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This document provides an overview of vaginal discharge, including what constitutes normal versus abnormal discharge. It discusses the objectives of classifying and evaluating vaginal discharge and covers the most common causes of discharge including infections like bacterial vaginosis, candidiasis, trichomoniasis and cervical infections like gonorrhea and chlamydia. Treatment options are provided for each condition. The document emphasizes the importance of taking a detailed history, examining the discharge characteristics, and conducting tests like vaginal smears and cultures to properly identify the cause and manage abnormal vaginal discharge.

Health & Medicine

VAGINAL DISCHARGE
DR Sathisha Nayak
Dept. of O & G
MMMC

VAGINAL DISCHRGE
OBJECTIVES :
1.WHAT IS LEUCORRHOEA?
2.IS IT NORMAL?
3. NORMAL VS BNORMAL
4.CLASSIFICATION
5.COMMON CAUSES
6.CLINICAL FEATURES
7.EVALUATION
8.MANAGEMENT

LEUCORRHOEA
• EXECESSIVE VAGINAL DISCHARGE
NOT DUE TO INFECTION(EXECESSIVE
CERVICAL MUCUS OR VAGINAL
TRANSUDATION)
ECTROPION, CERVICAL TEARS.

IS VAGINAL DISCHARGE
NORMAL?
• COULD BE PATHOLOGICAL
• YES –SOME SITUATIONS IT CAN BE
- PUBERTAL
- PREGNANCY
- PREMENSTRUAL
- OC PILLS
-SCANTY,NO SMELL,WHITISH,NO ITCHING
NOT BLOOD STAINED.

CLASSIFICATION
• PHYSIOLOGICAL
• PATHIOLOGICAL
- INFECTIVE
- NON INFECTIVE- NEOPLASTIC
- ATROPHIC
- ALLERGIC,FB

INFECTIVE CAUSES
• VAGINAL
- CANDIDA VAGINITIS
- TRICHOMONIAL VAGINITIS
- BACTERIAL VAGINOSIS
• CERVICAL
- GONORRHOEA CERVICITIS
- CHLAMYDIA CERVICITIS

CANDIDA VAGINITIS
AGE- 20-40Y
COMMON IN – PREGNANCY
DIABETIC
OBESE WOMEN
FEATURES - CURDY WHITE,ITENSE ITCHING
EXCORATION OF VULVA
SMEAR- 10%KOH-FUNGAL HYPHE SEEN
TREATMENT-CLOTRIMAZOLE-100MG BDx7D
200MGBDx3D
RECURRENT -FLUCONOZLOE 150 MG WX4W

TRICHOMONIAL VAGINITIS
• AGENT - TRICHOMONIA VAGINALIS
• AGE -20-40YRS,SEX ACTIVITY
FEATURES
GREENISH,FROTHY,COPIOUS,ITCHING
STRAWBERRY SPOTS ON VAGINA
VAG. SMEAR-MOTILE ORGANISMS
TREATMENT- METRONIDAZOLE
- 200XBDX7D OR400XBDX3
-COUPLE TREATED TOGETHER

BACTERIAL VAGINOSIS
AGENT–G.VAGINALIS+ANAEROBIC
AGE -20-40 YRS
FEATURES-WHITISH GREY,COPIOUS
NO ITCHING,FISHY SMELL
VAG.SMEAR-CLUE CELLS
TREATMENT-METRONIDAZOLE500XBD
X7DAYS

HOW TO ASSES..?
DETAILED HISTORY
COLOUR AMOUNT,SMELL,ITCHING
RELATION TO COITUS /MENSES,pH
CLINICAL EXAMINATION-EX GENITAL
P/S EXAM
INVESTIGATIONS-VAGINAL SMEAR
-CULTURE

CERVICAL INFECTIONS
GONORRHOEA-NEISS. GONORRHOEAE
-85 %ASYMPTOMATIC
- MUCOPURULANT
- SMEAR FROM CX O&URETHRA
- INTRACELL. GM –VE DIPLOCOCCI
-SINGLE DOSE CEFETRIOXONE

CERVICAL INFECTIONS
• CLAMYDIA-CL.TRACHOMATIS
• AGE -20-40
• MUCOPURULANT
• SEXUAL TRANSMITTED
• FLOROSCENT ANTIBODY TEST/CULT.
• DOXYCYCLINE 100XBDX7D

BEWARE !
IN ANY VAGINAL DISCHARGE R/O-
-CARCINOMA CERVIX,CA ENDOMET.
(FOUL SMELL OR BLOOD STAINED)
-POLYPS,FB,VAG DOUCH(CHEMICAL)
-STD-PARTNER SCREENING
-DIABETES/HIV IN CANDIDA

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