By, Dr. Aarti Kulkarni , Ayurveda
White discharge per vagina, vaginal itching/irritation, bad odor are very common gynecological complaints.
Leucorrhoea: Leucorrhoea refers to a white discharge from female genitals.
Causes of Leucorrhoea:
I. Physiological Leucorrhoea
Certain amount of secretions are always present in healthy vagina to protect it and keep it moist. Physiological leucorrhoea can be seen in following conditions :
- During pregnancy
- At Ovulation
- During sexual excitement
- During premenstrual phase of menstrual cycle.
Natural Defense Mechanism Of Genital Tract
The genital tract forms a continuous open pathway from the exterior to the peritoneal cavity and the natural defense system against ascending infection is therefore necessary.
Vaginal flora are the bacteria that lives in vagina. The normal flora are dominated by lactobacillus. Lactobacilli help to keep vagina healthy by producing lactic acid and other substances that inhibit growth of yeast and other unwanted organisms. The efficiency of vaginal defense is directly proportional to the relative number of lactobacilli present. The defense is imperfect during childhood and after menopause, during menstruation and during Post-delivery or post abortion period.
II. Pathological Leucorrhoea
When vaginal discharge is increased with other symptoms like itching, irritation, bad odor, pain in abdomen, backache; it has to be treated. The causative factors for pathological leucorrhoea are –
- General health causes
- Genital causes
A] General Health Causes
- Ill health
- General debility
- Local improper hygiene
- Diabetes mellitus
- Thread worm infestation
- Prolonged use of antibiotics
- Low levels of estrogen
B] Genital Causes
- Vulva: Ulcers, Bartholinitis.
- Vagina:Trichomonas vaginitis, Candidiasis, Chlamydial infection Atrophic vaginitis (senile)
- Cervix: Cervical erosion, Cervical cancer
- Uterus: fibroid, Genital prolapse, Endometrial infection.
- Pelvic Inflammation
- Contraceptives: IUCD, Contraceptive jelly, Pessaries, OC pills.
- Others: Foreign body, Trauma, Post cervical cautery.
- Vaginal discharge with unpleasant odor
- Genital burning
- Genital itching
- Pain while urination
- Painful intercourse
- Frequent urge to urinate
Most Common Types of Vaginitis:
- Trichomoniasis: It is a sexually transmitted disease mostly caused by protozoan trichomonas vaginalis. It can cause white/green/yellow vaginal discharge with unpleasant smell
- Bacterial Vaginosis: It is a vaginal disease caused by excessive growth of bacteria. There may be no symptoms, but it increases risk of early delivery. Itching is uncommon. The discharge has a characteristic fishy odor.
- Yeast infection (Vaginal candidiasis): It is a fungal infection in which itching is more than discharge. The discharge is usually like cottage cheese.
- Chlamydial vaginitis: It is sexually transmitted infection caused by bacteria chlamydia trichomatis. The infection can ascend in upper genital tract and can cause pelvic inflammatory disease which may cause infertility or ectopic pregnancy.
- Viral vaginitis: One form is caused by herpes simplex virus (HSV) in which sores are primary symptom. Another form is caused by Human Papilloma Virus (HPV) in which warts are primary symptom.
- Senile Vaginitis: It is atrophic vaginal inflammation due to estrogen deficiency; mostly seen in postmenopausal women. Main symptoms are vaginal dryness and painful intercourse due to decreased vaginal lubrication.
Excessive vaginal white discharge is termed as shwetpradara in Ayurveda.
- Incompatible diet
- Sedentary lifestyle
- Unhygenic activities
- Cervical erosion
- Kapha vitiating diet in Preganancy
- Beholding impulses of vomiting and expiration in pregnancy
- Excessive sexual activities
- Vata and kapha vitiating diet
- Herbs useful in shwetpradar: As there is discharge and mild inflammation, one has to choose purifying, anti-inflammatory, cleansing, healing, soothing drugs both internally and externally. Nyagrodh, Lodhra, Patha, Daruharidra, Rohitak, Lajjalu, Shalmali, Musta, Nagkeshar, Sariva, Tanduliyak (Amaranthus)
- Formulations recommended in Shwetpradar: Patrangasav, Lodhrasava, Chandraprabha vati, Pushyanug choorna etc.
- Diet: Milk, Cow Ghee, Ash gourd, dates, red spinach, gooseberry, green gram, red rice etc. Local treatments explained in Ayurveda are much more helpful in vaginitis and especially recurrent infections and urinary tract problems due to vaginal infections.
- Yoniprakshalana: YoniPrakshalan is nothing but irrigation of vulva and vagina with warm decoction. Medicines for decoction are used according to the cause. It is helpful in vaginal infections and white discharge.
- Pichudharan: A sterile tampon soaked with medicated oil or ghee is kept in posterior fornix of vagina for 4-5 hours, the procedure is called as pichudharan. It is useful in vaginismus, cervical erosion, cervicitis, 1st degree uterine prolapse etc. Medicines for pichu are used according to the cause.
- Vartidharan: Yonivarti is vaginal suppository or pessary. It is indicated in white discharge, vaginal infections and cervical erosion.
- Dhoopan: It is the process in which fumigation if vulval and vaginal region is done by herbal medicines. Mostly, it is done after delivery to reduce watery secretions, pus and wound discharge.
- Kshar pratisaran: It is an application of Kshar (ash obtained by burning herbs) over affected areas, mainly cervical erosion and cervicitis.
It is necessary to treat partner as well, if the woman is sexually active. Ayurvedic medicines, local treatments, avoidance of causative factors, lifestyle and diet modification and regular exercise will cure vaginal infections from its root and prevent its recurrence and complications due to that.