Leucorrhoea

Abnormal vaginal discharge is a frequent complaint of women seen in the gynaecologic clinic. The discharge may range from what is called excess of normal to one which is a part of wide spectrum of ailments. It may be blood-stained or contaminated with urine or stool, all of which are however excluded from the discussion made below.[2]

Indian epidemiology then other

The excessive secretion is due to:

[a] Physiologic excess

[b] Cervical cause (cervical leucorrhoea)

[c] Vaginal cause (vaginal leucorrhoea)

[a] Physiologic excess:

The normal secretion is expected to increase in conditions when the oestrogen levels become high. Such conditions are:

• During pubertyIn general, Increased levels of endogenous oestrogen leads to marked overgrowth of the endocervical epithelium which may encroach onto the ectocervix producing congenital ectopy (in other words, erosion) →Increased secretion.

• During menstrual cycle

[1] Around ovulation—Peak rise of estrogen →

increase in secretory activity of the cervical glands.

[2]Premenstrual pelvic congestion also increased mucus secretion from the hypertrophied endometrial glands.

• Pregnancy—There is hyperestrinism with increased vascularity. This leads to increased vaginal transudate also cervical gland secretion.[2]
• During sexual excitement, when there is abundant secretion from the Bartholin’s glands.

[b]Cervical cause:

Non-infective cervical lesion may produce excessive secretion, which pours out at the vulva. Such lesions are—cervical ectopy, chronic cervicitis, mucous polyp also ectropion (cervical glands are exposed to the vagina).

[c] Vaginal cause:

Increased vaginal transudation occurs in conditions associated with increased pelvic congestion. Additionally, The conditions are uterine prolapse, acquired retroverted uterus, chronic pelvic inflammation, ‘pill’ use also vaginal adenosis. Ill health is one of the important causes of excessive discharge. It produces excess exfoliation of the superficial cells.[2]

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Risk factors are things that make you more likely to develop a disease in the first place.

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Normal Vaginal Secretion: The origin and nature of the normal vaginal secretion during the reproductive period.

The physiologic basis involved in normal vaginal secretion is dependent on the endogenous oestrogen level. In detail, With the rising oestrogen level, there is abundant secretory activity of the endocervical glands and the superficial vaginal epithelium becomes rich in glycogen.

The mucoid secretion from the cervical glands is normally small in amount. Besides this, The carbohydrate radicle of the glycoprotein mucin is split off and fermented into lactic acid. If, however, the mucus is secreted in excess, it pours out at the vulva.[2]

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• The excess secretion is evident from persistent either vulval moistness or staining of the undergarments (brownish yellow on drying) or need to wear a vulval pad. [2]
• Intense itching of the vulva
• Vaginitis
• Pain while Passing Urine
• Pain during during or after sex
• Lower back pain[4]

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Evaluation of patient with vaginal discharge.

• History
• Physical examination
• Investigations

       Pap smear

Urine for R/e, c/S

HIV serology

       Blood tests when PID is suspected [2]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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• Treatment may include antibiotics, such as metronidazole. Other antibiotics common for the treatment of STIs include clindamycin or tinidazole.[1]
• Improvement of general health.
• Cervical factors require surgical treatment for example, electrocautery, cryosurgery or trachelorrhaphy
• Pelvic lesions producing vaginal leucorrhoea require appropriate therapy for the pathology.
• Pill users may have to stop ‘pill’ temporarily, if the symptom is very much annoying.
• Above all, local hygiene has to be maintained meticulously.

• Treatment for specific infection.[2]

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Homeopathic Treatment

Homeopathy being an individualistic science tries to find an individual remedy for each case. Different females suffering from Leucorrhea (in other words, White Discharge) present with different symptoms regarding the character, localization, extension also severity. Also varying are the accompanying symptoms like backache, itching & burning in genital region etc.

Individualization

Some females will have complaints much before menses while others are worse only during it. The character of leucorrhea, its color, presence of blood, the underlying cause such as fibroids, cysts, endometriosis etc. differentiate one case from another.

From the treatment’s point of view, it is better to make it normal than to stop it because physiologically it is important. If it is stopped completely, vaginal dryness may result which may cause pain & distress during sexual activity.

Duration of treatment

Also, if it is not treated properly, it may often recur and sometimes it can be infected and become persistent. Always take treatment for 2-3 cycles of periods to analyze it. So, do not stop treatment as soon as symptoms disappear and periods become normal. So, take least 3–4-month treatment.

In Homeopathy, we boost the immune system which plays a very important role in natural elimination of disease organism or the disease itself and also in prevention. Homeopathic prescriptions are based on the nature and time of the discharge and also depend upon the patient’s constitution.

The treatment can give permanent relief to recurrent leucorrhea.

Alumina. [Alum]

Leucorrhea in chlorotic girls which is transparent or of yellow mucus, which is very profuse and ropy, and greatly exhausting, as it is very rich in albumen. It occurs chiefly in the daytime; the great profuseness is its characteristic. It is apt to be acrid. Causticum. Leucorrhea occurring chiefly at night.

Arsenicum. [Ars]

Leucorrhea from exhausting diseases; cancer, etc. It best suit to weak persons, old women, especially the chronic form with much weakness; the discharge is acrid, corrosive and yellow. Dictamnus was one of Hahnemann’s remedies for leucorrhea. It is of tenacious mucus, attended with painful erosions of the pudendum and itching of the anus. Secale. Brownish and offensive leucorrhea, with metrorrhagia, especially in thin scrawny women who suffer from excessive menstruation and prolapsus.[3]

 Belladonna

corresponds to recent or acute attacks of leucorrhea dependent upon pelvic inflammation also congestion; oftentimes bearing down in pelvis. Thin, odorless, bland leucorrhea. Additionally, Sensitive cervix and bearing down pains. Stannum. Profuse bland leucorrhea, yellowish, with great debility, backache; patients weaken also sallow.

Borax [Bor]

suits a clear, copious and albuminous leucorrhea having an unnatural heat to it. Leucorrhea midway between menses with great nervousness, white as starch, perfectly bland without pain. Dr. Hughes recommends this remedy in the 2X trituration for a chronic vaginal catarrh, which sometimes mistaken for uterine leucorrhea. In detail, Graphites cures a leucorrhea associated with pains in the lower abdomen and weakness of back in pale young girls. It is profuse, very thin, white mucus, occurs in gushes; the menses delay, scanty and pale. Leucorrhea more profuse in morning when rising, especially indicates Graphites.[3]

Kreasote. [Kreos]

Few medicines have the same power in leucorrhea as Kreasote. It cures a profuse watery, sometimes a yellowish leucorrhea. The acridity is marked; it causes excoriating of the parts which come in contact with it, causes soreness and smarting and red spots and itching on the vulva, always with great debility; leucorrhea preceding menses. It is so acrid that it causes the pudenda and thighs to swell and itch. Nitric acid.

Highly recommended by Jahr in a corrosive leucorrhea; it being one of our best remedies, and one too often neglected. In fact, all of our remedies are prone to be neglected in leucorrhea, and their place taken by far less efficient local applications. Nitric acid suits a greenish, fetid, obstinate leucorrhea; the presence of fig warts and condylomas a will further indicate the remedy. Platinum. Periodical, thin watery leucorrhea with very sensitive organs. Albuminous leucorrhea in the daytime. Iodine has an acrid, corrosive leucorrhea accompanied by right ovarian inflammation.

Mercurius. [Merc]

Acrid excoriating leucorrhea smarting and burning, swelling of external genital organs. Purulent greenish yellow leucorrhea worse at night; heat, tenderness and pain involving Nabothian glands, form good indication for Mercurius. Scrofulous and syphilitic subjects with yellow and thick leucorrhea also indicate the remedy.[3]

Pulsatilla [Puls]

Basically, it produces a cures a milky leucorrhea which becomes watery, acrid also burning from being retained in the vagina. Moreover, It is a mucous, thick, creamy, white leucorrhea sometimes replacing menses, with chilliness, disposition to lie down and lowness of spirits. Additionally, It corresponds to a disposition to leucorrhea and suits leucorrhea in chlorotic subjects. Helonin. Besides this, Southwick recommends this remedy in the 1X or 2X trituration for profuse, yellow, thick leucorrhea with some irritation and itching. All in all, In anemic sallow patient with much prostration and general debility, worse from slight colds and exertion, it is a most useful remedy.[3]

Sepia

Cures a leucorrhea which is yellowish green color, somewhat offensive and often excoriating, due to pelvic congestion of a passive type. It is milky, worse before menses with bearing down; there are pains in the abdomen and pruritus. The patient has a sallow, pimply face, and it is most suitable to those of dark complexion who are feeble and debilitated and who have a sensation of emptiness at the pit of the stomach. It leads all other remedies in leucorrhea of little girls, though Mercurius pro-iodide should not be forgotten if the discharge be yellow.

Lilium tiglium has an excoriating-, watery-, yellowish- or yellowish-brown leucorrhea, which is profuse and is accompanied by a depression of spirits and bearing down in pelvic region. Hydrastis suits a tenacious, thick, ropy leucorrhea with erosion of the cervix; a mucous leucorrhea which is profuse and debilitating corresponds to Hydrastis. Kali Bichromicum has a yellow, ropy, stringy leucorrhea. It is suitable to fat, light-haired persons.[3]

Diet & Regiment of Leucorrhoea

• Wash genitals every day. Wear clean garments every day. Always wear cotton underwear to avoid moisture. Synthetic or nylon garments which cause dampness of genital organs.
• Abstain from sexual intercourse during heavy discharges and during the process of healing to avoid irritation of tissues
• Please avoid Sprays, deodorants, and strong perfumed soap and bath products
• Avoid Stress since it may affect the hormonal level and may increase secretions
• Don’t Share towels and garments. Eat nutritious diet, especially food rich in vitamins A, B, C, and E, magnesium and zinc, to improve general health. Plenty of water and juices to avoid urinary tract infection and its spread to the vagina or cervix.[4]

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[1]https://en.wikipedia.org/wiki/Leukorrhea#:~:text=or%20yellow%20mucous.,Treatment,STIs%20include%20clindamycin%20or%20tinidazole.

[2] DC Dutta’s Gynaecology

[3] Therapeutics from zomeo ultimate LAN

[4]https://www.drbatras.com/all-about-leucorrhoea-and-homoeopathic-management#:~:text=Always%20wear%20cotton%20underwear%20to,cause%20dampness%20of%20genital%20organs.&text=Don’t%20Share%20towels%20and,zinc%2C%20to%20improve%20general%20health.

Frequently Asked Questions

What is Leukorrhea?

Leucorrhoea is strictly defined as an excessive vaginal discharge.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Leukorrhea?

• Alumina
• Arsenicum
• Belladonna
• Borax
• Calcarea Carb
• Kreasote
• Mercurius
• Pulsatilla
• Sepia

What causes Leukorrhea?

• Physiologic excess
• Cervical cause (cervical leucorrhoea)
• Vaginal cause (vaginal leucorrhoea)

What are the symptoms of Leukorrhea?

• The excess secretion is evident from persistent vulval moistness
• Staining of the undergarments (brownish yellow on drying) or need to wear a vulval pad.
• Intense itching of the vulva
• Vaginitis
• Pain while Passing Urine
• Pain during or after sex
• Lower back pain