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Leucorrhea is defined as an excessive normal vaginal discharge that is nonpurulent, nonoffensive, and nonirritant, typically resulting from cervical and endometrial secretions. Physiological factors such as high estrogen levels during puberty, menstrual cycles, oral contraceptive use, sexual arousal, and pregnancy can lead to increased discharge. Diagnosis involves assessing the discharge's characteristics and conducting examinations, while management focuses on reassurance and hygiene, with treatment only necessary for identified infections.

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4 views14 pages

Untitled Design

Leucorrhea is defined as an excessive normal vaginal discharge that is nonpurulent, nonoffensive, and nonirritant, typically resulting from cervical and endometrial secretions. Physiological factors such as high estrogen levels during puberty, menstrual cycles, oral contraceptive use, sexual arousal, and pregnancy can lead to increased discharge. Diagnosis involves assessing the discharge's characteristics and conducting examinations, while management focuses on reassurance and hygiene, with treatment only necessary for identified infections.

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maink
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LEUCORRHEA

Definition
“An excessive normal vaginal discharge not associated with pelvic disease.”

The term leucorrhea should fulfil the following criteria:

It is nonpurulent
It is nonoffensive.
It is nonirritant and never causes pruritus.
Normal vaginal discharge is produced by:
Cervical glands
Endometrial glands
Vaginal transudate
Desquamated epithelial cells
Bartholin gland secretions
It helps in:
Lubrication of vagina
Maintaining vaginal pH
Preventing infection
Physiology

The physiologic basis involved in normal vaginal secretion is dependent on


the endogenous estrogen level. With the rising estrogen level, there is
abundant secretory activity of the endocervical glands and the superficial
vaginal epithelium becomes rich in glycogen.

The mucoid secretion from the cervical glands is normally small in amount.
The carbohydrate radical of the glycoprotein mucin is split off and fermented
into lactic acid. If however, the mucus is secreted in excess, it pours out at the
vulva.
Characteristics of Physiological White Discharge
Color: Clear or milky white
Consistency: Thin to slightly mucoid
Odor: Odorless
Quantity: Small to moderate
Non-irritant
No itching or burning
No dyspareunia
No lower abdominal pain
No fever
Physiologic excess

The normal secretion is expected to increase in conditions when the estrogen


levels become high. Such conditions are:

During puberty
Increased levels of endogenous estrogen lead to marked overgrowth of the
endocervical epithelium which may encroach onto the ectocervix producing
congenital ectopy (erosion) → increased secretion.
During menstrual cycle

Around ovulation — Peak rise of estrogen → increase in secretory activity of the


cervical glands.
Premenstrual pelvic congestion and increased mucus secretion from the
hypertrophied endometrial glands.
Oral Contraceptive Use
Combined oral contraceptive pills contain estrogen and progesterone.
Estrogen component causes:
Increased cervical mucus secretion
Increased vaginal epithelial activity
Sexual Arousal
Sexual stimulation produces:
Pelvic vasocongestion
Increased vaginal transudation
Pregnancy
There is hyperestrinism with increased vascularity. This leads to increased
vaginaltransudate and cervical gland secretion.
Differences B/w Physiological and Pathological Discharge
Diagnosis
1. History
Nature, color, quantity, odor of discharge
Duration
Itching
Dysuria
Dyspareunia
Pelvic pain
Menstrual and sexual history
Contraceptive use
Previous episodes
2. General Examination
Anemia
Poor nutrition

3. Local Examination
Healthy vulva and vagina
No erythema
No excoriation
No cervical lesion
Clear/white non-offensive discharge
Management
Reassurance
Explain that it is a normal physiological condition
General advice
Maintain genital hygiene
Pill users may have to stop ‘pill’ temporarily, if the symptom is very
troublesome
Avoid excessive vaginal douching
Maintain nutrition and hydration
Treatment
No drug treatment required
Treat only if pathological infection is identified
THANK YOU

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