One of the commonest health problem facing the female members of our species, from early childhood to advanced age is vaginal discharge (leucorrhoea). This condition includes all discharge of substances from the vagina, except blood, urine and stool, which forms distinct condition in females.

As would be expected, the discharge itself would vary widely in appearance, from white, watery matter to foul smelling, thick, yellowish matter. It is not only common, it is universally distressing to the women folks; and the most disturbing aspect of the condition is that large percentage of affected women are so embarrassed about it, that is they shy away from consulting their doctors.

Much more so, they avoid informing their husband, less they are charged with adultery, infidelity, waywardness, etc. Indeed one such case came to the clinic of the author in Lagos late last year after suffering from such a discharge for over three years, she was about 34 years old, two children, and obese. Her discharge began with scanty white matter especially before her period and gradually worsened till it becomes copious, yellowish and offensive; and what was most irritating, her entire private parts and in-between her thighs became sore and extremely itchy. She used two or three pants daily; and has refused to go near husband for six months.

The viscous circle goes on, she become despondent and depressed, she nagged her husband; she was irritable to her children, and in the heat of her anger her private itched more and she tore it apart with her finger nails. In the midst of all these, her friend called, and managed to discover the root of her problem - an odious discharge from her vagina. Her friend advised her to see a nearby doctor;  and distressing disease was promptly cured.

CAUSES OF VAGINAL DISCHARGE

1) Normal (ie physiological) : normally all part of the female organ, from the womb down to the lips of the vagina have secretions increased under the following conditions -

a. At about ovulation (midway into menstrual cycle when an egg is discharged from the ovary) and for a few days before a normal period commences.

b. During sexual excitement. This increased secretion are aim at lubricating passages; but occasionally pour out to stain the underclothing.

2) Abnormal (ie pathological) : for the sake of easy understanding of vaginal discharge which is considered abnormal will be discussed according to the age of the female.

a.  Before puberty (ie 0 to 12 years): the unusual cause of vaginal discharge in this age group is infection of the opening (Vulva)  into the vagina and the vagina itself. Children of this age in our country play around in bare ground, mostly naked especially in the rural areas. Dirts readily get into the vagina; and from time to time these children playfully introduce such foreign bodies as beads etc.

b. After puberty in the young virgins: In this group, the discharge is commonly the excess of mucous from the neck of the womb or occasionally thin watery discharge from the mild degree of infection of the vagina. Major contributory factor to these excessive mucous and irritation are poor general health unclean personal hygiene; shortage of blood and often masturbation.

c. Married women without issues: It is in this group that infections with various organism are very common. They are trichomonas, gonococcus, and many other pus producing germs. The parts infected include two tiny glands at the entrance to the vagina (Bartholin's glands); the vagina; and the neck of the womb. In recent years, contraceptive devices have become very common causes of discharge in all groups. The discharge is thick and full of pus, and such heavy infection may lead to disturbance ovarian function leading to heavy scanty, absence or irregularity of menses.

d. After childbearing age: The here is largely due to normal damage to the neck of the womb during the child bearing years. In addition, sevile infection of the vagina and cancers of the tract are important.

e. Childbearing women during childbearing age: the commonest cause in this group is the condition of the neck of the womb called "Cervical Erosion" of cause they may also be present all other causes earlier mentioned, chronic dysentery favours the infection of the vagina; irritant douches, tampons may lead to the same thing.

In all these groups discussed above it is extremely important to stress that their is no airtight compartment between them. What has been discussed under each group is mainly related to the known socially acceptable norms of the group.

In these days of promiscuity, virgins are hardly common place commodities; unmarried mothers are strewn all over the place; and excessive sexual indulgence is fashionable at all the ages from 12 to 60.

Naturally, therefore, therefore all the causes discussed may be found at any age, except, of course, the cancers of the tract which may not occur before the age of 40.

In conclusion, vaginal discharge is common, but readily cured or controlled. It is of paramount importance for affected women to seek proper advice. Self medication is to be discouraged. In all cases through investigations are necessary and good personal hygiene and sound general health are wise preventive prerequisite against this distressing and embarrassing disease.

By Dr Ebun Ekunwe (Contributing Editor)

Edited By Fidelis C. K. (Editor-In-Chief)