Leucorrhea is abnormally excessive vaginal discharge that is:
- Non-purulent (not containing pus)
- Non-irritant (does not cause itching or burning sensation)
- Not associated with pain or inflammation
It is a common gynecological condition and can be physiological or pathological.
Types of Leucorrhea
1. Physiological Leucorrhea
Occurs due to hormonal changes and is considered normal in:
- Puberty (due to estrogen stimulation)
- Ovulatory Phase of Menstrual Cycle
- Pregnancy (due to increased estrogen levels)
- Sexual Excitement (due to cervical gland activity)
2. Pathological Leucorrhea
Occurs due to infections or anatomical abnormalities, including:
· Cervical Causes:
- Cervical erosion
- Chronic cervicitis
- Mucus polyp
- Cervical ectropion
· Vaginal Causes:
- Excessive vaginal discharge
- Foul-smelling, non-irritant discharge
Causes of Leucorrhea
- Endogenous Estrogen Overproduction – Stimulates excessive discharge.
- Hyperactivity of Endocervical Glands – Leads to increased mucus secretion.
- Glycogen Metabolism by Lactobacillus – Maintains vaginal pH in acidic range, but imbalances may cause leucorrhea.
Investigations
1. General Examination
- Pelvic examination
- Speculum examination to assess vaginal and cervical pathology
2. Laboratory Tests
- Gram Staining & Culture Sensitivity Test – To identify infection
- Routine Blood Examination – To rule out systemic causes
Treatment & Management
1. General Measures
- Maintain Genital Hygiene
- Use Cotton Undergarments
- Avoid Perfumed Soaps & Douches
- Manage Anxiety & Stress
2. Medical Management
- Antibiotics (If Bacterial Infection Present)
- Antifungal Therapy (For Candidiasis)
- Hormonal Therapy (If Due to Estrogen Imbalance)
Keynote Symptoms of Leucorrhea
- Profuse, thick, or thin vaginal discharge, which may be white, yellow, or greenish
- Accompanied by itching, burning, or irritation in the genital area
- Weakness, backache, and dragging pain in the lower abdomen
- Foul-smelling or acrid discharge causing soreness
- Worsened by exertion, during pregnancy, or before/after menstruation
1. Sepia
Indications:
- Yellowish-green, offensive vaginal discharge
- Associated with backache and weakness
Keynote Symptoms:
- Bearing-down sensation in the uterus.
- Irritability and indifference to loved ones.
- Vaginal dryness with aversion to intercourse.
- Worse from cold air, better with exercise.
- Dark pigmentation on the face (chloasma).
2. Pulsatilla
Indications:
- Thick, milky-white leucorrhea, worse before periods
- Associated with mood swings and weepiness
Keynote Symptoms:
- Mild, gentle nature, seeking consolation.
- Symptoms constantly changing.
- Worse in warm rooms, better in open air.
- Vaginal discharge worsens after menses.
- Craving for fresh foods and dislike for fatty meals.
3. Calcarea Carbonica
Indications:
- Thick, milky or yellow leucorrhea with profuse sweating
- Associated with extreme tiredness and cold sensitivity
Keynote Symptoms:
- Cold, clammy feet with excessive perspiration.
- Weakness and exhaustion with slightest exertion.
- Fear of failure, anxiety, and forgetfulness.
- Strong craving for eggs and indigestible substances.
- Worse from dampness and cold weather.
4. Kreosotum
Indications:
- Profuse, acrid, and highly offensive leucorrhea causing itching
- Associated with burning and soreness in the vagina
Keynote Symptoms:
- Leucorrhea worsens between periods.
- Corrosive discharge causing rawness of the thighs.
- Painful intercourse due to vaginal irritation.
- Worse at night and after sexual activity.
- Sensation of something warm flowing down the vagina.
5. Borax
Indications:
- Clear, egg-white leucorrhea with a sensation of warm water passing
- Associated with vaginal tenderness and sensitivity
Keynote Symptoms:
- Sharp shooting pains in the vagina.
- Vaginal walls feel dry and sensitive.
- Fear of downward motion (e.g., fear when going downstairs).
- Leucorrhea worsens during pregnancy.
- Symptoms aggravated by sudden noises.
