Ask Dr. Johnson topic of the week: Vaginal Discharge

Vaginal Discharge is a complaint that I deal with day in and day out. My major aim with this discussion is to let women know what is normal vs. abnormal.

In reproductive-aged women, normal vaginal discharge consists of 1 to 4 mL fluid (per 24 hours), which is white or transparent, thick or thin, and mostly odorless. (THIS MEANS THAT DAILY DISCHARGE IN SMALL AMOUNTS IS NORMAL) This physiologic discharge is formed by the cervix (which produces mucus), dead skin cells in the vagina (skin everywhere on your body dies daily and new skin regenerates), normal vaginal flora (normal bacteria that we discussed in the douche conversation). Vaginal discharge is more noticeable at times of physiologic leukorrhea (discharge), such as at mid-menstrual cycle close to the time of ovulation or during pregnancy or use of estrogen-progestin contraceptives (Birth Control Pills).

Diet, sexual activity, medication, and stress can also affect the volume and character of normal vaginal discharge. Although normal discharge may be yellowish, slightly foul smelling, and accompanied by mild irritation, it is not accompanied by itching, pain, burning or bleeding. The absence of these signs and symptoms distinguishes normal discharge from discharge related to an infection.

I was asked a specific question about why Antibiotics cause yeast infections. The answer is simple. In addition to killing the intended target, antibiotics also can kill the normal protective bacteria of the vagina. This allows for fungal growth and yeast infections. If this is a recurrent problem then it is recommended that an antifungal medication (Diflucan) is administered before the antibiotic is given. This will reduce the incidence of this problem.

Last point I will address before I open the floor to comments and questions, is the use of probiotics and yogurt. I even heard of someone producing a yogurt tampon for yeast infection treatment. STOP……Save your time and money until there are actual studies that support the success rates of these theoretical treatments. As of today, they are still speculative at best.

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