Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Research Article Volume 3 Issue 12

Vaginal Discharge: Common Causes and Management in Women of Reproductive and Prepubertal Girls in a Primary Care Setting - A Narrative Review

Siva Achanna1, Jaydeep Nanda1* and Avanya Paloma2

1MAHSA University, Bandar Saujana Putra, Jenjarom, Selangor, Malaysia
2Bachelor of Science Biology at Sunway University, Bandar Sunway, Subang Jaya, Selangor, Malaysia

*Corresponding Author: Jaydeep Nanda, MAHSA University, Bandar Saujana Putra, Jenjarom, Selangor, Malaysia.

Received: November 03, 2021; Published: November 30, 2021

Abstract

Apart from the physiological form of vaginal discharge (VD), the early detection of pathological VD is important to prevent complications of the underlying diseases which can severely compromise a women’s health, fertility, ectopic pregnancy, cervical malignancy, pelvic inflammatory disease (PID) and vertical transmission of disease to the neonate are perhaps the most common clinical scenarios which are required to manage immediately. Partner notification and treatment is an essential part of the management. They may present to a number of different services, including primary care, family planning, genitourinary medicine and gynaecology. Many women express embarrassment, anxiety and taboo to complain in disclosing their problem, leading to self-management, home remedies and purchase of over the counter (OTC) prescriptions, without realizing the inability to differentiate between the normal physiological and pathological VD.

A thorough history, examination and investigations are needed to arrive at a diagnosis and formulation of the management plan. Sexual history should be taken in a sensitive manner to discuss regarding full sexually transmitted infection (STI) screening and other tests should be tailored appropriately to those at high risk. The prevalence of STI has risen in the United Kingdom since the 1990s. Hence, gynaecologists are required to be extra vigilant in the diagnosis and subsequent management of the sequelae.

The three main causes of VD in reproductive aged women are: bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonas vaginalis (TV). Discharge of cervical origin is the other important cause of VD with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG) and primary genital herpes simplex can also manifest as VD. These are the most common pathogens isolated. Cervicitis should be suspected in women with purulent endocervical discharge with easily inducing cervical bleeding. To detect specific pathogens causing cervicitis, laboratory testing is essential to identify the organisms involved.

Keywords: Vulvovaginal candidiasis; Trichomonas vaginalis; Bacterial vaginosis; Inflammatory Vaginitis; Neisseria gonorrhoeae; Chlamydia trachomatis; Pelvic Inflammatory Disease

References

  1. Singh K Ed. “Integrated Approach to Obstetrics and Gynaecoogy”. New Jersey World Scientific (2016).
  2. Samudrika Ilankoon JM., et al. “Women’s understanding, and cultural practices related to vaginal discharge: a qualitative study”. Nursing and Midwifery Studies 7 (2018): 74-80.
  3. Paladine HL and Desai UA. “Vaginitis: diagnosis and treatment”. American Family Physician 97 (2018): 321-329.
  4. Rao VL and Mahmood T. “Vaginal discharge”. Obstetrics, Gynaecology and Reproductive Medicine 30 (2020): 11-18.
  5. Mamtaand KN. “Reproductive Tract Infections: Prevalence and Health Seeking Behavior among women of Reproductive Age Group”. International Journal of Science and Research 3 (2014): 2319-7064.
  6. Rizvi N and Luby S. “Vaginal discharge. Perception and Health Seeking Behavior amongst Nepali Women”. Journal of Pakistan Medical Association12 (2004): 620-624.
  7. Rabin KA., et al. “Female reproductive tract infections: understanding and care seeking behavior among women of reproductive age in Lagos, Nigeria”. BMC Women’s Health (2010).
  8. Theroux R. “Bypassing the Middleman: A Grounded Theory of Women’s Self-Care for Vaginal Symptoms”. Health Care for Women International 23 (2020): 417-431.
  9. World Health Organization. “Comprehensive Cervical Cancer Control”. A guide to essential practice (2006).
  10. Verma A., et al. “Clinicopathological correlation of infective vaginal discharges in non-pregnant sexually active women of reproductive age group in tertiary care center of Western UP”. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 3 (2013): 349-354.
  11. EKieran and DP Hay. “Sexually transmitted infections”. Current Obstetrics and Gynecology 16 (2006): 218-225.
  12. Oliveira F., et al. “Sexually transmitted infections, bacterial vaginosis and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study”. Memórias do Instituto Oswaldo Cruz 102 (2007): 751-756.
  13. Fang X., et al. “Prevalence and risk factors of trichomoniasis, bacterial vaginosis and candidiasis for married women of child-bearing age in rural Shandong”. Japanese Journal of Infectious Diseases 60 (2007): 257-261.
  14. Bhalla P., et al. “Prevalence of bacterial vaginosis among women in Delhi, India”. Indian Journal of Medical Research Pa 167-172.
  15. SA Khan., et al. “Evaluation of common organisms causing vaginal discharge”. Journal of Ayub Medical College Abbottabad 2 (2009): 90-93.
  16. Barousse MM., et al. “Vaginal epithelium cell anti-candida albicans activity is associated with protection against symptomatic vaginal candidiasis”. Infection and Immunity 11 (2005): 7765-7767.
  17. Patel D., et al. “Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study”. American Journal of Obstetrics and Gynecology 190 (2004): 644-653.
  18. Guerrero-Lozano I., et al. “Vulvovaginal candidiasis by non-albicans Candida species”. Mycosis47 (2012): 205.
  19. Dennerstein GJ and Ellis DH. “Oestrogen, glycogen and vaginal candidiasis”. The Australian and New Zealand Journal of Obstetrics and Gynaecology 3 (2001): 326-28.
  20. Tarry W., et al. “Candida albicans: The estrogen target for vaginal colonization”. Journal of Surgical Research 2 (2005): 278-282.
  21. Fischer G and Bradford J.” Vulvovaginal candidiasis in postmenopausal women: the role of hormone replacement therapy”. Journal of Lower Genital Tract Disease 15 (2011): 263-267.
  22. Pirotta MV and Garland SM. “Genital candida species detected in samples for women in Melbourne, Australia, before and after treatment with antibiotics”. Journal of Clinical Microbiology 44 (2006): 3213-3217.
  23. Oliveira CS., et al. “Clinical epidemiological and laboratory findings among women with recurrent vulvovaginal candidiasis (RVVC) in a university hospital, Brazil”. Mycoses 58 (2015): 68.
  24. AA Hoosen. “Management of vaginal discharge”. Continued Medical Education2 (2004): 72-78.
  25. Stricker T., et al. “Vulvovaginitis in prepubertal girls”. Archives of Disease in Childhood 88 (2003): 324-326.
  26. Joshy M., et al. “Do we need to treat vulvovaginitis in prepubertal girls?” BMJ 330 (2005): 186-188.
  27. Altcheck A. “Pediatric vulvovaginitis”. The Journal of Reproductive Medicine 29 (1984): 359-375.
  28. Makwela MR. “Paediatric vaginal discharge”. South African Family Practice 7 (2007): 30-31.
  29. PannonenJ and Brunham RC “Bacterial vaginosis and desquamative inflammatory Vaginitis”. The New England Journal of Medicine 379 (2018): 2246-2254.
  30. SS Balamurugan and Bendigeri ND. “Community-Based Study of Reproductive Tract Infections among Women of the Reproductive Age Group in the urban Health Training Centre Area in Hubli, Karnataka”. Indian Journal of Community Medicine 37 (2012): 34-38.
  31. Andersen MR., et al. “Evaluation of vaginal complaints”. JAMA11 (2014): 1368-1379.
  32. Vermeulen GM., et al. “Changes in vaginal flora after 2% clindamycin vaginal cream in women in high risk of spontaneous preterm birth”. BJOG 108 (2001): 697-700.
  33. Varsha C., et al. “Prevalence and determinants of vaginal discharge among women of reproductive age group in tertiary care hospital of Northern India”. National Journal of Community Medicine 4 (2012): 661-665.
  34. Smith YR., et al. “Premenarcheal vaginal discharge findings of procedures to rule out foreign bodies”. The Journal of Pediatric and Adolescent Gynecology 4 (2002): 227-230.

Citation

Citation: Jaydeep Nanda., et al. “Vaginal Discharge: Common Causes and Management in Women of Reproductive and Prepubertal Girls in a Primary Care Setting - A Narrative Review". Acta Scientific Women's Health 3.12 (2021):45-60.

Copyright

Copyright: © 2021 Jaydeep Nanda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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