Common Gynaecological Problems

Learn what some of the symptoms of common vaginal infections are

One of the most common complaints
seen daily in any gynaecologists clinic
is the complaint of having abnormal
vaginal discharge. The abnormalities
could be the color, consistency or timing
of the discharge with respect to a
womans menstrual cycle, and whether
there are associated symptoms of itch,
pain on passing urine or abdominal
pains.
Normal Vaginal Discharge
The amount, color and thickness of the
vaginal discharge change during each
monthly cycle. The discharge is clear
and watery during ovulation and becomes thicker and an opaque white after ovulation has occurred, until
the next menses comes along and then the vaginal discharge becomes minimal again.
What changes may be a sign of a problem?
Changes that may signal a problem include an increase in the amount of discharge, a change in the color or
smell of the discharge, and irritation, itchiness or burning in or around the vagina. A discharge that is stained
with blood when not having a period could also be a sign of a problem. If you have any of these signs, you
should seek a doctors opinion.
These changes can occur if the normal balance of healthy bacteria (germs) in the vagina is upset. Many
things can disturb the balance of a healthy vagina, including douching, certain soaps or bubble baths,
antibiotics, diabetes, pregnancy or infections.
The chemicals in douches may irritate your vagina and change the normal balance of germs in your vagina.
Douching can also spread an infection into the uterus, increasing the risk of getting pelvic inflammatory
disease (PID). PID is an infection of the fallopian tubes that can cause infertility.


What is a yeast infection?
Small amounts of yeast fungus are often found in a healthy vagina. But if too much grows, it can cause a
yeast infection. They often present as white cottage cheese like discharge and is associated with intense
itching, leading to swelling and pain around the vulva region. Needless to say, a huge amount of burning
pains are experienced during intercourse.
Yeast infections usually are not caught from a sex partner. One is more likely to get a yeast infection
following antibiotic treatment for other ailments. It can also happen during pregnancy, due to diabetes, or
when one stays hot and sweaty for long periods.
Yeast infections are usually treated with a medicine inserted into the vagina. The infections can also be
treated with oral medicine. Removing sugar and excessive breads during an infection al so helps reduce the
risk of recurrence.
What is bacterial vaginosis?
Bacterial vaginosis is usually caused by the Gardnerella vaginalis bacteria. Why some women are
susceptible to this infection is unclear. The infection is probably not caught from a sex partner. It presents as
a white grey or yellowish vaginal discharge and produces a fishy odour which is strongest after sex. It is also
associated with burning or itchiness and possible swelling in the vulvovaginal area. Bacterial vaginosis is
treated with oral antibiotics or pessaries.
What is trichomoniasis?
Trichomoniasis is caused by an organism called Trichomonas vaginalis. One can be infected but have no
signs of the infection for a long time. It presents with a watery yellowish greenish bubbly dischar ge
associated with pain and itching. Trichomoniasis is treated with oral antibiotics and ones partner should be
given the same treatment as well.
Other Infections
Two sexually transmitted infections, chlamydia and gonorrhoea, can also cause vaginal discharge. These
are infections of the cervix caused by bacteria. Sometimes the only symptom may be an increase of vaginal
discharge. Both of these infections can be treated with antibiotic shots or pills.
Hence, vaginal discharge should not be disregarded as a figment of a womans mind but treated with
respect, in order to help her find the solution to her problem.



Other Causes of Vaginal Discharge are:
Endocervical or Endometrial Polyps and certain ovarian cysts, as they tend to exude more sticky mucoid to
watery discharges. Submucosal fibroids can also lead to excessive vaginal discharge and abnormal
bleeding. Hormonal disruptions are also common culprits!
Treatment
Treatments should include advice on diets i.e. increase pro- biotic intake as the correct balance of the
good bacteria lacto- bacillus within the vagina is a key preventive measure against undesirable infections.
The use of boric acid pessaries (available from compounding pharmacies) will also enhance the pH of the
vagina and reduce the risk of vulvovaginal candidiasis. Thereafter specific treatment should be rendered to
get rid of the offending organism and often the partner should be treated as well to prevent a recurrence.
Dr. Ann Tan, PBM
MBBS (Spore), MRCOG (London), MMED (O&G), FAM (Spore), FRCOG
Women & Fetal Centre
Address: 290 Orchard Road, #20-01, Paragon Singapore 238859
Tel: (65) 6887 1106
Fax: (65) 6887 1102
Email: mail@dranntan.com
Centre Timings:
Mon - Wed: 9 am - 6 pm
Thurs: 9 am - 1 pm
Fri: 9 am - 6 pm
Sat: 9 am - 1 pm
Website: www.anntan.com.sg