Family Doctor Health Advisor
Breast problems | Bladder control problems in women | Absent periods | Heavy periods | Painful periods | Irregular vaginal bleeding | Abnormal vaginal discharge | Genital irritation | Lower abdominal pain in women | Painful intercourse in women | Low sex drive in women | Fertility problems in women | Contraception choices for women | Nausea and vomiting in pregnancy | Weight problems and pregnancy | Vaginal bleeding in pregnancy | Abdominal pain in pregnancy | Skin changes in pregnancy | Swollen ankles in pregnancy | Back pain in pregnancy | Recognizing the onset of labour | Breast problems and pregnancy | Depression after childbirth
Abnormal vaginal discharge
Consult this chart if you notice an increase in your vaginal discharge or a change in its colour, consistency, or smell. Secretions from the walls of the vagina and the cervix keep the vagina moist and clean. The secretions usually produce a thin yellowish-white discharge that varies in quantity and consistency during the menstrual cycle. The volume of secretions increases at times of sexual arousal and during pregnancy. This is completely normal and is no cause for concern. However, a sudden increase in the amount of vaginal discharge for no obvious reason or vaginal discharge that looks abnormal or smells unpleasant may be a sign of an infection. If the abnormal discharge is accompanied by abdominal pain and/or fever, the infection may involve the reproductive organs and needs urgent treatment.
Self-Help Preventing vaginal thrush
The fungus that causes thrush is one that is normally present in the vagina. Thrush is an excess of this fungus, resulting in symptoms such as vaginal discharge. The condition may occur when the normal chemical or bacterial balance of the vagina is changed. Thrush may be related to the menstrual cycle or the use of spermicides. It is also common after taking antibiotics to treat another condition and in women who have diabetes. If you often develop thrush, the following self-help measures may help to prevent recurrent episodes of the condition:
- Do not use perfumed soaps, bubble bath, or vaginal deodorants or douches.
- Avoid using spermicides. You may need to change your method of contraception.
- Ideally, use sanitary towels instead of tampons. If you do use tampons, change them frequently.
- Wear loose-fitting underwear made of natural fibres.
If, despite taking these measures, thrush still recurs frequently, consult your doctor so that an underlying problem can be ruled out.
Sexually transmitted infections in women
Infections passed from one person to another during sexual intercourse (vaginal, anal, or oral) are known as sexually transmitted infections (STIs). Although these infections affect both men and women, the symptoms are often different (see Sexually transmitted infections in men). The symptoms may also affect different areas of the body depending on which type of sexual contact you have had. Even when there are few symptoms, infection can spread from the vagina to all of the reproductive organs and may cause permanent damage if left untreated. An STI contracted during pregnancy may affect the fetus before birth, or the baby may acquire the infection during delivery. If you think you or your partner has an STI, you should consult your doctor or go to a sexually transmitted infections clinic, where you will be treated in confidence. You should avoid sex until your doctor confirms that the infection has cleared up. The risk of contracting an STI can be reduced by practising safe sex.
|
Infection |
Incubation period * |
Symptoms in women |
Diagnosis and treatment |
| Chlamydial infection | 14-21 days | Often causes few or no symptoms. There may be an abnormal vaginal discharge or pain on passing urine. If the infection affects the fallopian tubes, there may be fever, abdominal pain, or pain on intercourse. | The doctor will take a swab from the cervix or test the urine to identify the infectious organism. Treatment is usually with antibiotics. |
| Genital herpes | 4-7 days | There is usually soreness or itching in the genital area or on the thighs, followed by the appearance of a crop of small, painful blisters. The blisters burst to produce shallow ulcers, which are painful when urinating. The ulcers heal after 10-21 days. The condition may recur. | The diagnosis is usually made according to the appearance of the skin. Oral antiviral drugs taken early shorten episodes but do not eradicate the virus. Genital herpes is most infectious while the ulcers are present, but in some cases can remain infectious after the ulcers heal. |
| Genital warts | 1-20 months | Pink, fleshy lumps on the vulva, and in some cases, inside the vagina, on the cervix, and around the anus. Warts may go unnoticed if they occur internally. | Warts may be removed by surgery or by applying drugs to them. In some cases, they recur after treatment. Regular cervical smear tests are needed because some types of genital wart may be associated with cervical cancer. |
| Gonorrhoea | 7-21 days | May be symptomless in women. It may cause abnormal vaginal discharge, lower abdominal pain, and fever. If there is rectal infection, there may be pain when passing faeces. | The doctor will take a swab from the vagina or the rectum to identify the infectious organism. Treatment is with antibiotics. |
| HIV infection | 6-8 weeks | May be no initial symptoms, but some people may have a brief flu-like illness, sometimes with a rash and swollen lymph nodes. After years without symptoms, AIDS may develop (see HIV infection and AIDS). HIV can be passed on whether or not you have symptoms. | Diagnosis is made by a blood test taken 3 or more months after the initial infection. People with HIV infection are usually referred to specialists for treatment. Combinations of antiviral drugs are often effective in delaying the progression of HIV to AIDS. |
| Pubic lice | 0-17 days | Usually there is intense itching in the pubic region, particularly at night. The lice are 1-2 mm long and may be visible. | Treatment is with a lotion that kills the lice and their eggs. Such lotions can be bought over the counter. |
| Syphilis | 1-12 weeks | In the first stage, a highly infectious, painless sore called a chancre develops in the genital area or inside the vagina. In some cases, the sores go unnoticed. If the condition is left untreated, it can progress to involve internal organs, causing a rash, fever, and swollen lymph nodes. | The disease is diagnosed by blood tests and tests on swabs taken from any sores. The usual treatment is a course of antibiotic injections. You will need to have regular blood tests for 2 years after the treatment to check that the disease has not recurred. |
| Trichomonal infection | Variable | An unpleasant-smelling, greenish-yellow vaginal discharge, associated with irritation and soreness around the vagina. Pain on intercourse. | The diagnosis is confirmed by examination of a sample of discharge taken from the vagina. The usual treatment is with oral antibiotics. |
*Time between contact with the disease and the appearance of symptoms
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009
Authorised By: RACGP
