My question is: Is abnormal leukorrhea vaginitis? Don’t worry, let’s understand what’s going on with leukorrhea first.
The composition of leukorrhea
Leukorrhea is a mixture of vaginal mucosal exudate, cervical canal and endometrial glandular secretions. Its formation is related to estrogen. Pre-pubertal women and post-menopausal women will have little leucorrhea and are very clean.
Normal leukorrhea
Normal leucorrhea is slightly fishy or odorless. As for the color and volume are closely related to the menstrual cycle, just before the menstrual period until ovulation, the color is milky white and thin, the volume is relatively small; to the ovulation period becomes white and transparent egg white like, pulling a long silk, can be as long as 10cm, and the volume is large; after ovulation into the luteal phase, the leucorrhea is white again, thick, the volume is medium.
Pathological leucorrhea
This is what we call abnormal leucorrhea, which is characterized by a significant increase in the amount of leucorrhea and some changes in its nature. For example, the color becomes yellow, purulent; for example, watery, white belt mixed with blood; for example, the smell, fishy smell, etc.. When these abnormalities occur, it is important to seek medical attention.
The abnormal leucorrhea does not mean that it is all vaginitis, but let’s see what diseases are related to it.
1. Vaginitis
The clinical manifestations of different types of vaginitis are different. In trichomoniasis, the leucorrhea is thin, pus-like, yellow-green and foamy, with a foul odor; in mycosis, the leucorrhea is white and bean curd-like. The diagnosis is made by taking the vaginal discharge for a routine leucorrhoea test to find out what germs are infecting the vagina and to use the right medication. Do not use antibiotics and lotions without permission, as this may cause dysbiosis and delay or even aggravate the condition. Do not douche your vagina before going to the hospital for routine leucorrhea examination, and stop using medication 3 days before, otherwise it will affect the test results.
2.Acute cervicitis
It is characterized by increased leucorrhea, mucopurulent, and itching and burning sensation in the vulva due to the stimulation of secretions. Cervical secretions can be taken for pathogenic examination. One is sexually transmitted disease pathogens: Neisseria gonorrhoeae and Chlamydia trachomatis; two is endogenous pathogens: some are related to bacterial vaginosis pathogens and reproductive mycoplasma infections; three is part of the pathogens are not clear. Antibiotic therapy is the main choice. Including empirical and pathogen-specific antibiotic therapy.
3. Chronic cervicitis
Most are asymptomatic; a few patients may have increased leucorrhea, yellowish or purulent. There are three manifestations: chronic cervical mucositis, cervical polyps, and cervical hypertrophy. However, it needs to be differentiated from cervical columnar epithelial ectopic and cervical intraepithelial neoplasia. Both have to be distinguished from cervical erosion, although both can manifest as localized erosion-like changes in the cervix. In fact, cervical erosion is only a clinical sign and can be either a physiological or pathological change. To differentiate, cervical cytology (TCT) and/or human papillomavirus (HPV) testing and, if necessary, colposcopy and biopsy must be done to rule out cervical intraepithelial neoplasia or cervical cancer. Physiologic columnar epithelial ectoplasia, which presents as erosion but is asymptomatic, does not require treatment. If it is symptomatic, it can be treated with physical therapy or local vaginal plugs. Chronic cervical mucositis should be treated for the cause; cervical polyps can be removed and sent for pathological examination after surgery; cervical hypertrophy does not require treatment.
4.Cervical cancer
Most patients show contact bleeding, and a few patients show yellow watery foul-smelling leucorrhea. In addition to TCT and HPV test, colposcopy and biopsy are needed to confirm the diagnosis by pathological examination. Individualized treatment plan is given according to the pathological type and clinical stage of cervical cancer. There are surgical treatment, radiotherapy and chemotherapy.
5.Placement of intrauterine device
Some women with IUDs will have mixed blood in the leukorrhea. To be cautious, routine cervical screening is needed to exclude cervical lesions, and ultrasound examination can be done to exclude other diseases, and of course, to check whether the ring position is normal.
6.Vulvar cancer
It is manifested as vulvar itching, skin breakage, burning sensation and ulceration, which should be examined in hospital and biopsy and pathological examination should be done. Treatment is mainly surgical excision, supplemented by radiation therapy and chemotherapy.
7.Uterine submucosal myoma with infection
The manifestation is large amount of purulent leucorrhea, if there is ulcer, necrosis, bleeding, there may be bloody or purulent blood, or even foul-smelling vaginal fluid. Gynecological examination may reveal a swelling falling out from the cervical opening. It can be removed under hysteroscopy.
8.Fallopian tube cancer
If there is intermittent discharge of clear, yellow-red or red watery leucorrhea, it should be considered. Vaginal discharge together with abdominal pain and pelvic mass is called the “triad of tubal cancer”, but less than 15% of patients have the typical “triad of symptoms”. Therefore, it is easy to be ignored in clinical practice. Vaginal ultrasound or MRI can be done for further diagnosis. Treatment is the same as ovarian cancer, mainly surgery, and can be supplemented with chemotherapy after surgery.
Seeing this, are you confused? A small abnormal leucorrhea contains so many mysteries!
Are you afraid? Don’t be afraid! All you have to do is to go to the hospital for examination as early as possible if you have symptoms, and the doctor will help you take care of everything. In fact, gynecological examination, cervical cancer screening, ultrasound examination can not be missing one, the disease will be nowhere to hide.