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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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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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