What is Leukorrhea & How is it Treated?|Types, Causes, Symptoms, Complications of Leukorrhea

Leukorrhea (also called Leucorrhoea) is a medical condition where a woman experiences white, thin and sticky vaginal discharge. It is also called as ‘Whites’. It is seen globally in women of reproductive age. Any deviation in its color, consistency and odor is an indication of infection and needs to be treated right away.

Women all over the world at some point in their life experience vaginal discharge called Leukorrhea. It is white (or clear), thin (or thick), sticky and odorless. Leukorrhea results from the mucus secreted from the walls of the cervix and vagina. It is caused by the increase in levels of hormones, especially estrogen. The presence of leukorrhea indicates that vagina is kept clean and is in healthy condition. Vaginal discharge is composed of mucus secreted from vagina and cervix along with old cells and normal bacterial flora of vagina.

Some women experience leukorrhea more frequently than others. Although, leukorrhea is common and considered normal to occur; however, many woman finds it scary and is uncomfortable. Further, women are embarrassed to discuss this condition with their peers and physician. Hence, leukorrhea becomes a challenge.

There are two main types of leukorrhea:

White discharge which occurs during puberty, pregnancy and in female infants is called physiological leukorrhea. It is a normal process and has no accompanied symptoms.

• Leukorrhea during Puberty: It begins in the reproductive age (puberty) within some months to a year after onset of the girl’s menses. Leukorrhea occurs between girl’s menstrual cycles and lasts for few days to weeks. Vagina produces a lot more watery or sticky discharge during ovulation.
• Leukorrhea during Pregnancy: Leukorrhea is common in pregnancy due to increase in the levels of estrogen hormone and changes in the walls of the cervix. It is noticed around the start of the second trimester (at 13 weeks) and increases as the pregnancy progresses. It offers protection to the birth canal from infections and allows growth of healthy bacteria in the vagina.
• Newborn Infants: Leukorrhea is seen in new-born female infants for the initial one to two months after their birth. This is due to intra-uterine exposure to estrogen when the infant was in the womb.

Vaginal discharge with change in the color, consistency and smell due to infections or diseases of the female reproductive system is called pathological type of leukorrhea. The discharge of yellow or green color with offensive odor is abnormal and alarming. In addition, it is often accompanied by itching, pain and swelling around labia. Pathological leukorrhea is caused by infections due to bacteria, fungi and other microorganisms. Female genitals are moist and covered for most of the time. Further, sweat in this area is common, which makes the female genitals more prone to infection and inflammation. Pathological leukorrhea requires immediate medical attention.

Commonly observed symptoms of leukorrhea are:

• Change in color, consistency and odor. Yellow or green, thick, milky discharge with a bad odor
• Persistent and abundant vaginal discharge
• Pain during micturition
• Pain in the pelvic region and calves
• Lethargy and weakness
• Itching in the genital region
• Spot on the undergarments
• Headaches

Physiological Leukorrhea Causes: This type of leukorrhea is caused due to the hormonal changes which occur during puberty and pregnancy. During pregnancy, the amount of discharge may increase. However it is not something to be worried.

Causes of Pathological Leukorrhea: It is caused due to many factors

• Infections which cause inflammation of themucus glands of the genital area leads to secretion of excess mucus mixed with pus.
  • Bacterial Infections: These are caused by Chlamydia and Gardnerella vaginalis. They cause sexually transmitted diseases (STDs) such as gonorrhoea, syphilis and AIDS. Female patients with STDs show abnormal leukorrhea. Discharge in gonorrhoea is with mucus and foul odor.
  • Fungal Infections caused by Candida albicans leads to white and lumpy discharge accompanied by intense itching in the genital region.
  • Protozoan Parasite Causing Leukorrhea: Trichomonas vaginalis is a most common cause of leukorrhea. It leads to infection which affects both, lining of the vagina and cervix. It causes both vaginal discharge and chronic inflammation. It spreads through sexual intercourse. The discharge is abundant, clotted and greenish in color.
  • Infection due to Candida albicans and Trichomonas vaginalis are the most common cause of pathological leukorrhea.
• Disease of female reproductive system such as cancer of uterus and cancer of cervix.
• Use of intrauterine devices
• Poor hygiene:
  • Vaginal area is not kept cleaned.
  • Use of tampons for extended time duration.
  • Wearing of nylon panties.
• Excessive washing (douching) of vagina results in removal of the normal flora and alteration of pH
• Hormonal disorders
• Application of jellies and lubricants
• Poor nutrition diet
• Medical conditions such as anaemia, diabetes and tuberculosis
• Emotional cause such as stress and anxiety which create imbalance of hormones, removal of healthy bacteria and cause vaginal discomfort
• Inappropriate eating habits, smoking and alcohol consumption

A good gynecologist should be consulted when symptoms of leukorrhea are observed. The exact cause of leukorrhea needs to be determined so that proper treatment can be given. The routine diagnosis may involve the following:

• Physical examination of the vaginal region for injuries.
• Microbiological culture tests are performed to diagnose the exact underlying cause of the infection. The presence of gram negative diplococci indicates of the bacterial infections; while presence of spores and mycelia are indicative of fungal infections.
• Pap smear and biopsy of cervix to check for cervical cancer.
• Blood tests and urine tests to detect infections.
• Vaginal and cervix pH is determined. Vaginal pH is 4.5 and it is increased in bacterial infections and trichomoniasis.
• PCR is used to detect antigens of Trichomonas.

A woman should consult a gynecologist when the discharge is too heavy and is not showing normal characteristics. Physiological leukorrhea is mainly caused due to hormonal imbalance. Therefore, treatment to improve or correct this imbalance will be helpful. In case of pathological leukorrhea, antibiotics are prescribed to kill the infectious agent. Trichomonas is treated with Metronidazole and Chlamydia is treated with Azithromycin. A number of home remedies too are present to treat leukorrhea. However, pregnant women should consult a doctor before trying on any of the home remedies or taking the over the counter medicines to treat leukorrhea.

It is important that leukorrhea be brought to the attention of a doctor. If not treated, it can lead to the following complications:

• Pre-term birth
• Miscarriage
• Erosion of the cervix
• Scarring of the fallopian tubes
• Endometriosis
• Pain in the lower abdomen

The following are some of the precautions to be taken to prevent leukorrhea:

• Excessive douching of the vaginal area should be avoided to maintain the normal flora and pH balance of the vaginal area.
• Use of scented perfumes and soaps with strong odor for cleaning vaginal area should be avoided.
• Use of cotton panties, instead of synthetic panties, is advised to prevent sweat from being retained in genital region.
• The undergarments should be washed with antibiotic solution and should be thoroughly dried in sun. Wearing clean panties is a mandatory.
• Drink at least 3 liters of water to flush out the toxins from your body.
• It is necessary to restrict sexual activity with multiple partners to avoid infection and associated leukorrhea.
• Females with leukorrhea should avoid eating excess of meat, fish, eggs, fermented products, bread and sweets. Instead a diet designed for leukorrhea is recommended which involves consuming plenty of fruits and vegetables. Fruits such as plums, oranges, lemons, pomegranates, banana, and green leafy vegetables. Further, milk and yogurt to be taken in more amounts.

Physiological leukorrhea is normal and generally not a thing of concern. Pathological leukorrhea definitely requires medical attention and needs to be treated to prevent complications.