Normal Vaginal Discharge
Istanbul Wet vagina is important for women's health. Irritation of the lips during walking and exercise is prevented and lubrication is provided during sexual intercourse. Apart from these, microbes in the vagina can be expelled with normal vaginal discharge, so the vagina cleans itself in a sense. At this point, the most important problem is in the definition of normal vaginal discharge. Classical information is that it can be defined as a colorless, transparent, egg white-like odorless discharge that is not excessive in amount and does not accompany itching, burning and pain. The amount of normal vaginal discharge varies according to age and menstrual cycle days, but it varies between 2-4 ml per day on average. Measuring this amount is practically impossible.
Abnormal Vaginal Discharge
Istnbul Abnormal vaginal discharge is colored (yellow, green, white), odorous, variable in consistency and in excess. It is usually accompanied by a number of symptoms, these are unpleasant complaints such as itching, burning, stinging. The most common cause of abnormal vaginal discharge is vaginitis. The incidence of vaginitis, which is the inflammatory process of the vagina, can reach up to 40%. Up to 10% of these cases can become chronic. Abnormal vaginal discharge may sometimes be bleeding, which is also important. It is a condition that can be seen with bleeding discharge, which can be caused by benign or malignant pathological conditions caused by the cervix.
Recurrent / persistent Vaginal Discharge
Istanbul Recurrent vaginal discharge is a serious problem that makes life difficult for some women. Generally, patients go to many clinics and receive similar medical treatments (antibiotic pills and/or vaginal suppositories), but they cannot achieve the desired result. This situation becomes a stress factor after a certain period of time and causes restrictions in their lives. Sometimes in clinics, it can be considered as physiological and may be a psychological obsession. Because in general, the results of the vaginal culture are negative or the patient does not clearly show the vaginal discharge that he is uncomfortable on the day of the examination. This situation creates confusion and the patient appears to be facing an insoluble problem. Why this situation arises, it is necessary to evaluate it in the first place. The first reason may be the deterioration of the flora in the vagina. The second reason may be the biofilm layer formed by bacteria in the vagina. The third reason can be counted as recurrent infection because the partner treatment is not taken. The fourth reason may be that the patient does not perform the treatments given properly (such as leaving the treatment unfinished, having difficulty using vaginal suppositories, forgetting to take medications, stopping using vaginal suppositories during menstruation). The fifth reason is incorrect or incomplete hygiene. The sixth reason is the deterioration of the flora structure and prevention of its reoccurrence due to excessive hygiene (such as washing the inside of the vagina, using daily pads). There are many more reasons for this. The most emphasized subject is the biofilm layer formed by bacteria. This is a gel structure (consisting of proteins and polysaccharide) made by the bacterium itself, which is a layer that protects the bacterium and is responsible for approximately 65% of chronic infections. The most important feature of this layer is that the antibiotics used by the patient cannot pass through this layer and cannot kill the bacteria, and vaginal infection and discharge continue continuously or intermittently. The treatment of such infections should be treated with different treatment protocols and techniques to be used other than classical drug (antibiotic pills and vaginal suppositories) treatments. techniques should be treated.
Causes of Normal Vaginal Discharge
Normally, the vagina does not contain any raft glands. Well, the answer to the question of how it is moist and how the discharge is formed is as follows: There is a small amount of salivary glands in the cervix located at the top of the vagina, and some secretion comes into the vagina from here. In addition, a small amount of interstitial fluid from the mucous membrane that forms the vagina contributes to the moistness of the vagina. Vaginal mucosa is very similar to the mucosa in our mouth. Another secretory gland is the glands called bartholin, which are located at the exit of the vagina and secrete during sexual intercourse or with any stimulation. Its main purpose is to provide lubrication during sexual intercourse. These structures secrete varying amounts according to the level of hormones, sexual arousal and the intensity of physical activity. In this way, normal vaginal discharge is formed. CAUSES OF ANORMAL VAGINAL DISCHARGE If the vaginal discharge contains an abnormal feature, infection with bacteria, fungus, parasite or virus comes to mind first. How the infection can be transmitted or occurs. This type of bacteria, virus or other factors can be transmitted sexually, as well as infection may develop due to the anatomical structure of the genital area. Vagina (The vagina is an internal genital organ that is invisible when viewed from the outside. The genital structure we see when we look from the outside is called the vulva.) It contains close proximity to the anus and the urethra where the urine output is. For this reason, microorganisms in that area can easily settle into the vagina due to incorrect or incomplete hygiene.
The vagina is not a sterile organ, it has its own flora (benign non-pathogenic bacteria structure) structure. If for any reason this flora structure is disturbed, malignant bacteria or fungi can easily settle and begin to reproduce. Among the reasons that disrupt the flora, use of antibiotics, use of hormonal drugs, weakening of the immune system, use of daily pads (blocking the airway of the vagina), washing the inside of the vagina at the end of sexual intercourse or menstruation (vaginal douche), diabetes, chemicals used for different purposes in that area can be listed. . Apart from these, malignant tumors (cervical cancer), which are usually originating from the cervix, cause vaginal discharge in wounds formed in the cervix. In this case, what needs to be done is to consult a specialist physician. In addition, although rare, allergy to latex (condom, condom) or semen may develop and cause discharge.
Acute Vaginitis
Istanbul It is the inflammation of the vaginal mucosa and is the most common reason for applying to the obstetrics clinic. This inflammation is caused by fungi, bacteria or parasites. The most common symptom is abnormal vaginal discharge. Other symptoms are irritating symptoms such as itching, foul odor, burning and stinging. It is usually of sudden onset and improvement is observed with effective treatment. If not treated properly, it can turn into chronic vaginitis.
Chronic Vaginitis
The diagnosis of chronic or recurrent vaginitis is used for patients who have 4 or more vaginal infections per year. The factors are generally the same as the microorganisms that cause acute vaginitis. The problem here is the negative change in the vaginal mucosa and flora. It is a distressing and life-threatening disease for patients. Treatment of recurrent infections is difficult with classical antibiotics, and it may be necessary to use ozone, aromatherapy or laser applications apart from classical treatments. Here, patient selection should be made correctly and treatment should be planned accordingly.
Vaginitis Diagnosis
Classical diagnostic methods can be evaluated and diagnosed according to the characteristics of vaginal discharge during gynecological examination. Apart from this, a number of laboratory tests may be requested by the doctor if he deems it necessary. These, in turn, can be used to examine the swab taken from the stream under a microscope, to look at the sample taken from the stream by culture, or to use PCR, which is an indirect diagnostic method. One of the confusing issues here is the smear test. The smear test is performed to screen for cervical cancer precursor lesions. It is not performed for diagnosis in vaginal infection. Sometimes cultures can be negative. Some bacteria require special media for growth. If culture is cultivated on nonspecific medium, the culture result may be negative. For this reason, PCR test comes to the forefront for diagnosis. Although the culture result is negative, the patient's abnormal vaginal discharge continues, which is a troublesome situation for both the patient and the physician. In this case, the patient may be diagnosed with chronic vaginitis (having had 4 or more vaginitis attacks in a year). Sometimes it can be said to be physiological or psychological. In fact, this type of patient group should be examined in more detail and followed for a long time.
Vaginitis Treatment
Abnormal vaginal discharge must be treated. If the cause of the discharge is due to infection and is not treated, it may spread to the uterus, ovaries and tubes, and this may lead to infertility in the future. If the discharge is caused by a malignant lesion in the cervix, it may cause cervical cancer in the future. Apart from these, it is a health problem that requires treatment in terms of comfort, hygiene and self-confidence. In the presence of infection, medical treatments (oral and/or vaginal antibiotic suppositories) are initially administered to the patient according to the examination and test results. If it is an acute vaginitis (vaginal inflammation), improvement occurs in a short time. Sometimes there is no improvement in patients or the infection may recur. in this case, the patient is evaluated as chronic vaginitis (consistent/recurrent vaginal inflammation). Apart from medical treatment, different treatment protocols are successfully applied. For non-infectious causes, treatment protocols are created according to the source of the disease.