Is there something wrong with my vaginal discharge?

Most female patients phrase this question in a sheepish and embarrassed tone. These patients also tend to look as if they’d rather be anywhere else than in our consult room asking about vaginal discharge.

 

 

What is vaginal discharge?

First of all, vaginal discharge is perfectly normal in ladies of childbearing age. It is produced by glands in your cervix & vagina and this mucus carries away dead cells and bacteria, keeping your female reproductive tract healthy!.

 

The amount and consistency of your vaginal discharge can vary depending on the time of your cycle as this is influenced by hormones. The colour may vary from milky white to yellow after exposure to air. During ovulation, vaginal discharge takes on a clear stretchy egg white texture.

 

 

 

When should i see a doctor about my vaginal discharge?

• Has a funny colour or odour,
• Blood streaks when it is not near your period
• Thick & clumpy
• Vaginal itch or burning is present

 

 

 

Some causes of abnormal Vaginal discharge:

 

Vaginal thrush

This is a yeast infection that tends to cause thick clumpy white vaginal discharge & intense itching. It is treated with anti-fungal oral pills or vaginal pessaries.

 

 

Bacterial Vaginosis (or Gardneralla)

This is a common bacterial infection that creates a characteristic fishy odour with thin watery vaginal discharge & discomfort, easily treated with a course of antibiotics.

 

 

Sexually transmitted diseases

Gonorrhoea, Chlamydia, Trichomoniasis – These conditions also cause abnormal vaginal discharge together with other symptoms like vaginal burning, painful intercourse, painful urination & bleeding.

 

 

Cervical or endometrial (womb) cancer

There might be abnormal bleeding noticed after sexual intercourse or foul-smelling vaginal discharge. Most cervical cancers are due to HPV infections ( Human papilloma virus) hence cervical cancer vaccines such as Gardasil 9 are recommended for females before they become sexually active. Regular pap smears aid in early detection of any early cancerous changes & presence of HPV infections in the cervix.

 

 

It is important to have a proper consultation, examination and tests so that you will receive appropriate treatment.

 

 

 

Why do women get abnormal vaginal discharge?

 

Medications

Medications like birth control pills alter the hormonal balance and pH of the vaginal environment. Antibiotics kill both good and bad bacteria sometimes allowing overgrowth of yeast resulting in vaginal thrush.

 

 

Multiple sexual partners & unprotected sex.

Sexually transmitted diseases like chlamydia, gonorrhoea, trichomoniasis are spread via sexual contact with infected partners. Bacterial vaginosis is also more common in women with multiple partners.

 

 

Diabetes

Diabetes causes raised blood glucose levels due to insulin resistance resulting in reduced immunity and increased susceptibility to infections such as yeast.

 

 

Douching, vaginal dryness, natural lack of lactobacilli

Douching, vaginal dryness, natural lack of lactobacilli in your vaginal flora all predispose to vaginal infections such as bacterial vaginosis.

 

 

Vaginal atrophy during menopause

The vaginal walls become thin and dry may cause increased number of vaginal & urinary tract infections.

 

 

Cervical cancer or endometrial cancer

 

 

 

Tips on vaginal health

• Do not douche or use scented soaps or lotions on a regular basis.
• If you require a course of antibiotics & are prone to vaginal yeast infections, do take probiotics as well.
• Maintain proper hygiene, try to wear cotton undies & avoid thick pantiliners especially in our hot humid climate as this can encourage vaginal yeast & bacterial infections.
• Pap Smear should be done yearly for all ladies who are sexually active. A routine STD screen must also be included if you are not in a stable relationship or have multiple sexual partners.

 

 

 

If you are unsure if your vaginal discharge is normal or not please see your doctor early.

 

Our doctors at Mint medical Centre are well equipped to see to your needs. Contact us today!

 

 

Why Did I Get A Urinary Tract Infection (UTI)?

 

This is the question most of our urinary tract infection (UTI) patients in Singapore ask. in this article, i will be explaining what is a UTI, the types of UTI, the symptoms, the probable causes and how to reduce your risk of getting them in the future.

 

 

 

What is a urinary tract infection (UTI)?

 

The urinary system consists of the kidneys, ureters, urinary bladder and the urethra. Urine is formed in the kidneys and is drained down this system (tract). Urinary tract infection is the infection that involves one or more components of this system. The presence of pathogens, such as yeast and bacteria, in the urine suggest the presence of an infection along the urinary tract.

Recurrent UTI is a condition where patients keep contracting the infection two or more times over a 6 months period or three or more times over a 1-year period. This for is more common among young and healthy women.

There are two types of acute uncomplicated UTI, which is based on the location of the infection:

 

 

 

 

There are two types of UTI:

 

Lower UTI (Most common)	Upper UTI
Cystitis (Urinary bladder	Pyelonephritis (Kidney)
Urethritis (Urethra)	Ureteritis (Ureter

 

 

 

Who gets UTI?

 

Unfortunately, UTI’s are more common in women than in men. Almost 50% of women will experience an episode of UTI during their lifetime. Approximately, 1 in every 3 women will have had an episode of infection requiring antibiotics by the age of 24 years old.

UTI is uncommon in males with an incidence of approximately 5 to 8 per 10,000 per year in men aged below 50. The incidence of UTI in male increase only after the age of 50.

The reason for the low incidence in males is due to the urinary tracts more superior innate defense to infections. This means when a male gets a UTI, it is usually a more complicated condition and further investigations are needed. Things to look out for include an enlarged prostate gland blocking the outflow of urine from the bladder, diabetes, partial blockage of the urethra by a stricture and even a sexually transmitted disease.

 

 

 

 

What are the symptoms of UTI?

 

• Dysuria– Burning sensation or pain when passing urine.
• Urinary Urgency– Having the feeling of a full bladder and the need to urgently pass urine.
• Urinary Frequency– The need to pass urine often despite only having small volume of urine.
• Haematuria– Blood in the urine.
• Discomfort in lower abdominal region.
• Pain in the flank and/or lower back.
• Fever, chills, malaise (Seen more in kidney infections).
• Nausea and/or vomiting.

 

 

 

 

What increases you risk of getting UTI?

 

 

Shorter urethra in females

 

One of the main reasons why it is more common in females is because of the shorter urethra when compared to males. Besides that, the opening of the urethra is close to the anus. This allows bacteria from your intestine to enter the urethra and due to the short urethra, it easily travels up to the bladder.

 

 

Age

 

The rate of men and women getting it increases as they get older.

 

 

Genetics

 

Some research studies have linked a family history of UTI to an increased likelihood of having recurrent UTI.

 

 

Sex

 

Sexual intercourse is known to trigger UTI in women and is the cause of up to 80% of cases in women. Research data has shown that the more frequent you have intercourse the higher your risk of getting it. This is where the term ‘honeymoon cystitis’ came about. This is where women develop a bladder infection due to the increased amount of sexual activity on their honeymoon.

Besides that, it is also known that the risk of recurrent UTI is higher when having a new sexual partner.

 

 

Postmenopause

 

There are a lot of changes that happen to the structures in the pelvis after menopause. Due to weakening of the pelvic floor muscle, the bladder and uterus may shift downwards causing a prolapse of those structures. This in turn may cause changes in the flow pathway of urine and cause incomplete urination. Due, to the hold up of urine, bacteria may start growing and cause an infection.

There are also changes in the vagina, which may affect the bacterial lining (flora) around the urethra. This may also potentially lead to an infection.

 

 

Others

 

Other risk factors associated with UTI and/or recurrent UTI are:

a) Pregnancy

b) Use of diaphragm or spermicide

c) Diabetes

d) Presence of indwelling urinary catheter (draining urine from bladder using a tube)

e) Pre-existing urinary tract structural abnormalities or stones along the urinary tract.

 

 

 

What should you do if you think you have a UTI?

 

Well after reading the section above on symptoms and you think you might have a UTI, it is advised to see a doctor. The doctor will need to take a full detailed history and examine you to make sure you don’t have any complications of the infection and to see if a cause can be identified. The doctor will then prescribed you antibiotics and advise you on methods to reduce your risk of developing UTI.

 

 

 

How can I reduce the risk of getting a UTI?

 

These tips are essential for patients who suffer from recurrent UTI:

 

 

Changes in contraception and sexual behavior

 

As described above, sexual activity increases your risk of contracting the infection especially with the use of spermicide. Therefore, you should reduce the use of spermicide or spermicide containing products during sexual activity. Besides that, having a high number of active sexual partners also increase your risk of getting a UTI, so one should reduce the number of partners. For those that are using diaphragm for contraception should consider other options for birth control.

 

 

Drinking loads of water

 

We all have been told by our parents, when young, that we should drink a lot of water. Besides keeping you well hydrated, that advice decreases your risk of getting a UTI because this leads to a higher urine production which makes you pass more frequently. Therefore, it reduces the stagnation of urine and doesn’t provide the bacteria a lot time to cause an infection.

 

 

Urination after sex

 

During intercourse, there is a probability of introducing new pathogens in the urethral opening. Therefore, urination right after intercourse will help flush them away and reduce the changes of them causing an infection.

 

 

Wipe from front to back.

 

There are a lot of bacteria that tend to hang around the anus. Wiping from back to front, especially after a bowel movement, potentially transfers some of those bacteria to the urethral region. However, if you wipe from front to back, it is less likely that you would transfer them to the urethral region.

 

Consumption of Cranberry juice

 

You tend to see a lot of people recommending the consumption of cranberry juice during or in preventing a UTI. However, there has not been any conclusive clinical studies demonstrating its benefit in reducing recurrent UTI rate. Despite that, there have been some lab-based research that showed cranberries have certain properties that may stop the adherence of bacteria to the cells found in the lining of the urinary tract. In conclusion, there is no direct harm in trying this prevention method except for the slight increase in calorie intake.

 

 

Antibiotics & Prophylaxis

 

Antibiotic prophylaxis is a type of treatment prescribed by a doctor to prevent illnesses.

Taking antibiotics over a period has been shown to be very effective in patients with recurrent UTI. Usually the doctor will recommend the above behavioral changes initially, if not working they will then prescribe antibiotics. This is under the discretion of the doctor as it depends on each patient’s situation such as the frequency of recurrences and if there are any patterns in the recurrences. In other words, it can be used continuously or just after sex (post-coital) to prevent recurrences.

In some patients, the doctor may prescribe antibiotics for self-treatment when a patient starts developing early signs of recurrence.

 

 

 

If you are experiencing any of the above symptoms or recurrent UTI please see your doctor early. This leads to a quicker recovery and lesser complications.

 

Our doctors at Mint medical Centre are well equipped to see to your needs. Contact us today!