Leucorrhoea – Complications, Risk factor and Prevention

What is leucorrhoea?

Leucorrhea, also spelled as leukorrhea, is a medical condition characterized by a thick, yellowish or whitish vaginal discharge in women. This discharge is a natural part of the female reproductive system and is usually odorless or has a mild, inoffensive odor. leucorrhoea is primarily caused by an increase in the production of estrogen, a hormone that regulates the menstrual cycle and maintains the health of the reproductive organs. This condition commonly occurs during puberty, when girls first start their menstrual cycles, and during pregnancy when hormonal levels fluctuate significantly. It can also be a result of sexual arousal or emotional stress. In most cases, leucorrhoea is harmless and does not require medical treatment. However, if the discharge is accompanied by itching, irritation, a foul smell, or changes in color, it could be indicative of an infection or other underlying health issues, and medical consultation is recommended.

Leucorrhoea becomes a cause for concern when it is associated with other symptoms such as itching, redness, pain, or discomfort in the genital area. These symptoms could be signs of an infection, such as yeast infection, bacterial vaginosis, or a sexually transmitted infection (STI) like gonorrhea or chlamydia. Infections that cause abnormal leucorrhea are usually treated with antifungal or antibiotic medications prescribed by a healthcare professional. Maintaining good personal hygiene, wearing breathable cotton underwear, and avoiding irritants like scented soaps or douches can help prevent infections and minimize the risk of abnormal leucorrhea. It is important for individuals experiencing unusual vaginal discharge or related symptoms to consult a healthcare provider for proper diagnosis and appropriate treatment.

Types of leucorrhoea

Physiological leucorrhea: It can be a natural defense mechanism that the vagina uses to maintain its chemical balance as well as to preserve the flexibility of the vaginal tissue. It is not a major issue can be resolved as soon as possible. It mainly occurs during pregnancy caused by increased blood flow to vagina due to increased estrogen.

Inflammatory leucorrhea: Causes due to inflammation or congestion of vaginal mucosa. Since it could be a sign of several diseases including bacterial infection.

Parasitic leucorrhea: It is also called as trichotillomania a group of parasitic protozoa, specifically trichomonas vaginalsis cause burning sensation, itchy, discharge of forthy substances, thick white or yellow mucus.

Prevalence of leucorrhoea

Leucorrhoea is a widespread condition among women of reproductive age, occurring globally and influenced by various factors such as hormonal changes, infections, and sexual activity. Its prevalence rates vary significantly due to geographical differences, socioeconomic factors, and healthcare accessibility. In many developing countries, limited access to healthcare and lack of awareness about reproductive health contribute to underreporting and untreated cases. Conversely, in developed regions with better healthcare infrastructure, women are more likely to seek medical advice and treatment for leucorrhea, leading to higher reported cases. The condition predominantly affects adolescents, sexually active women, and those experiencing pregnancy or menopause, all marked by significant hormonal fluctuations, emphasizing the diverse contexts influencing the prevalence of leucorrhea worldwide.

Pathophysiology

leucorrhoea, characterized by abnormal vaginal discharge, stems from various underlying causes. Infections, such as bacterial vaginosis, yeast infections, or sexually transmitted diseases, disrupt the natural balance of vaginal microorganisms, leading to inflammation and altered secretions. Hormonal imbalances, like those occurring during pregnancy or menopause, influence the consistency and quantity of vaginal discharge. Cervical abnormalities, such as inflammation or ectopy, can also contribute. Furthermore, allergic reactions to substances like latex and irritants from hygiene products trigger immune responses, causing irritation and discharge. Additionally, psychological factors and stress can impact hormonal equilibrium, indirectly influencing vaginal secretions. Identifying the specific cause is essential for effective treatment, highlighting the importance of a comprehensive medical evaluation to address the root pathology of leucorrhoea.

Signs and symptoms of leucorrhoea

Symptoms of leucorrhoea may vary in intensity from woman to woman. Some women may experience several symptoms together, while others may be relatively asymptomatic. Some of the common leucorrhoea or white menstruation symptoms include:

• Whitish or yellowish discharge from the vagina
• Frothy and foul-smelling discharge
• Pain in the calves and lumbar region
• Lethargy and weakness
• Heaviness in the abdominal region
• Vaginal itching
• Constipation
• Frequent headaches
• Digestive problems
• Irritability
• Black patches on the skin under the eyes
• Spotting on the underwear
• White menstruation symptoms like severe irritability and black eye patches are generally common in chronic cases of leucorrhoea.

What are the main causes of leucorrhoea?

Leading Factors That Cause Leucorrhoea

• Inadequate genital hygiene, wearing dirty and damp underwear can lead to the growth of bacteria and leucorrhoea
• Bacterial, yeast, and fungal infections may lead to increased vaginal discharge a primary symptom of leucorrhoea
• Urinary Tract Infections may affect the vagina and lead to increased discharge
• Intestinal worms may lead to vaginal infections and a burning sensation
• Sexually transmitted diseases and unprotected sex is a major reason for leucorrhoea
• Medications like steroids, painkillers, birth control pills, and antibiotics may cause excess discharge from the vagina
• An imbalance in hormone levels caused by stress may be the prime reason behind vaginal infections and increased discharge
• Lifestyle diseases like diabetes and anemia may also lead to leucorrhoea
• Hormonal diseases like polycystic ovarian syndrome (PCOS) may cause increased discharge and vaginal infections
• Vaginitis and Cervicitis affecting the female reproductive organs may also lead to increased irritation of the vagina and leucorrhoea

Risk factors

The risk of leucorrhoea without any pathology depends on many factors like the age of the woman, educational status, family background, number of pregnancies, use of contraceptives and the method of childbirth. The risk of abnormal vaginal discharges is increased in:

• Sexually active individuals.
• Multiple sexual partners.
• Past untreated infections.
• Unprotected sexual contact.
• Sexually active women under 25 years.
• Previous history of sexually transmitted diseases.
• HIV infection.
• Weak immunity.
• Not using condoms often.
• Use of contraceptive devices.

Complications

Leucorrhoea itself is a natural and common occurrence in women, often without serious complications. However, if it is caused by an underlying infection or an untreated condition, complications can arise. Here are some potential complications associated with leucorrhoea:

1. Recurrent Infections: Chronic or recurrent leucorrhoea may indicate an ongoing infection, which can lead to persistent discomfort and irritation.
2. Vaginal Irritation: Continuous leucorrhoea, especially if it is abnormal in consistency or odor, can cause irritation, itching, and redness in the vaginal area.
3. Discomfort during Sexual Intercourse: Vaginal infections associated with leucorrhoea can lead to pain or discomfort during sexual activity.
4. Pelvic Inflammatory Disease (PID): If left untreated, certain infections causing leucorrhoea, such as gonorrhea or chlamydia, can spread to the reproductive organs, leading to PID. PID can cause pelvic pain, fertility problems, and long-term complications.
5. Infertility: In some cases, chronic infections associated with leucorrhoea can lead to scarring of the reproductive organs, which may impair fertility.
6. Preterm Birth: Pregnant women with untreated infections causing leucorrhoea are at a higher risk of preterm birth, which can lead to complications for the baby.
7. Increased Susceptibility to STIs: Continuous leucorrhoea can indicate an imbalance in the vaginal flora, making women more susceptible to contracting sexually transmitted infections (STIs).
8. Emotional and Psychological Distress: Chronic leucorrhoea and its complications can cause emotional distress due to discomfort, pain, and worries about fertility and overall health.

Diagnosis of leucorrhoea

The diagnosis of leucorrhoea involves a thorough medical evaluation conducted by a healthcare professional, typically a gynecologist. Here are the steps and methods commonly used for diagnosis:

Medical History

The healthcare provider will begin by taking a detailed medical history, including questions about the nature, duration, and characteristics of the vaginal discharge. Information about recent sexual activity, contraceptive methods, and any associated symptoms such as itching, pain, or discomfort will also be important.

Physical Examination

A physical examination, including a pelvic exam, will be conducted. During the pelvic exam, the healthcare provider examines the external and internal reproductive organs to check for any signs of infection, inflammation, or abnormal discharge.

Vaginal Swab

In many cases, a sample of the vaginal discharge is collected using a cotton swab. This swab is then sent to a laboratory for microscopic examination. The laboratory analysis helps identify the presence of infection-causing microorganisms such as bacteria, yeast, or parasites. This test can confirm the underlying cause of leucorrhoea, whether it is due to a yeast infection, bacterial vaginosis, or a sexually transmitted infection.

pH Testing

The pH level of the vaginal discharge may be tested. Normal vaginal pH is typically acidic (around 3.8 to 4.5). Certain infections, such as bacterial vaginosis, can cause an increase in pH.

Cervical Smear/Pap Test

If necessary, a cervical smear or Pap test may be performed to screen for cervical cancer or detect abnormal cervical cells. This test is often done in conjunction with the evaluation of leucorrhoea.

Blood Tests

In some cases, especially if a sexually transmitted infection is suspected, blood tests may be conducted to check for the presence of specific antibodies or antigens related to the infection.

Based on the findings from these diagnostic methods, the healthcare provider can accurately diagnose the underlying cause of leucorrhoea and recommend appropriate treatment.

Treatment of leucorrhoea

Leucorrhea, also known as vaginal discharge, is a common symptom in women. It can be caused by a variety of factors, including hormonal changes, infections, and other medical conditions. Treatment for leucorrhea depends on its underlying cause. Here are some general guidelines:

Identify the underlying cause

The first step in treating leucorrhea is to determine the underlying cause. A healthcare provider may perform a physical examination, take a medical history, and possibly order tests such as a vaginal swab or blood tests to identify any infections or hormonal imbalances.

Leucorrhea, also known as vaginal discharge, is a common symptom in women. It can be caused by a variety of factors, including hormonal changes, infections, and other medical conditions. Treatment for leucorrhea depends on its underlying cause. Here are some general guidelines:

Hygiene and lifestyle modifications

• Maintain good hygiene: Keeping the genital area clean and dry can help prevent and manage leucorrhoea. Use mild, unscented soaps and avoid harsh chemicals or perfumed products.
• Wear cotton underwear: Choosing breathable cotton underwear can help reduce moisture and irritation in the vaginal area.
• Avoid tight clothing: Tight-fitting clothes can trap moisture and heat, promoting the growth of microorganisms.

Dietary and lifestyle changes

• Stay hydrated: Drinking plenty of water can help maintain vaginal moisture and reduce dryness.
• Maintain a balanced diet: Eating a nutritious diet with adequate vitamins and minerals is essential for overall health, including vaginal health.
• Manage stress: High levels of stress can affect hormonal balance and potentially lead to leucorrhoea. Practices such as meditation, yoga, and exercise can help manage stress.

Treating underlying infections

• Bacterial or fungal infections: If an infection is the cause of leucorrhoea, your healthcare provider may prescribe antibiotics or antifungal medications.
• Sexually transmitted infections (STIs): If an STI is suspected, appropriate treatment and partner notification may be necessary.

Hormonal imbalances

If hormonal imbalances are contributing to leucorrhoea, hormone therapy or oral contraceptives may be recommended.

Herbal and home remedies

Some herbal remedies, such as amla (Indian gooseberry) and neem, are believed to have antimicrobial properties and may help manage leucorrhoea. Consult with a healthcare provider before using herbal remedies, as they may interact with other medications or have contraindications.

Medication Options

According to HHS and the Merck Manual, treating the underlying issue that is causing unhealthy vaginal discharge might include taking medications, such as:

• Corticosteroid cream, such as hydrocortisone, or an oral antihistamine to relieve itching
• Antibiotic medication to treat bacteria that cause infections
• Vaginal cream containing estrogen to treat vaginitis due to menopause

Steps to prevent leucorrhoea

Sometimes you can help prevent abnormal vaginal discharge by following simple steps:

• Using warm water and unscented non-soap cleanser to wash your private parts.
• Not using sprays or powders on your vagina
• Not douching (douching is when a lady puts a liquid inside her vagina to rinse it out)
• Not wiping with baby wipes or scented toilet paper after you use the toilet