What are the signs of abnormal vaginal discharge?

Some signs that may indicate an abnormal vaginal discharge and infection include:

*Changes in color, consistency, or amount
*Constant, increased vaginal discharge
*Presence of itching, discomfort, or any rash
*Vaginal burning during urination
*The presence of blood when it’s not your period time
*Cottage cheese-like vaginal discharge
*A foul odor accompanied by yellowish, greenish, or grayish white vaginal discharge

If you have a vaginal discharge along with any of these signs, consult your health care provider for diagnosis and treatment. Vaginal discharges are common and you it’s likely you’ll have at least one vaginal infection in your life. The most common vaginal infection is bacterial vaginosis. Vaginal yeast infections are also very common and over-the-counter treatments are available; however, it’s important to never self-diagnose a vaginal yeast infection unless you have previously been diagnosed by your health care provider. Another common vaginal infection is called trichomoniasis.

let's talk about vaginal discharge...

Do you know the difference between normal vaginal discharge and abnormal vaginal discharge? Did you know that having a vaginal discharge is normal? Let’s take a look at various types of vaginal discharges so that you’ll know when you have an abnormal vaginal discharge.

The Natural Vagina

The basic function of you vagina is to provide a route from the outside of your vagina to your uterus and the rest of your internal reproductive system. The natural, acidic, pH of your vagina acts to prevent infections. The acidic nature of your vagina is caused by natural, good, bacteria produced by your body. When your vagina is healthy, the vagina keeps itself clean and in a healthy state by producing secretions of normal vaginal discharge. The natural balance of the vagina can be disrupted by anything that interferes with its’ normal environment.

What is Normal Vaginal Discharge?

First it’s important to understand that all women experience some amount of vaginal discharge. Glands in your vaginal and cervix produce small amounts of fluid that flows out of your vagina everyday taking with it old cells that line the vagina. Your normal vaginal discharge helps to clean the vagina, as well as keep it lubricated and free from infection and other germs. A normal vaginal discharge does not have a foul odor and usually has no odor at all. Normal vaginal discharge often appears clear or milky when it dries on your clothing; occasionally you may notice white spots or a normal vaginal discharge that is thin and stringy looking.

Other things that may cause changes in the appearance or consistency of your vaginal discharge include:
-Your menstrual cycle
-Emotional stress
-Pregnancy
-Any prescribed or OTC medications you take including hormones such as in the Pill
-Sexual excitement
-Breastfeeding
-Ovulation
-Your diet

Other things that can upset the natural pH balance of your vagina and lead to vaginal infections include vaginal douches, feminine hygiene products, perfumed or deodorant soaps, antibiotics, pregnancy, diabetes, or the presence of another infection.

How does your period affect your vaginal discharge?

Your menstrual cycle has a significant affect on the type of vaginal discharge you experience throughout the month. Did you know you’re more likely to experience vaginal infections just before or during your period? This is because the pH balance of your vagina varies during your monthly cycle causing the acidic level of your vagina to be at its’ lowest point a few days before and during your period. About halfway between your periods an increase in vaginal discharge that appears clear is normal. This increased wetness and clear vaginal discharge is an indication of ovulation.

menorrhagia

At some time in your reproductive life, you've probably experienced heavy bleeding during your menstrual period. If you're like some women, every period you have causes enough blood loss and cramping that you can't maintain your usual daily activities. The medical term for periods like these — excessive or prolonged or both — is menorrhagia.

Although heavy menstrual bleeding is a common concern among premenopausal women, few women experience blood loss severe enough to be defined as menorrhagia. If you have menstrual bleeding so heavy that you dread your period, talk with your doctor. There are many effective treatments for menorrhagia.

Normal menstrual flow:

• Occurs every 21 to 35 days
• Lasts four to five days
• Produces a total blood loss of about 2 to 3 tablespoons (30 to 44 milliliters)

The menstrual cycle isn't the same for every woman. Your period may be regular or irregular, light or heavy, painful or pain-free, long or short and still be considered normal. Menorrhagia refers to losing about 5 1/2 tablespoons (81 milliliters) or more of blood during your menstrual cycle.

The signs and symptoms of menorrhagia may include:

• Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
• The need to use double sanitary protection to control your menstrual flow
• The need to change sanitary protection during the night
• Menstrual periods lasting longer than seven days
• Menstrual flow that includes large blood clots
• Heavy menstrual flow that interferes with your regular lifestyle
• Tiredness, fatigue or shortness of breath (symptoms of anemia)

When to see a doctor
Doctors generally recommend that all sexually active women and women over the age of 21 have yearly pelvic exams and regular Pap tests. However, if you experience heavy or irregular vaginal bleeding, schedule an appointment with your doctor and be certain to record when the bleeding occurs during the month. If you're having heavy vaginal bleeding — soaking at least one pad or tampon an hour for more than a few hours — seek medical help. Call your doctor if you have any vaginal bleeding after menopause.

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

• Hormonal imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.
• Dysfunction of the ovaries. Lack of ovulation (anovulation) may cause hormonal imbalance and result in menorrhagia.
• Uterine fibroids. These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.
• Polyps. Small, benign growths on the lining of the uterine wall (uterine polyps) may cause heavy or prolonged menstrual bleeding. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.
• Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Adenomyosis is most likely to develop if you're a middle-aged woman who has had many children.
• Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you may need to remove it.
• Pregnancy complications. A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy — implantation of a fertilized egg within the fallopian tube instead of the uterus — also may cause menorrhagia.
• Cancer. Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.
• Inherited bleeding disorders. Some blood coagulation disorders — such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding.
• Medications. Certain drugs, including anti-inflammatory medications and anticoagulants (to prevent blood clots), can contribute to heavy or prolonged menstrual bleeding. Improper use of hormone medications also can cause menorrhagia.
• Other medical conditions. A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia.

Menorrhagia is most often due to a hormonal imbalance that causes menstrual cycles without ovulation. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.

Menstrual cycles without ovulation (anovulatory cycles) are most common among two age groups:

• Adolescent girls who have recently started menstruating. Girls are especially prone to anovulatory cycles in the first year and a half after they have their first menstrual period (menarche).
• Older women approaching menopause. Women ages 40 to 50 are at increased risk of hormonal changes that lead to anovulatory cycles.

Excessive or prolonged menstrual bleeding can lead to other medical conditions, including:

• Iron deficiency anemia. In this common type of anemia, your blood is low on hemoglobin, a substance that enables red blood cells to carry oxygen to tissues. Low hemoglobin may be the result of insufficient iron. Menorrhagia may deplete iron levels enough to increase the risk of iron deficiency anemia. Signs and symptoms include pallor, weakness and fatigue.

  Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods. Most cases of anemia are mild, but even mild anemia can cause weakness and fatigue. Moderate to severe anemia can also cause shortness of breath, rapid heart rate, lightheadedness and headaches.

• Severe pain. Heavy menstrual bleeding often is accompanied by menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require prescription medication or a surgical procedure.

Your doctor will most likely ask about your medical history and menstrual cycles. You may be asked to keep a diary of bleeding and nonbleeding days, including notes on how heavy your flow was and how much sanitary protection you needed to control it. Your doctor will do a physical exam and may recommend one or more tests or procedures such as:

• Blood tests. A sample of your blood is evaluated in case excessive blood loss during menstruation has made you anemic. Tests may also be done to check for thyroid disorders or blood-clotting abnormalities.
• Pap test. Your doctor collects cells from your cervix for microscopic examination to detect infection, inflammation or changes that may be cancerous or may lead to cancer.
• Endometrial biopsy. Your doctor takes a sample of tissue from the inside of your uterus to be examined under a microscope.
• Ultrasound scan. This imaging method uses sound waves to produce images of your uterus, ovaries and pelvis.

Based on the results of your initial tests, your doctor may recommend further testing, including:

• Sonohysterogram. This ultrasound scan is done after fluid is injected through a tube into the uterus by way of your vagina and cervix. This allows your doctor to look for problems in the lining of your uterus.
• Hysteroscopy. A tiny tube with a light is inserted through your vagina and cervix into the uterus, which allows your doctor to see the inside of your uterus.
• Dilation and curettage (D and C). In this procedure, your doctor opens (dilates) your cervix and then inserts a spoon-shaped instrument (curet) into your uterus to collect tissue from the uterine lining. This tissue is examined in the laboratory.

Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition.

Consider these tips for successful self-care of menorrhagia:

• Get your rest. Your doctor may recommend rest if bleeding is excessive and disruptive to your normal schedule or lifestyle.
• Keep a record. Record the number of pads and tampons you use so that your doctor can determine the amount of bleeding. Change tampons regularly, at least every four to six hours.
• Avoid aspirin. Because aspirin interferes with blood clotting, avoid it. However, other nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), often are very effective in relieving menstrual discomfort.