LEUCORRHOEA or WHITE DISCHARGE & ITS AYURVEDIC CURE

Normal vaginal discharge is transparent white in colour, odourless with a pH of 4.5 to 5.5. It contains squamous epithelial cells and few bacteria. Vaginal discharge helps to eliminate toxins from the body to maintain a healthy vagina. But if there is an infection, characteristic features of normal vaginal discharge change and it is abnormal vaginal discharge.

Abnormal vaginal discharge is a frequent complaint of women seen in the gynecologic clinic. The discharge may be thick whitish like curdy nature, yellowish or green, sticky and foul smell. It may be associated with other symptoms.

WHAT IS LEUCORRHOEA ?

Leucorrhea is strictly defined as an excessive normal vaginal discharge. The symptoms of excessive discharge vary from person to person, while to declare it to be normal and not infectious one, requires clinical and laboratory investigations.

The term leucorrhea should fulfil the following criteria:

The excess secretion is evident from persistent vulval moistness or staining of the undergarments (brownish yellow on drying) or needs to wear a vulval pad.
It is non-purulent and non-offensive.
It is nonirritant and never causes pruritus.

Leucorrhoea is a medical condition where women experience thick whitish or yellowish colour discharge from the vagina.

The physiological vaginal discharge increases at birth, puberty, and time of ovulation, in some women’s premenstrual phase of the cycle, pregnancy, during sexual excitement.

CONCEPT OF AYURVEDA

In Ayurveda leucorrhea is considered “Shweta Pradara”. ‘Shweta means white and ‘Pradara’ means discharge from the vagina.

It is due to aggravation of Kapha dosha and vitiation of Rasadhatu and Agnimandhya occurs.

PATHOPHYSIOLOGY OF VAGINAL DISCHARGE

The vaginal secretion is very small in an amount sufficient to make the surface moist. Normally, it may be little excess in mid-menstrual or just prior to menstruation, during pregnancy and during sexual excitement. The secretion is mainly derived from the glands of the cervix, uterus, transudation of the vaginal epithelium, and Bartholin’s glands (during sexual excitement)

The physiologic basis involved in normal vaginal secretion is dependent on the endogenous estrogen level. With the rising estrogen level, there is an abundant secretory activity of the Endo-cervical glands and the superficial vaginal epithelium becomes rich in glycogen.

The mucoid secretion from the cervical glands is normally small in amount. 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.

CAUSES OF LEUCORRHOEA

The excessive secretion is due to:

Physiologic excess
Cervical cause (cervical leucorrhea)
Vaginal cause (vaginal leucorrhea)

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

During puberty—Increase levels of endogenous estrogen lead to marked overgrowth of the Endo-cervical epithelium which may encroach onto the ectocervix producing congenital ectopy (erosion) causing increased secretion.
During menstrual cycle
Around ovulation—Peak rise of estrogen →increase in secretory activity of the cervical glands.
Premenstrual pelvic congestion and increased mucus secretion from the hypertrophied endometrial glands.
Pregnancy—There is hyperestrogenism with increased vascularity. This leads to increased vaginal transudate and cervical gland secretion.
During sexual excitement, when there is an abundant secretion from the Bartholin’s glands.

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 and ectropion (cervical glands are exposed to the vagina).

Vaginal cause: Increased vaginal transudation occurs in conditions associated with increased pelvic congestion. The conditions are uterine prolapse, acquired retroverted uterus, chronic pelvic inflammation, ‘pill’ use and vaginal adenosis.

Ill health is one of the important causes of excessive discharge. It produces excess exfoliation of the superficial cells.

OTHER COURSES OF LEUCORRHOEA

Spread of infection from urinary tract
Allergy or contact dermatitis
Pelvic inflammatory disease
Contraceptives used by women
Lack of cleanliness of pure hygienic measures especially during menses
Diabetes and anaemia can provoke infections due to weakened immunity
Mental anxiety and sexual frustration.
Leucorrhea is caused by infection with bacteria, yeast or
another microorganism
Fungus-like (candida Albicans) yeast infections reproductive organs and cause leucorrhoea.
- If it is because of a fungal infection the discharge will be thick white with itching in the vagina. This kind of discharge is called vaginal mildew.

Some sexually transmittable disease causes leucorrhoea. Such gonorrhoea and chlamydia are bacterial infections and Trichomonas Vaginalis is a parasite infection and also the most common sexually transmitted disease which makes discharge greenish or yellow.
Inflammation of uterus
Injuries to the vagina, the womb or cervix.
Nutritional deficiency
Stress or depression

SYMPTOMS AND SIGNS OF LEUCORRHOEA

Excessive vaginal discharge
Pain in the thighs and calf muscle
Burning micturition
The vaginal discharge colour may be whitish, yellowish or greenish and it is accompanied by a foul smell, itching and pain if infected.
Other symptoms are:
Pain and heaviness in the lower abdomen
Constipation
Anaemia
Headaches
Pain in the lumbar region
Pain in the stomach or cramps

HOW TO DIAGNOSE LEUCORRHEA

The Patient’s complaints of excess vaginal discharge associated with some symptoms of leucorrhea are presented. Leucorrhea is finally diagnosed by characteristic features of discharge, physical examination like abdominal examination and per vaginal examination and lab investigations.

WHAT ARE THE INVESTIGATION TO BE DONE

Blood examination
Urine examination
Pap smear test
Clue cell
KOH test
HVS
NAAT test etc.

TREATMENT OF LEUCORRHOEA

Improvement of general health.
Cervical factors require surgical treatment like electrocautery, cryosurgery or trachelorrhaphy.
Pelvic lesions producing vaginal leukorrhea require appropriate therapy for the pathology.
Stop using contraceptive pills temporary if it causes issues
local hygiene has to be maintained.
Treatment for a specific infection. Antibacterial and antimicrobial medicines are given according to the underlying cause.

DIET FOR LEUCORRHEA

DIETS TO BE FOLLOWED

A balanced diet includes high fibre, protein, carbohydrates, healthy fats, vitamins and minerals.
Increase intake of fruits, vegetables and salads.
Eat whole grains such as brown rice, pulses etc.
Drink enough water

AVOID

Avoid heavy, oily, fried, spicy and sour foods.
Tea, coffee, alcohol and aerated drinks should be avoided.
Avoid Non-vegetarian food.
Refined sugar foods to be avoided.

HOME REMEDIES FOR LEUCORRHEA

Tandulodaka (rice water) boils 2 tablespoons of rice and removes rice and water is taken internally.
Douche (vaginal wash) for that Neem leaves taken and boiled after cooling down used for vaginal wash.
Aloe vera pulp is used for applying external genital area.
Decoction of cassia is also used for vaginal wash.

AYURVEDIC LINE OF TREATMENT

Nidanaparivarjana(avoid improper diet and regimen etc.) is done.
Kaphashamana treatment (use of Katu, Kashaya Dravyas)
Symptomatic management is done

External management

Yoni prakshalana(vaginal wash)
Yoni Purana
Yoni Varti
Yoni Dhupana

Internal medicines

Pushyanuga Churna, Ashoka Ghruta, Lakshmanarishta, Ashokarishta, Lodhrasava, Amalaki Churna, Kadali Madhusnuhi Rasayanam etc… are given.

These treatments are to be done under doctor advice.

YOGASANA AND PRANAYAMA

Yogasana

Suryanamaskara
Sarvangasana
Suptavajrasan
Pawanmuktasana
Shalabasana
Padahastasana

Pranayama

Anulom vilom and Bhastrika

HOW TO PREVENT LEUCORRHOEA ?

Clean the innerwear with a good quality detergent which has bactericidal and fungicidal properties.
Immediately change the clothes including undergarments, if clothes get wet in the rain or due to any other reason.
Underwear made of nylon material should be avoided in summer because it may remain sweaty in the genital area. Cotton is the best choice for undergarments.
Do not unnecessarily use any cosmetics in the genital area. They should be strictly avoided.
Exercise, yoga and meditations to be followed in daily routine.
Good hygienic health is to be maintained. Cleanliness of the genital area is very important.
Drink enough water
Healthy nutritious food habits to be followed.