Leucorrhoea, colloquially called “white discharge”, is a daily occurrence in premenopausal women from the onset of puberty. However, colored, smelly and profuse discharge can be a sign of an infection. Explanations.

Leucorrhoea is a bloody discharge from the vagina. Indeed, bloody losses, for their part, can correspond to periods or metrorrhagia (that is to say anarchic flow of blood that occurs between periods).

We distinguish :

• physiological leucorrhoea which correspond to secretions of cervical mucus (glycoprotein located in the cervix), ancillary glands (Skene’s glands and Bartholin’s glands) and vaginal desquamation. All of this White discharge have nothing pathological. They are daily in premenopausal women. The first white discharge usually appears at the onset of puberty. They are usually milky, whitish or transparent. They are not badly smelling, nor accompanied by other clinical signs (pruritus, pain, fever, etc.);

• pathological leucorrhoea which are linked to the presence of pathogens in the lower (vulva, vagina and outer part of the cervix) or upper (inner part of the uterus or endocervix and urethra) genital tract. But leucorrhoea can also be indicative of cervical cancer (most of the time linked to infection with HPV (human papillomavirus). The pathogens involved in genital infections are parasites (most often trichomonas vaginalis) or certain germs or bacteria (candida albicans, chlamydia trachomatis, Neisseria gonorrhoeae, etc.). The presence of these infectious agents is explained by a imbalance of the vaginal flora or a sexually transmitted infection (STI). Pathological leucorrhoea are usually yellowish to greenish in color, smelly and accompanied by other clinical signs (pain, pruritus, fever, bleeding, etc.). They must push to see a doctor.

Physiological leucorrhoea is secreted daily by premenopausal women from the onset of puberty. They are not pathological. They also do not contain polynuclear white blood cells (immune cells) and do not cause any irritation, pain or odor. They result from:

• vaginal desquamation which causes milky discharge, the quantity of which increases during the premenstrual period;
• secretion of cervical mucus from columnar cells of the endocervix. These mucus secretions increase at 8^st and at 15^st days of the menstrual cycle. These losses are usually translucent and crystallize on contact with air.
• mucus secretion from the Skene glands (diffuse glands located all along the urethra) and Bartholin glands (glands located in the vulva on either side of the opening of the vagina).

Leucorrhoea may be a sign of an infection of the lower genital tract, i.e. the vulva, vagina and / or the outer part of the cervix.

Pathological leucorrhoea: the sign of cervicitis?

Cervicitis is an inflammation of the cervix that may or may not be infectious. It is often linked to Chlamydia trachomatis, Neisseria gonorrhoeae or Mycoplama genitalium. It can be asymptomatic but can also cause leucorrhoea with or without associated metrorrhagia (bleeding). Antibiotic therapy can be given without waiting for test results.

Pathological leucorrhoea: beware of High Genital Infections (IGH)

Leucorrhoea can signal an upper genital infection (IGH). These include:

• endometritis;
• salpingitis (infection of one or both tubes);
• purulent collections (abscesses);
• the pelviperitonitis of genital origin (iinflammation of the pelvic peritoneum).

IGH results from the ascent of germs from the vagina and cervix to the uterine and tubal cavities. Pathogens can be sexually transmitted bacteria (chlamydia trachomatis, mycoplasma genitalium, etc.), opportunistic pathogens from the vaginal flora (streptococcus, staphylococcus, enterococcus, anaerobic, etc.) and more rarely agents responsible for infections. specific primary (tuberculosis, bilharzia).

IGH can be serious and cause sequelae. High-rise buildings can be complicated by a tubo-ovarian abscess (ATO) or pelviperitonitis. These conditions require intervention and hospitalization.

White discharge and cancer

If you feel like you want to take the White discharge therefore represent a normal phenomenon which should not alert you, they can however be annoying especially when they are abundant. Be careful, excessive intimate hygiene in reaction to these secretions can lead to an alteration of the vaginal flora and promote the occurrence of often chronic lower vaginal infections.

Indeed, the vagina is a dynamic ecosystem that has many microorganisms. The dominant flora is called Bacillus of Döderlein. This lactobacillus lines the vaginal mucosa and converts glycogen (contained in vaginal and cervical cells) into lactic acid. This acid explains the acidic pH of the vagina which is a protective factor against bacterial proliferation.

Untimely washing but also rubbing (wearing too tight clothes, prolonged sexual intercourse, etc.) weaken the microbial balance of the vagina. They are the door open to vaginal infections such as yeast infections. It is therefore recommended to avoid them if you do not want to see abundant and bad-smelling secretions arrive.

Opt for washing intimate areas once a day (even if your losses are greater than usual) with a suitable soap that respects the microbial flora. Prefer cotton underwear (especially if it is a thong). If your losses are heavy, you can adopt the panty liner occasionally. Indeed, studies show that the latter increases the risk of mycosis.