What Is Leukorrhea?

Leucorrhea is a female vaginal discharge, which is a mixture of vaginal mucosal exudate, cervical canal and endometrial gland secretion, and its formation is related to estrogen action. Under normal circumstances, the quality and quantity of leucorrhea changes with the menstrual cycle. After the menstruation is clean, the leucorrhea is small, white, and pasty. When the ovary is about to ovulate in the middle of menstruation, due to the strong secretion of the cervical glands, the leucorrhea is increased, transparent, slightly sticky, and egg white-like. After 2 to 3 days of ovulation, the leucorrhea becomes cloudy, sticky and small. Before and after menstruation, due to pelvic congestion, vaginal mucosal exudate increased, leucorrhea often increased.

Basic Information

Chinese name

Leucorrhea

Foreign name

Leukorrhea

Leucorrhea classification

Physiological leucorrhea

Normal leucorrhea is white paste or egg white-like, sticky, no fishy odor, small amount, called physiological leucorrhea. Due to the pelvic floor muscles, the female vaginal opening is closed, and the front and back walls are tight. The moisture in the leucorrhea makes the woman's vagina in a humid state. This humid environment can reduce the friction between the front and back of the vagina and protect the vaginal wall from damage. At the same time, this moist state makes women's vagina smooth and elastic, which is conducive to improving the quality of sexual life.

2. Pathological leucorrhea

When genital tract inflammation such as vaginitis, acute cervicitis, or canceration occurs, the amount of leucorrhea significantly increases and the characteristics change, which is called pathological leucorrhea.

Leucorrhea abnormal performance

1. Cheese-like leucorrhea or tofu-like leucorrhea: fungal vaginitis, often accompanied by severe vulvar itching or burning pain.

2. Thin purulent, yellow-green, foamy, stinky leucorrhea, characteristic of trichomonas vaginitis, with itching of the vulva.

3. Off-white, thin, fishy smelly leucorrhea, characteristic of bacterial vaginosis, with mild itching of the vulva.

4. Purulent leucorrhea: yellow or yellow-green, thick, odorous, caused by bacterial infection. Can be found in Neisseria gonorrhoeae vaginitis, acute cervicitis and cervicitis, vaginal cancer or cervical cancer complicated by infection. Purulent uterine cavity or foreign body residues in the vagina can also cause purulent leucorrhea.

6. Watery leucorrhea: thin as watery or rice-shaped, smelly vaginal drainage, found in advanced cervical cancer, vaginal cancer or submucosal fibroids with infection. The intermittent discharge of clear, yellow-red or red watery leucorrhea should consider the possibility of fallopian tube cancer.

7. Bloody leucorrhea: The leucorrhea is mixed with blood, and the blood volume varies. Cervical cancer, endometrial cancer, cervical polyps, cervical columnar epithelial ectopic infection or submucosal fibroids should be considered. Placing an IUD can also cause bloody vaginal discharge.

Leucorrhea routine inspection

PH value

pH check is an important check item for leucorrhea abnormalities. The pH of the normal vagina is between 3.8 and 4.4, and it is weakly acidic, which can prevent pathogenic bacteria from multiplying in the vagina. The vaginal pH of patients with trichomoniasis vaginitis is 5.0 to 6.5. Patients with bacterial vaginitis have a vaginal pH> 4.5.

2. Leucorrhea cleanliness

The vaginal secretion smear is observed under a microscope, and the cleanliness of the vagina is determined by the number of vaginal bacilli, white blood cells (WBC) and miscellaneous bacteria.

degree: there are a large number of vaginal bacteria and epithelial cells, no bacteria, white blood cells, clean vision, indicating normal secretions.

degree: the amount of vaginal bacilli and epithelial cells, a small amount of white blood cells and miscellaneous bacteria, still belong to normal vaginal secretions.

degree: a little vaginal bacillus and squamous epithelium, more bacteria and leukocytes, suggesting milder vaginal inflammation.

degree: no vaginal bacilli, only a few epithelial cells, a large number of white blood cells and miscellaneous bacteria. Prompt relatively severe vaginal inflammation, such as fungal vaginitis, trichomonas vaginitis.

Degrees I to II are normal, and degrees III to IV are abnormal leucorrhea, indicating vaginal inflammation.

3. Examination of pathogenic microorganisms

After the leucorrhea is treated, the presence or absence of trichomoniasis or mold can be found under the microscope according to its morphology. If there is trichomoniasis or mold, it is indicated by "+" regardless of its quantity, or "-" if there is no.

4. Amine test

Leucorrhea with bacterial vaginosis can emit a fishy odor, which is caused by the release of ammonia by amines and alkalis.

5. clue cells

Clue cells are specific signs of bacterial vaginosis, and a diagnosis of bacterial vaginosis can be made based on positive amine tests and clue cells.

Leucorrhea treatment principles

Leucorrhea patients are treated for different causes.

1. Trichomonas vaginitis: oral metronidazole treatment (drinking is prohibited during medication and within 72 hours of discontinuation). Local simultaneous treatment. Tongzhi of sexual partners.

2. Mycotic vaginitis: Broad-spectrum antibiotics, estrogen and corticosteroids should be stopped in time. Placing a nystatin suppository / clotrimazole suppository / daconin suppository equals the vagina.

3 bacterial vaginosis or non-specific vaginitis: mostly anaerobic infections, metronidazole topical or oral treatment.

4. Senile vaginitis: supplement estrogen to increase vaginal resistance and antibiotics to inhibit bacterial growth.

5. Cervical polyps and submucosal fibroids: surgical removal.

6. Malignant tumor: for tumor treatment.