Discharge in women at menopause: bloody, odorous, brown, yellow, white, watery, abundant

Due to the decrease in the synthesis of sex hormones and follicular atresia of the ovaries, which are characteristic of the period of fading reproductive function in women, vaginal discharge during menopause is reduced to a minimum.

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Causes menopausal discharge

Due to physiologically conditioned atrophy of the vaginal mucosa in menopause, even the natural release of vaginal secretions, which protect the mucosa from infection, stops. So the presence of any discharge during menopause indicates some pathology and is a reason to consult a gynecologist to avoid the development of inflammatory and oncological diseases of the pelvic organs, which have serious consequences and dangerous complications.

Depending on the intensity and volume, a distinction is made between profuse discharge during menopause and scanty or, as they are commonly called, spotting discharge during menopause.

So, what could be the reasons for discharge during menopause?

Minor watery discharge mixed with mucus (uncolored or yellowish) appears with vaginal dysbiosis and atrophic vaginitis (colpitis). Other symptoms of these conditions include itching in the genital area and burning during urination.

Bloody discharge during menopause may occur when:

• inflammation of the vaginal mucosa (vaginitis);
• inflammation of the cervix (cervicitis);
• cervical dysplasia;
• polyps of the cervix or the uterus itself;
• ovarian cysts during menopause;
• primary or metastatic vaginal cancer (which causes heavy vaginal discharge during menopause);
• cervical cancer;
• endometriosis during menopause;
• cancer of the mucous membrane (endometrium) of the uterus.

Brown spotting during menopause is a possible first sign of endometrial hyperplasia or fibrous neoplasms of the uterus.

Pink discharge during menopause, which doctors call serous discharge during menopause, indicates the release of lymphatic fluid from small vessels of the intravisceral lymphatic system of the uterus when they are damaged. Serous exudate acquires a pink tint due to the content of erythrocytes, which get into it from damaged tissues. Discharge of this nature - with painful sensations in the lower abdomen and in the small pelvis - is noted with severe dysplasia of the cervix, a benign tumor - uterine fibroids during menopause; uterine polyps and malignant tumors of the uterus (including metastatic). It should be borne in mind that the pathogenesis of these diseases of the female genital tract may be associated not only with the presence of a hereditary predisposition, but also with the irrational use of hormonal drugs, often used recently to reduce the unpleasant manifestations of the onset of menopause.

Mucous white discharge during menopause (especially foamy, with an unpleasant odor) is a symptom of damage to the genitals by Chlamydia trachomatis and the development of a sexually transmitted infectious disease such as chlamydia.

Thick (with an admixture of purulent exudate) white discharge during menopause, accompanied by itching in the vestibule of the vagina, burning and pain in the urethra, appear with gonorrhea. And with bacterial and trichomonas vaginitis, purulent cervicitis and endocervicitis (an inflammatory process in the cervical canal), mucopurulent yellow discharge is observed during menopause. Also, such discharge is one of the symptoms of cervical erosion with the addition of infection - staphylococci, streptococci, ureaplasma or mycoplasma.

When profuse discharge during menopause resembles cottage cheese and has a characteristic sour smell, and is accompanied by symptoms such as severe irritation and itching of the genitals, burning during urination, then this is the well-known fungal disease candidiasis (thrush).

In addition to vaginal discharge, menopause may also cause breast discharge (usually when pressing on the nipples). Mammologists associate this with diffuse changes in the parenchyma of the mammary glands, in particular, with periductal fibroadenoma or ligamentous fibrosis. With these mastopathies, painless seals of various sizes and locations form in the breast. See - Fibrosis of the mammary gland.

Colorless discharge from the nipple may appear with a lipoma of the mammary glands, that is, an involutionary replacement of glandular tissue with fatty tissue.

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Diagnostics menopausal discharge

Diagnosis of discharge during menopause begins with anamnesis and recording of the patient's complaints. Then a gynecological examination is carried out, and a mammologist conducts a palpation examination of the mammary glands.

The main tests consist of:

• general and biochemical blood tests;
• blood test for pathogens of STDs;
• blood test for estradiol, testosterone and other hormones;
• analysis for CA125 (ovarian tumor marker);
• vaginal smear for bacterial microflora;
• pap test (Papanicolaou smear from the cervix);
• smear for the presence of HPV (human papillomavirus);
• cervical (or uterine) biopsy.

Standard instrumental diagnostics include: vaginal endoscopy (colposcopy); transvaginal ultrasonography (ultrasound); mammography (x-ray of the mammary glands) and ultrasound of the mammary glands.

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Differential diagnosis

Based on the results of examination, laboratory tests and instrumental examination, differential diagnostics are carried out and the exact cause of discharge during menopause is determined.

Treatment menopausal discharge

What is the treatment of menopausal discharge aimed at? At the cause of their appearance. This means that inflammation should be treated and anti-inflammatory drugs should be used. Although in some cases, drugs containing analogues of female sex hormones are used.

For example, in case of vaginal mucosa atrophy, vaginal suppositories Ovestin (Estriol) can be prescribed - one suppository per day. However, this remedy is contraindicated in case of bloody discharge and malignant neoplasms. In addition, its side effects can increase irritation and burning of the vaginal mucosa.

For vaginitis and cervicitis, the following are used: bactericidal anti-inflammatory suppositories Betadine, Hexicon, Chlorhexidine; vaginal suppositories and tablets Metronidazole; phytosuppositories Eucalimin (with eucalyptus extract) and Vagikal (with calendula extract); vaginal gelatin capsules with antibiotics Polygynax.

An effective remedy for vaginal candidiasis is the antifungal suppositories Nystatin and Pimafucin); the antifungal agent Fluconazole (Flucostat, Diflucan) is prescribed orally - 1-2 capsules (once a day).

If the HPV test results show the presence of papillomavirus, the best antiviral vaginal suppositories are Viferon or Genferon.

More useful information in the material - Suppositories for inflammation in gynecology

In cases of abnormal discharge during menopause, homeopathy can help.

If there is yellow discharge during menopause, the remedy Argentum nitricum is recommended, and when the discharge is bloody - Kreosotum and Sulfuricum acidum.

For discharge caused by cervical dysplasia, homeopathic remedies Thuja occidentalis or Beta-Mannan are used.

Surgical treatment involves cauterization of cervical erosion, electrical conization of damaged cervical tissue in case of dysplasia, as well as surgical methods of treating malignant tumors (in combination with radiation and chemotherapy).

In case of significant fibrous formations and cysts of the mammary glands, surgical intervention is performed according to indications - lumpectomy or nucleation Treatment of discharge from the breast - more details in the article Fibroadenoma of the mammary gland

Many gynecologists consider folk treatment (tampons with honey or olive oil, sitz baths and douching with various decoctions) to be ineffective, and in cases associated with malignant processes, delaying timely medical attention. Nevertheless, herbal treatment is widely practiced in everyday life. For example, see - Folk treatment of cervical erosion

Prevention

Considering the polyetiological nature of discharge during menopause, its prevention consists of preventing STIs and promptly seeking medical help.

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Forecast

And the prognosis depends on the cause of pathological discharge during menopause. And, naturally, it will be different, for example, with thrush and cervical cancer.

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