DEAR DOCTOR, I am in my mid-twenties but my vaginal discharge is very heavy especially during ovulation. The colour of the discharge is normal (white) and it is without bad odour, however it still worries me. Is this normal? Jane DEAR Jane, When did you start having heavy vaginal discharge? Is it associated with lower abdominal pain, itching over vagina, backache and any other symptoms? Normally, a woman has some discharge around ovulation time, that is, anytime from 14th to 21st day since the first day of bleeding. This physiological discharge is white thick, may be scanty or copious and is usually odourless. It subsides by itself, after ovulation and may recur with each cycle. However vaginal discharge is also commonly due to infections. Poor menstrual hygiene results in persistent dampness, which becomes a favourable ground for microbes of all kinds to multiply. This results in infection, manifesting as foul smelling, thick or yellow and dirty looking vaginal discharge. There may be associated backache, pain over lower abdomen, with or without fever. Fungal infections cause itching as one of the manifestations. Unprotected sexual intercourse with an infected partner, is yet another source of infection. Individuals with reduced immunity, like those with diabetes or HIV/AIDS are more vulnerable to acquire infection and in a more severe form. Whether the discharge is physiological, that is normal or due to infection, it can easily be detected by microscopic examination of the discharge. Moreover, a physiological discharge will occur in a consistent pattern, that is, with each menstrual cycle. The type of infecting microbes are easily detected by the microscope. Treatment is by suitable antimicrobial drugs. However treatment given once is for the infection at that point of time. It does not provide protection against future infection. If risk factors persist, infection relapses. Therefore it is important to pay attention to the risk factors as preventive measure. From a young age, a girl should be taught the importance of good menstrual hygiene. It involves keeping the vagina and perineal region clean and dry. The menstrual pads should be changed frequently so that dampness does not occur. As far as possible, nylon under pants should be avoided and replaced by cotton ones. Because nylon under garments aggravate dampness. If sexually active, one should give due attention to sexual hygiene also. Avoid intercourse with an infected partner, that is, anyone with genital discharge, sores, itching and or discharge. After intercourse, it is good to wash the vagina and pass urine. This helps clean any germs present on the surface or those which may have entered the bladder. Having a good balanced diet, regular physical exercise and adequate physical and mental rests, helps keep the body’s immunity high and prevents any infections. Even if infection occurs, it does not become severe. Dr Rachna Pande is a specialist in internal medicine Dr Rachna Pande is a specialist in internal medicine
