There is always water flowing down there and there is a strange smell. What's going on?

Because the structure of a woman's private parts is very special and the entire private parts are exposed to the outside, it is easy for various abnormalities to occur. Once an odor appears, it is very likely that a gynecological disease has occurred. The constant discharge of water and the odor from below are consistent with the symptoms of vaginitis, but these are not enough to prove that you have vaginitis. We must have some understanding of the situation of vaginitis and conduct a comprehensive analysis based on other manifestations of the body.

Clinical manifestations

1. Bacterial vaginosis

10% to 40% of patients have no clinical symptoms. Those with symptoms mainly present with increased vaginal discharge with a fishy odor, which is especially aggravated after sexual intercourse and may be accompanied by mild vulvar itching or burning sensation. Examination showed no signs of congestion or inflammation in the vaginal mucosa. The secretions were grayish white, uniform, thin, and often adhered to the vaginal wall, which could be easily wiped off.

2. Candidal vaginitis

(1) Vulvar itching, burning pain, and pain during sexual intercourse.

(2) Frequent and painful urination. The characteristic of dysuria is that urine irritates the edematous vulva and vestibule during urination, causing pain.

(3) Characteristic secretion: white, thick, and resembling curd or bean curd residue.

(4) Vulvitis presents with geographic erythema, edema, and scratches.

(5) Vaginitis may cause edema, erythema, and white membrane.

3. Trichomonas vaginitis

(1) Characteristics of increased vaginal discharge: thin, purulent, yellow-green, foamy, and smelly.

(2) Location of vulvar itching: vaginal opening and vulva.

(3) If combined with urinary tract infection: frequent urination, urgency, pain, and sometimes hematuria.

(4) Infertility: Trichomonas vaginalis can devour sperm, hinder the production of lactic acid, and affect its survival in the vagina.

(5) Examination revealed: congestion of the vaginal mucosa with scattered bleeding spots, and a large amount of "strawberry-like" leucorrhea in the posterior fornix of the cervix, which was grayish yellow, yellowish-white thin liquid or yellowish-green purulent secretions, often in a foamy state. There are no abnormal changes in the vaginal mucosa of carriers.

4. Senile vaginitis

Increased vaginal discharge, vulvar itching, etc., are often accompanied by pain during sexual intercourse.

5. Childhood vaginitis

The main symptoms are vaginal purulent discharge and vulvar itching.

treat

Generally, the drug treatment for vaginitis is mainly external use. Patients with pelvic inflammatory disease or recurrent vaginitis can take oral medications. If necessary, couples can be treated together. Note that long-term oral antibiotics may inhibit normal flora and cause secondary fungal infection.

1. Bacterial vaginosis

The principle of treatment is to use anti-anaerobic drugs, mainly metronidazole, tinidazole, and clindamycin. Caution: Disulfiram-like reactions may occur with both oral and topical metronidazole.

(1) Oral medication: Metronidazole is the first choice.

(2) Local drug treatment.

(3) Sexual partners do not require routine treatment.

2. Candidal vaginitis

(1) Eliminate the cause: If you have diabetes, you should be treated actively and stop using broad-spectrum antibiotics, estrogen and cortisol in time. Change your underwear frequently, and wash used underwear, basins, and towels with boiling water.

(2) Topical medications: miconazole suppositories, clotrimazole suppositories, and nystatin suppositories.

(3) Systemic medications (for patients with recurrent attacks or who cannot take vaginal medication): fluconazole, itraconazole, and ketoconazole. Fluconazole has a lower risk of hepatotoxicity and should be used instead of ketoconazole.

(4) Sexual partners should be tested and treated for Candida albicans.

(5) Pregnancy complicated by Candida vaginitis is mainly treated with local treatment, and oral azole drugs are contraindicated.

3. Trichomonas vaginitis

(1) Local vaginal medication: Metronidazole vaginal effervescent tablets or 0.75% metronidazole gel, 1% lactic acid or 0.5% acetic acid solution flushing can relieve symptoms.

(2) Systemic medication: Metronidazole can be used for initial treatment, but the medication should be discontinued if side effects are detected. Do not drink alcohol during the use of metronidazole and within 24 hours of stopping the medication, and do not drink alcohol during the use of tinidazole and within 72 hours of stopping the medication. The efficacy and side effects of metronidazole and tinidazole are similar, including possible disulfiram-like reactions. Do not breastfeed while taking medication.

(3) Sexual partners should receive treatment at the same time and avoid unprotected sexual intercourse before recovery.

4. Senile vaginitis

The principle of treatment is to supplement estrogen, enhance vaginal immunity and inhibit bacterial growth.

5. Vaginitis in young girls

The principles of treatment are to keep the vulva clean, treat symptoms, and select antibiotics targeting the pathogen.