There is a white foreign object on my wife's underwear

Leucorrhea health has always been a concern for women. Leucorrhea is a secretion. Normal leucorrhea will appear as a milky white gelatinous substance on the underwear, without any odor or the appearance of tofu dregs. However, if the leucorrhea is abnormal, it may cause odor, changes in color and texture, and may even be accompanied by tofu dregs or water. In addition, the amount of leucorrhea is particularly large, and the stomach has recently started to feel uncomfortable. Therefore, the judgment of gynecological diseases can start with the secretions.

Leucorrhea (white vaginal discharge) is a mixture of vaginal mucosal exudate, cervical gland secretions and endometrial gland secretions, and contains vaginal epithelial exfoliated cells, white blood cells and lactobacilli.

It is divided into physiological leucorrhea and pathological leucorrhea. Physiological leucorrhea is white, thin, paste-like or egg white-like, with no fishy smell. The amount varies and is related to the level of estrogen. When the ovaries gradually develop and secrete estrogen during puberty, vaginal secretions begin to be discharged, usually in the middle of the menstrual period, close to ovulation, due to the vigorous secretion of cervical endometrial glandular cells, cervical mucus is the main component. At this time, the leucorrhea increases, is clear and transparent, and is thin like egg white. 2 to 3 days after ovulation, the leucorrhea becomes turbid and sticky in small amount, which has no adverse effects on women's health. Pathological leucorrhea is caused by inflammation of the reproductive tract, especially vaginitis and cervicitis or cancer. The color, quality and quantity of leucorrhea will change.

diagnosis

You should inquire in detail about the amount of leucorrhea, whether it stains underwear or requires a menstrual belt; the color of the leucorrhea; whether there is any special odor; the time of occurrence; whether it irritates the vulva and causes itching; whether there has been a diagnosis of pathological leucorrhea in the past; what kind of treatment has been received; whether the spouse suffers from urinary and reproductive system diseases, etc.

Differential Diagnosis

1. Physiological leucorrhea

Under normal circumstances, the amount and smell of leucorrhea vary from person to person, and publicity work should be done to eliminate concerns.

2. Pathological leucorrhea

1. Non-inflammatory leucorrhea

Any condition that can cause congestion in the pelvis and uterus can cause the cervical glands and endometrium to overfunction and secrete excessive mucus; at the same time, vaginal mucosal exudation also increases. For example, patients with pelvic tumors, retroflexed uterus, chronic diseases such as heart failure, tuberculosis, diabetes, anemia, and weak women often have more egg white-like secretions or white watery vaginal exudate.

In addition, mental stimulation can cause a continuous increase in secretions from the vulva, vagina and cervix, which is called "psychogenic leucorrhea". Patients often complain of discomfort such as moisture and itching of the vulva. The vulva of these patients is obviously moist, and they may even have acute or subacute eczema. The surface of the labia minora is gritty and uneven due to the protrusion of a large number of sebaceous glands.

If the above-mentioned hypersecretion continues for a long time, the cervical mucosa will be soaked by the corrosive alkaline cervical secretions, which may cause erosion, reduce the acidity of the vagina, and allow pathogenic bacteria to multiply. It may also lead to chronic cervicitis and pathological leucorrhea.

2. Inflammatory leucorrhea

The leucorrhea caused by inflammatory diseases of the reproductive organs contains varying amounts of white blood cells and is mostly purulent, but the properties of the leucorrhea vary depending on the pathogen.

(1) Bacterial vaginosis

The patient reported that the vaginal discharge had a fishy odor, which worsened during sexual intercourse. Leucorrhea is a grayish white or grayish yellow thin liquid that is homogeneous. It often adheres evenly to the mucosal surface of the anterior or lateral wall of the vagina without gathering in the posterior fornix. Microscopic observation: low white blood cell count, lack of inflammatory response, and the presence of clue cells can confirm bacterial vaginosis.

(2) Trichomonas vaginitis

The leucorrhea produced is yellow or yellow-green thin pus, sometimes foamy. In addition to the general redness of the vaginal wall, dot-like or bayberry-like hemorrhagic spots are often seen on the cervix and vaginal wall, which can be confirmed by testing of vaginal secretions. Since Trichomonas infection rarely extends beyond the external cervical os, there is generally no purulent mucus plug in the cervical canal.