Gynecology :: Leucorrhoea
Gynecology :: Leucorrhoea Leucorrhoea or vaginal discharge is the most common and annoying problems of females. It is not a disease in itself but a symptom of some underlying disease.
The origin of the discharge may be from uterus, cervix, vagina or vulva.
Vulval discharge is often found in small girls and in aged females, is seropurulent, viscid and offensive.
Vaginal discharge originates in vagina itself and is oestrogen dependent is of creamy white, purulent, bland or excoriating. Local congestive states of pelvic organs such as pregnancy, chronic pelvic inflammatory disease, even chronic constipation with sedantry habits cause increased vaginal discharge.
The cervical discharges are thick, mucus from endocervical glands as in chronic cervicitis, erosion or mucus polyp. An excessive mucoid discharge at external os is of cervical origin.
Physiological causes-Some vaginal discharge at puberty, during pregnancy, at the time of ovulation and during premenstrual phase is quite normal due to increased vascularity of the genital tract and requires no treatment.
In small girls and aged women, the vaginal epithelium is thin and ill protected against infections, glycogen content is low and vaginal pH is higher, exceeding 7.4.
History of the patient – Direct questions should be asked about colour, quantity, duration, acridity or blandness, offensiveness to determine the cause and origin of the discharge. Following points may help in arriving at correct diagnosis and follow up.
White vaginal discharge- nonirritating and nonoffensive is due to cervical erosion.
Yellow discharge is due to uterine and vaginal infections.
Purulent discharge is due to septic abortion, pyometra or puerperal sepsis.
Offensive discharge is because of necrotic lesion in the genital tract, septic myomata, septic IUCD, forgotten tampons.
Blood stained discharge is caused by ca cervix and uterus, ulcerated lesion of the genital tract due to retained products of conception or placental polyp.
Watery discharge may be due to urinary fistula or hydrosalpinx.
In ca fallopian tubes, an amber coloured discharge is present.
Fecal discharge is caused by rectovaginal fistula.
Some common associated symptoms of leucorrhoea may be backache, headache, general debility and loss of strength.
Includes general management of the patient and homoeopathic drugs.
1.Usually we see in our clinics, that a lady suffering with chronic leuc.is of weak constitution. Therefore the first advise is regarding diet containing proteins as green vegetables, eggs, milk and milk products.
2. Daily routine of some sort of exercise such as a simple walk in fresh air for 20 mints to half an hour is sufficient.
3. Sleeping in well ventilated room with windows open.
4. Proper hygiene of the genital parts, washing the area after every urination, drying of the underclothes in sunlight should be advised.
5. Constipation should be taken care of by advising intake of plenty of water and food containing roughage.
6. Reassurance to the mother in case of a small girl or to the patient, if adult, really helps to overcome the annoyance associated with the disease.
Proper case taking, as in any other case is the most essential aspect to begin the treatment of leucorrhoea. A constitutional and miasmatic medicine, most of the time is the only one sufficient to bring about the cure,however acute medicine covering the totality of the the symptoms of leucorrhoeal discharge is also required.
Some miasmatic considerations of leucorrhoea-
The psoric one is bland, albuminous, white and nonoffensive.
The sycotic is watery, or greenish yellow, acrid producing pruritis,with fishy, pungent odour.
The syphilitic would be thick, acrid,greenish, causing little vesicles or excoriation on pudendum.
I have found following remedies mostly indicated in clinical practice-
SEPIA- It covers psorosycotic type of leucorrhoea. The discharge is of milky white or thick curd like, yellow offensive, with dragging pain in the lower abdomen. Leuc. is better after exercise which relieves the congestion. Associated symptoms may be malpositions or displacements of uterus, chloasma on face, ball like sensation in inner parts, constipation, tiredness in the morning on waking, aversion to sex, irritability, indifference to children and husband and to household work. Sepia is a deep constitutional medicine with a large group of symptoms.
BORAX – White albuminous discharge with sensation as if warm water is flowing over the parts midway between the periods which is bland and painless. A peculiar hot feeling of the discharge is very helpful symptom. The concomitants may be aphthae in the mouth during menses, easily startled, cold washing, with backache and trembling of limbs, hard dry stool.
CONIUM- White acrid burning or dirty brown offensive leucorrhoea, paralysed sensation in small of back, after menses in old maids, with uterine fibroids and cancerous growths, vertigo, turning in bed, breast painful before menses.
CALCAREA PHOS. Leuc. like white of an egg, offensive, burning,
Dr. Poonam Batra
Near LML showroom, Marris Road,
Aligarh. 202 001
by Dr. Poonam Batra