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Changes ‘Down There’ Could Point to an Infection — or Worse
moments | March 2015 | www.statesboromoments.com
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ischarge “down there” can be an embarrassing topic for women, but fortunately, most vaginal discharge is normal. However, there is a spectrum of normal, which can make it confusing. The amount, color and consistency all vary from one woman to another. Normal color can range from clear to milky white or slightly yellow, for example. Also, a woman’s discharge can change, often times cyclically. The pH of the vagina is normally acidic, a by-product of the good bacteria that live there. Changes occur during the menstrual cycle — for example, discharge can vary around the time of ovulation. Did you know that one form of natural family planning helps women to evaluate changes in their cervical mucus during their hormonal cycles? When they can identify the changes, they are able to time their ovulation in order to avoid or enhance fertility. Similarly, the vagina itself undergoes some changes throughout the menstrual cycle. The pH of the vagina is somewhat less acidic before and during menses, so problems are noticed more often then. Aside from the changes that occur naturally during a woman’s menstrual cycle, many other factors can affect vaginal discharge, including stress, nutrition, pregnancy, diabetes and even medications like oral birth control pills, steroids and antibiotics. Sexual arousal, sexual activity and personal hygiene can affect it as well. We all have bacteria living on and in us, including a woman’s vagina. When “bad” bacteria outgrow the good bacteria, bacterial vaginosis, or BV, can occur. Also, normally occurring yeast
Maximilian Hecht Women's Health
sometimes can become overgrown and cause symptoms to arise. Other times, discharge can signify an infection such as a sexually transmitted disease or other more serious health problem. So, when is it concerning? Any changes in a woman’s normal pattern could be a sign something is abnormal. Discharge that is increased in quantity, persistent or accompanied by itching, rash, bumps or pain is cause for concern. Changes in smell, especially the development of a foul odor, or changes in color, including the appearance of blood, also can signify a problem. If any occur, see your doctor! Many women will have at least one vaginal infection in their lifetime. The most common are yeast infections and BV. White, clumpy discharge (often described as having a cottagecheese-like consistency) often is associated with yeast infections, which are typically accompanied by itching and irritation. On the other hand, thin grey, white or milky discharge with a fishy odor is often caused by BV. Both infections result from an imbalance and overgrowth of naturally present organisms in the vagina. Many things can trigger these issues, including the risk factors mentioned above. Many vaginal yeast infections can be treated safely with OTC medications.
However, if the symptoms do not improve with treatment, or if you are not sure about the diagnosis, it is better to have it checked by a healthcare provider. Some strains are resistant to OTC treatments, and self-diagnosis is often incorrect and mistakes the underlying problem. Unfortunately, there are no OTC medications to treat BV. However, OTC pH tests are available to help motivated patients in diagnosing the problem. Bacterial vaginosis is much more likely to occur if a woman has an abnormally elevated pH. (The good bacteria are unable to appropriately lower the pH in this situation). Fortunately, specific antibiotics are able to help shift the environment back to a healthy proportion of good bacteria. If you think you may have BV, you should contact your healthcare provider. Abnormal discharge also can be caused by STDs and other health problems. Common STDs including trichomoniasis, gonorrhea and chlamydia can present with abnormal discharge. However, it is important to note that discharge is not always
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present with these diseases. The following includes other common advice to help prevent vaginal infections: Avoid douching. Studies have not found douching to be beneficial; in fact, some have found it can make things worse. However, it is recommended that women wash regularly with gentle, mild soap and water. Avoid potential irritants, including scented soaps and sprays, and overly tight clothing. After using the bathroom, wipe clean from front to back. On a similar topic, women are advised to urinate after sexual activity to help flush bacteria out of the urethral opening to reduce the chance of developing a urinary tract infection. Female discharge is often a normal part of life for women, but sometimes it can indicate infections and other health problems. As always, for more information, I recommend you talk with your doctor. Dr. Maximilian Hecht moved to the area in June 2014 and currently works as a physician at Ogeechee OB/GYN.
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