All You Should Know About Leucorrhoea

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Center Head: What is Leucorrhoea? Maybe, this leucorrhoea term is not that common but the condition is very common and it is white discharge or discharge per vagina. So Madam, what is leucorrhoea?

Dr. Sadaf: Yeah, as you rightly said that it is discharge per vagina and it is defined as leucorrhoea when this discharge is excessive.

Center Head: Okay.

Dr. Sadaf: Now, these are found during puberty, just before the onset of menses, premenstrual time, then during pregnancy, before and after sexual intercourse, and also after childbirth in the puerperium time, that is known as Lochia.

Center Head: Right.

Dr. Sadaf: So these are the physiological reasons for leucorrhoea or it’s generally a normal white discharge, which is not associated with any itching, with any offensive odour and there are no other signs of inflammation.

Center Head: Okay.

Dr. Sadaf: So, it’s perfectly normal to have a white discharge during these times in our lives.

Center Head: Okay, so just sorry to interrupt you.

Dr. Sadaf: Yeah.

Center Head: So one should not like bother about this physiological discharge?

Dr. Sadaf: Exactly, exactly, yeah, which is very common and…

Center Head: No treatment is required.

Dr. Sadaf: No treatment is required. And if it is not bothersome to the patient as I have explained, so it requires no treatment at all.

Center Head: Right, okay.

Dr. Sadaf: The second main group is the pathological leucorrhoea, here the main cause is infection in the vagina. It is also seen in some cases in carcinoma cervix and certain conditions like obesity, predisposed to all the pathological causes.

Center Head: Okay, okay. Any particular age is related to this…?

Dr. Sadaf: Yes, commonly leucorrhoea is seen in the reproductive age group from 15 to say 40-45 years. But there are instances where we are seeing in the pre-adolescent group also, like less than 15 years in some, as I have said in infancy and childhood also, where the cause could be some foreign body, malnutrition, and other vitamin deficiencies together which cause this leucorrhoea.

Center Head: Okay. Is it associated with abdominal pain?

Dr. Sadaf: Basically, if it’s a pathological leucorrhoea, there might be some abdominal pain if the infection has gone, it’s deep rooted, from the cervix, it has entered into the uterus or the posterior vaginal wall leucorrhoea, which is seen as due to bacterial vaginosis. So in this bacterial vaginosis, what happens is the normal vaginal flora in a normal individual, healthy female has Doderlein’s bacilli, which are the lactobacillus, they are responsible for conversion of glycogen into lactic acid and this lactic acid also produces hydrogen peroxide, so it’s a normal defence mechanism for any woman. So in bacterial vaginosis, we see that this flora is altered due to any condition like say antibacterial therapy or some decrease in the immunity, so there is a breach in epithelium. So when we the patient, per speculum examination we do, we see that characteristic thin greyish discharge which is adherent to the vaginal walls, there maybe or may not be some signs of inflammation. And we do a few tests actually, in the OPD with patients it’s not possible to do the test, but there are a few tests like whiff test and some wet mount preparations. And then we can accordingly treat the patient with antibiotics, metronidazole and other suppositories and all.

Center Head: Yeah, okay, so basically bacterial vaginitis…

Dr. Sadaf: Vaginosis.

Center Head: Yes, vaginosis…

Dr. Sadaf: Yeah.

Center Head: …is treated with medicines.

Dr. Sadaf: Yes, it is treated…

Center Head: What about Trichomonas?

Dr. Sadaf: Trichomonas is also treatable. And since Trichomonas vaginalis is a sexually transmitted disease, there are symptoms of again green frothy discharge. There will be lot of pain while passing urine and patient will be having abdominal pain also. And the husband or the partner may also have some urethritis or some symptoms like that.

Center Head: Okay.

Dr. Sadaf: So, Trichomonas, we can see the patient and there is creamy discharge which is similar to like cottage cheese or curdy appearance and it causes lot of pruritus and the patient has constant complaints of itching, which may extend exteriorly also.

Center Head: Okay.

Dr. Sadaf: And there are few predisposing factors where we are seeing why fungal infection is on a rise, nowadays. There could be factors such as obesity, diabetes, hypothyroidism, certain pancreatic illnesses, autoimmune conditions; it is also seen in pregnancy. In pregnancy, we do see bacterial vaginosis and fungal infection, so it’s very important to diagnose and treat the patient because it may give rise to preterm labour, preterm births, and any endocervicitis or endometritis even after childbirth. So these are the reasons why fungal infections are on the rise. And the diagnosis is the same, clinical history and a very good speculum examination, reassuring the patient that it is a treatable condition, though it’s a very obstinate form of vaginitis, it takes a very long time to treat, sometimes we have to give therapy for 6 months also, so but it is both treatable and we can prevent it.

Center Head: So that is great information I think, Madam, you shared with us.

Dr. Sadaf: Thank you.

Center Head: So, I can say the take-home message for this particular condition that is leucorrhoea is to maintain cleanliness, to have good hygienic habits.

Dr. Sadaf: Correct, yeah.

Center Head: And whenever you are like seeing such kind of discharge, you please go and talk to your consultant because all conditions are treatable…

Dr. Sadaf: Are treatable, correct, yeah.

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