gland secretion.
- During sexual excitement, when there is abundant secretion from Bartholin’s glands.
ii) Cervical cause
Non infective cervical lesion may produce excessive secretion which pours out at the vagina. Such lesions are, cervical erosion, chronic cervicitis, mucous polyp and ectropion (cervical glands are exposed to the vagina).
iii) Vaginal cause
Increased vaginal transudation occurs in conditions associated increased pelvic congestion. The lesions are uterine prolapse, acquired retroverted uterus, chronic pelvic inflammation, ‘pill’ use and vaginal adenosis. Ill health is one of the important cause of excessive discharge.
If the discharge thick and white and there is an itching sensation, it may be due to vaginal thrush, caused by yeast like fungus, the commonest cause of leucorrhoea. It may also occur in women suffering from diabetes those or those who are being treated with antibiotics for some other illness. If the discharge is greenish yellow and has an unpleasant smell, could be due to trichomoniasis, a sexually transmitted disease, but it may also be transmitted via toilet articles from one woman to another, or perhaps you might have forgotten to remove a tampon or diaphragm.
If the discharge is brown, like blood, and usually follows intercourse, it may probably be due to cervical erosion. If the discharge is spotted with blood either mid-period or following intercourse, it may be due cervical polyp. If a low back, or an abdominal pain accompanies the discharge, and you feel sick, it may be due to an infection of the pelvic organs (pelvic inflammatory disease).
Leucorrhoea may also be noticed in females who are suffering from tuberculosis, anemia as also in those who have a general low resistance power, maintain poor local hygiene and those who use excess of vaginal medications such as strong disinfectants. Women who are constantly under stress and are anxious by nature may also complain of leucorrhoea.
Common causes of abnormal vaginal discharge
Factors |
Cause |
Nature |
Infective |
- Tricomonas vaginitis
- Monilial vaginitis
- Bacterial vaginitis
- Cervicitis |
- Frothy yellow discharge
- Curdy white in flakes
- Brown, rotten meat odor and non-pruritic
- Mucoid discharge |
Atropic |
- Postmenopausal
|
- Discharge is not prominent
- Irritation is prominent |
Foreign body
|
- Forgotten pessary, tampoon
- Mechanical irritation |
- Offensive, copious,
Purulent, often blood stained |
Chemical
|
-Douches, latex condoms
- Chemical irritation or allergy |
- Soreness is pronounced than the discharge
|
Excretions
|
- Contamination with urine or feces producing secondary vaginitis
|
- Offensive discharge with pruritis
|
Neoplasams
|
- Fibroid polyp or genital malignancy
|
-Serosanguinous, often offensive
|
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