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Leukorrhea: Causes, Symptoms and Treatment

Leukorrhea refers to a whitish or yellowish vaginal discharge. It can be a normal physiological occurrence or a sign of infection.

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Things worth knowing about "Leukorrhea"

Leukorrhea refers to a whitish or yellowish vaginal discharge. It can be a normal physiological occurrence or a sign of infection.

What is Leukorrhea?

Leukorrhea (also spelled leucorrhea or leukorrhoea) is a medical term describing an increased whitish or yellowish discharge from the vagina. The word derives from Greek, meaning roughly white flow. A certain amount of vaginal discharge is entirely normal and serves as a natural self-cleaning mechanism of the vagina. However, changes in quantity, color, consistency, or odor may indicate an underlying condition requiring medical attention.

Causes

Leukorrhea can be divided into physiological (normal) and pathological (abnormal) forms:

Physiological Leukorrhea

Hormonal fluctuations during the menstrual cycle (e.g., around ovulation)
Pregnancy (increased discharge due to higher blood flow and hormone levels)
Sexual arousal
Puberty and menopause (hormonal changes)

Pathological Leukorrhea

Bacterial vaginosis: An imbalance in the vaginal bacterial flora; the most common cause of abnormal discharge
Yeast infection (vulvovaginal candidiasis): Infection with fungi, typically Candida albicans, causing thick, white, cottage-cheese-like discharge
Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis, often producing a yellow-green, frothy discharge
Chlamydia or other sexually transmitted infections (STIs)
Cervicitis: Inflammation of the cervix
Foreign body in the vagina (e.g., a forgotten tampon)
Hormonal disorders or genital tumors (rare causes)

Symptoms

Symptoms vary depending on the underlying cause:

White, yellow, green, or gray discharge
Unusual odor (e.g., a fishy smell typical of bacterial vaginosis)
Itching or burning in the vaginal area
Redness or swelling of the vulva
Pain during sexual intercourse or urination

Physiological discharge, by contrast, is typically clear to milky white, odorless, and does not cause discomfort.

Diagnosis

Diagnosis is made through a gynecological examination. The following steps are commonly used:

Medical history: Questions about symptoms, menstrual cycle, sexual behavior, and prior conditions
Speculum examination: Visual inspection of the vagina and cervix
pH measurement of vaginal secretions: Helps distinguish bacterial vaginosis from yeast infections
Microscopy and swab: Detection of pathogens such as bacteria, fungi, or parasites
PCR testing: For detecting STIs such as chlamydia or gonorrhea

Treatment

Treatment depends on the underlying cause:

Bacterial vaginosis: Antibiotics such as metronidazole or clindamycin (topical or oral)
Yeast infection: Antifungals such as clotrimazole (topical cream or suppository) or fluconazole (oral)
Trichomoniasis: Oral metronidazole; treatment of the sexual partner is also required
STIs (e.g., chlamydia): Antibiotic therapy such as azithromycin or doxycycline
Physiological leukorrhea: No medical treatment required

Prevention includes gentle intimate hygiene without harsh soaps and the consistent use of condoms to reduce the risk of STIs.

When to See a Doctor

Medical evaluation is recommended if the discharge has an unusual odor, changes in color, or is accompanied by itching, burning, or pain. Any new or unfamiliar vaginal discharge warrants attention. During pregnancy, any change in discharge should be assessed promptly by a healthcare provider.

References

Workowski KA et al. - Sexually Transmitted Infections Treatment Guidelines, Centers for Disease Control and Prevention (CDC), MMWR Recomm Rep. 2021;70(4):1-187
Sobel JD - Vulvovaginal candidosis, The Lancet. 2007;369(9577):1961-1971
World Health Organization (WHO) - Laboratory Diagnosis of Sexually Transmitted Infections, WHO Press, Geneva, 2013

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