Vaginal discharge is a common symptom seen by clinicians. It may be physiologic or pathologic.
Physiologic vaginal discharge
Normal vaginal discharge in a reproductive-aged woman, also called physiologic discharge, usually consists of 1-4 mL per 24 hours. It is typically transparent, odorless (but can also be slightly malodorous), mucousy, and white-to-yellowish.
The character of physiologic discharge can vary over the menstrual cycle and in the different reproductive stages. For instance, it becomes more noticeable with higher estrogen states (e.g., during pregnancy, when using estrogen-progestin contraceptives, or at ovulation). Lactobacilli in the normal vaginal flora maintain vaginal acidity by producing hydrogen peroxide and lactic acid. The acidic pH of the vagina in reproductive women (4.0-4.5) creates a hostile environment for pathogens. In premenarchal and postmenopausal women with low estrogen states, vaginal pH may be 4.7 or more.
Vulvovaginal symptoms are prevalent in both premenopausal and postmenopausal women. However, the true prevalence of pathologic vaginal discharge is uncertain because vaginitis, which encompasses the symptom vaginal discharge, is often asymptomatic, self-diagnosed, and self-treated.
Abnormal vaginal discharge was reported by 14.5% of 3000 women (ages 18-50 years) who were randomly sampled from a population in Goa, India, in one community-based survey. Within one US community-practice setting, abnormal vaginal discharge was reported by 68% of women presenting with symptoms of vaginitis.
- Bacterial vaginosis
- Vulvovaginal candidiasis
- Chlamydia trachomatis infection
- Neisseria gonorrhoeae infection
- Mycoplasma genitalium
- Irritant and allergic vaginitis
- Physiologic discharge in adults
- Foreign body in children
- Nonspecific vaginitis
- Physiologic discharge in children
- Herpes simplex virus (HSV) infection
- Streptococcal vaginitis in adults
- Genital schistosomiasis
- Entamoeba gingivalis plus intrauterine device (IUD)
- Inadequate hygiene
- Foreign body in adults
- Combined contraceptive or hormonal vaginal ring-related
- Genitourinary syndrome of menopause
- Postpuerperal atrophic vaginitis; lochia
- Behcet syndrome
- Desquamative inflammatory vaginitis
- Erosive lichen planus
- Postoperative sling/mesh procedure
- Cervical cancer
- Carcinoma of the fallopian tube
- Pinworm infection
- Streptococcal vaginitis in children
- Sexual abuse
- Transmitted maternal birth canal infection
- Prolapsing fibroid
- Vaginal fistula
- Lymphoma of genital tract
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