Disease Index Woman's Health

Management of leucorrhoea

It is important to understand that the underlying factor in most of these conditions is congestion of the pelvic organs which inevitably results in an increased activity of the cervical, endometrial and vaginal epithelium to produce an excessive secretion.

Etiology of leucorrhea

As leucorrhoea is a symptom of various gynecological conditions, physiological as well as pathological, it is important to understand that the underlying factor in most of these conditions is congestion of the pelvic organs which inevitably results in an increased activity of the cervical, endometrial and vaginal epithelium to produce an excessive secretion. This excessive discharge may be physiological or pathological infective or non- infective:-

  1. The most common conditions, in which excess of this discharge is likely to be present, are pregnancy, premenstrual or menstrual periods, and congestion of the uterus.
  1. Pathological conditions of the female genital, organs, e.g., infection, growths and displacements, etc., also produce the same phenomenon, i.e., congestion and leucorrhoea.
  1. Irritation due to mechanical factors, e.g., use of chemical contraceptives, pessaries, intrauterine devices, etc, may also establish chronic inflammatory process causing congestion and hence leucorrhea.
  1. Psychogenic causes, e.g., worries, anxiety, overwork, and sexual excitement without fulfillment may also cause chronic leucorrhoea. It may seem strange, though it is now certain that emotional upsets affect hypothalamus, which in turn upsets the gonadotrophic functions of the pituitary gland, so much so that even an ovulation has been caused by mental stress and emotional situations. Considering the close relationship between pituitary, ovarian functions, glycogen deposition and PH value of vaginal flora, the hormonal theory also seems to be a possible cause.
  2. Recently, endocrinal factors have been given a great deal of prominence as a possible cause of leucorrhoea as is clear by the fact that the non-infective erosion is due to excess of oestrin in the system. Pregnancy and menstrual periods are also examples of hyper-secretion due to large amounts of oestrin in the blood at those periods.
  1. Errors in diet, excessive use of stimulants, e.g., tea, coffee, alcohol, smoking, all these things have been suggested to cause leucorrhoea it seems to be possible because of the absorption of toxic substances or by stimulation the nervous mechanism of gland causing hormonal imbalance. It is also suggested that faulty and deficient diet or severe Malabsorption apart from causing undernourishment and debility depresses the activity of pituitary gland producing hormonal disturbance, or a deficient diet may deprive the glands of raw material from which hormones are manufactured.
  2. Finally, the constitutional cause of leucorrhoea includes debilitated conditions due to anemia, tuberculosis, etc.

In an easier and more understandable way, the cause of leucorrhoea has been described as under:-

  1. A. General Causes
    1. Malnutrition.
    2. Anaemia.
    3. Sedentary habits.
    4. Chronic illness.
    5. Excess of tea and coffee.
    6. Alcohol.
    7. Occupation: women serving the whole day long.
    8. Constipation.
    9. Diabetes, and

10.  Intestinal worms in children.

  1. B. Local Causes
    1. Gonorrhea.
    2. Cervical erosion
    3. Displacements of uterus retroversion.
    4. Prolapsed of uterus.
    5. Cancer of all types.
    6. Leukoplakic vulvitis.
    7. Chronic salpingitis.

Cause of Leucorrhoea in Different Age Group

  1. A. Before puberty:
    1. Unhygienic conditions.
    2. Worms: oxyuris vermicularis or thread worms.
    3. Gonorrhoea.
  2. B. Unmarried girls after puberty
    1. Bad hygienic conditions during menses or otherwise
    2. Constipation.
    3. Sedentary habits
    4. Anemia.
    5. Any long continued chronic disease.
    6. Congenital erosion of cervix.
  3. C. In the married women:
    1. Bad hygienic conditions.
    2. Gonorrhea
    3. Trichomonas vaginalis
    4. Displace uterus retroversion.
    5. Cancer of all types.
    6. Long continued use of pessaries.
    7. Chronic cervicitis or erosion.
    8. Repeated and excessive intercourse.
    9. Birth control measure.

10. Chronic health.

D. After menopause

  1. Cancer of vulva.
  2. Cancer of uterus.
  3. Cancer of cervix.
  4. Leukoplakic vulvitis.
  5. Prolapse and decubitic ulcer.
  6. Gonorrhea.
  7. Chronic cervicitis.
  8. Trichomonas vaginalis
  9. Fungus infection

10. Chronic ill-health

Investigations

  1. 1. History
  • Duration of the complaint.
  • Fungus infection
  • Trichomonas.
  • Gonorrhea.
  • Excessive intercourse
  • About the discharge; character, modality etc.
  1. 2. External examination — Examination of vulva: bartholin’s glands, urethra, etc.
  2. 3. Special examinations:

(i)      Smears from urethra, vagina and cervix.

(ii)     Blood examination.

(iii)    Urine examination.

(iv)   Blood pressure examination.

(v)     Biopsy: for evidence of malignancy.

(vi)   For Trichomonas, hanging drop method is done.

General Treatment

(i)      Rest and exercise.

(ii)     Diet: none stimulating, but nourishing.

(iii)    Personal hygiene is important.

(iv)   Regularity of bowel movements and habits.

Local Treatment

If the discharge is acrid and too, copious douche of normal saline water is beneficial, otherwise, nothing is advised to apply. In some cases, Hydrastis lotion is recommended.

Homeopathic management of leucorrhea

Calcarea carbonica: – indicated by its general symptoms, prominent complaint of this remedy is morning affections, these are morning hunger, acidity of the stomach, cold and damp feet. It corresponds especially to scrofulous person with enlarged cervical glands. The leucorrhoea is profuse, milky, persistent or yellow and accompanied by itching and burning. It suits leucorrhoea in infants and young girls often recurring before puberty, leucorrhoea before menses or in recurring attacks between the menses.

Sulphur is another remedy suitable to scrofulous subjects; it has a leucorrhoea which makes the parts sore. It is rather indicated by the general than local symptoms.

Caulophyllum has leucorrhoea in little girls which is very profuse and weakness the child very much.

Calcaria phosphoric are a fine remedy in the scrofulous diathesis; it has a profuse milky bland leucorrhoea.

Pulsatilla produces and cures a milky leucorrhoea which becomes watery, acrid and burning from being retained in the vagina. mucous, thick, creamy, white leucorrhoea sometimes replacing menses, with chilliness, disposition to lie down and lowness of spirits. It corresponds to a disposition to leucorrhoea and suits leucorrhoea in chlorotic subjects.

Helonin For profuse, yellow, thick leucorrhoea with some irritation and itching, in anaemic sallow patients with much prostration and general debility, worse from slight colds and excretion, it is most useful remedy.

Lilium TIg has an excoriating, watery, yellowish or yellowish brown leucorrhoea, which is profuse and is accompanied by a depression of spirits and bearing down in pelvic region.

Hydrastis suits a tenacious, thick, ropy leucorrhoea with erosion of the cervix; a mucous leucorrhoea which is profuse and debilitating corresponds to Hydrastis.

Sepia Cures a leucorrhoea which is of yellowish green color, somewhat offensive and often excoriating, due to pelvic congestion of a passive type, milky, worse before menses with bearing down; there are pains in the abdomen and pruritis. The patient has a sallow, pimply face, and it most suitable to those of dark complexions who are feeble and debilitated and who have a sensation of emptiness at the pit of the stomach. It leads all other remedies in leucorrhoea of little girls, though Mercurius proto-iodide should not be forgotten if the discharge be yellow.

Kali Bich has a yellow, ropy, stringy leucorrhoea. It is suitable to fat, light haired persons.

Kreosote – few medicines have the same power in leucorrhoea as Kreosote. It cures a profuse watery, sometimes a yellowish leucorrhoea. The acridity is marked; it causes excoriation of the parts which come in contact with it, causes soreness and smarting and red spots and itching on the vulva, always with great debility; leucorrhoea preceding menses. It is so acrid that it causes the pudenda and things to swell and itch.

Nitric acid– Highly recommended in corrosive leucorrhoea; it being one of our best remedies, and one too often neglected. In fact, all of our remedies are prone to be neglected in leucorrhoea, and their place taken by far less efficient local application. Nitric acid suits a greenish, fetid, obstinate leucorrhoea; the presence of fig warts and condylomata will further indicate the remedy.

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Ashish Sharma

Ashish Sharma

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