Genital discharges have disturbed women in every period of their lives. In certain periods, currents with certain characteristics can be considered natural and physiological. In newborn girls, in the first 40 days, an increase in the discharge, which can sometimes be bloody, can be seen with the effect of the hormones coming from the placenta from the mother. From this period until the onset of puberty, discharge is not seen in girls. When seen, it should be considered that there may be infections related to foreign body or non-compliance with hygiene conditions. In this period, hygiene education should be given importance to girls, it should be recommended to wash from front to back in toilet cleaning, to dry quickly after bathing, to change woolen-cotton underwear frequently and not to sit in wet swimsuits. One year before the first menstrual bleeding occurs before puberty, with the increase in hormone levels, physiological discharge begins to increase in girls. This colorless, odorless, non-itchy discharge is a natural condition and does not require treatment.
Women of reproductive age have a slightly clear discharge immediately after menstruation. In the middle of two menstruation (during ovulation), the discharge from the cervix is seen in a slimy transparent way. In the premenstrual period, it turns into a more intense dark yellowish discharge. This discharge, which is seen in most women from puberty to menopause, is a natural condition. This is due to balanced hormone release, especially in women with regular menstruation and ovulation.
In the reproductive age, the cells in the upper layer of the vagina are shed under the influence of the hormones secreted from the ovaries. Lactobacilli in the vagina, which is a galaxy where 100 kinds of benign bacteria live in normal hormonal balance, break down the cells spilled over the vagina and form lactic acid. Lactic acid keeps the vaginal acidity above pH 4.4, providing the physiological balance in the vagina and protecting it from infections. At the time of ovulation, the pH is around 8.0 in the discharge from the cervix, in the menstrual bleeding and in the semen from sexual intercourse. Due to the false belief of our society called vaginal douching, washing the vagina and removing lactobacilli disrupts the acid balance in the vagina and turns it into an environment ready for infection.
In menopause, thinning (atrophy) of the vaginal tissue due to estrogen deficiency can sometimes lead to increased discharge.
Fungal infections (candida) are the most common causes of discharge in women of reproductive age. The candida agent lives in a balance with other microbes in the vagina. Especially when the acidity environment in the vagina changes, the fungi multiply and create disturbing discharge. It is a white, milky or yoghurt-like discharge when it thickens, odorless, itching that increases towards the evening, creates a slight burning sensation during urination, and causes pain due to dryness at the vaginal entrance during sexual intercourse. External genital organs may become red and irritated due to itching. Fungal infections occur in 1/3 of women and half of pregnant women. It does not cause infertility and cancer. The reason for the white intense discharge in the mouth of babies, which is called thrush among the people, is fungus. Just as the fungi in the mountains like moist environments, the fungi in the vagina increase in humid environments and cause infection. Fungal infection increases in those who do not dry quickly after bathing, those who sweat excessively, those who are overweight and those who sit in wet swimsuits.
Intensive use of antibiotics kills lactobacilli in the vagina. Vaginal douching, on the other hand, causes these benign bacteria to be thrown out with washing, disrupting the vaginal acid balance and increasing the fungus. Breaking the body resistance is also one of the important reasons that increase the fungus. Fungus is very common, especially in women with diabetes. Diabetes should be the first diagnosis that comes to mind in women with persistent itching and redness in the genital area. Unfortunately, the correct response to drug therapy can never be achieved unless blood sugar improves. affecting the immune system; anemia, thyroid, smoking, alcohol, fatigue, insomnia and other causes will increase the risk of fungus. It is known that there is even a fungus in the mouth in AIDS, which suppresses the immune system. Fungus can be easily treated with oral pills or vaginal suppositories. Pomades used in itching should be applied in a thin layer. During the periods when the fungus is intense, sexual intercourse for 3-5 days is not recommended. Pomades to be applied to the penis after the treatment increase the lubricity at the vaginal entrance and support the treatment. We should consider that when it finds a suitable environment, the fungus living in the vagina will increase again and reveal the signs of infection.
One of the most disturbing issues for women is the odors in the streams. It is seen in approximately 40% of the population. Benign anaerobic microbes in the vagina are the biggest cause of smelly discharge. Changes in the acidity of the vagina may increase the pH towards eight, and the alkalinity may cause these microbes to increase, and sometimes an irritating odor such as the odor of dead fish may appear. Since the pH of the semen is 8.0 (basic), an irritating odor appears after sexual intercourse, which can be noticed by the man. On examination, there is a gray, homogeneous, sticky discharge. Dropping a drop of potassium hydroxide on the discharge reveals the strong odor and makes the diagnosis. The reasons that break the body resistance and weaken the immune system reveal the smelly discharge. It can be easily treated with pills or vaginal suppositories. Since it is seen as one of the factors that increase the risk of preterm birth during pregnancy, it must be treated.
Another common cause of smelly genital discharge is sexually transmitted trichomonas. It occurs in 15-20% of the population. Stream; may be fragrant, sometimes foamy, greenish and itchy. Sometimes there may just be a slight odor. On examination, there are signs of infection in the vagina and redness in the form of strawberry in the cervix. Since trichomonas cannot be produced in vaginal culture, examination finding, direct smear and pap-smear evaluation are important. It can be treated with regular use of pills and/or suppositories. Since it is sexually transmitted, the spouse or partner must also be treated.
Other sexually transmitted diseases such as gonorrhea, chlamydia, and herpes also increase the discharge from the cervix. Stream; It is white, clear and odorless. In suspected cases, the diagnosis is made by vaginal cultures and blood tests. Especially since gonorrhea and chlamydia will increase the risk of infertility, they must be treated and it is inconvenient to apply an intrauterine device to these women. The importance of condom use in reducing the risk of sexually transmitted diseases should be emphasized.
Redness in the cervix, which is called wound among the people, and old tears from birth are also among the reasons that increase the discharge. It should be known that the first finding of female genital cancers, especially cervical cancer, may be discharge, and our women should be advised to have regular Pap-smear tests.