Itching and clear discharge
Last reviewed: 07.06.2024
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Clear discharge produced by the cells of the vaginal walls and glands of the cervix are physiological, but if itching and clear discharge are combined, it may be a sign of a pathological condition or disease.
Causes of the itching and clear discharge
Vaginal discharge can vary in consistency, color, odor, and associated symptoms.
The main causes of itching and burning with clear as well as white or gray discharge with an unpleasant odor are attributed to bacterial vaginosis, although it can be asymptomatic in 50-65% of cases. [1], [2]
In the initial stage of ureaplasma urealyticum caused by the bacteria Ureaplasma urealyticum, the scanty vaginal discharge is transparent, odorless, but accompanied by discomfort during urination and painful sensations in the pubic area. If the inflammation increases, the discharge becomes yellow and even greenish - with an unpleasant odor. [3]
Also transparent discharge with itching is often noted as the first signs of vaginal dysbacteriosis (including after prolonged use of antibiotics, in patients with diabetes mellitus or foci of chronic infection). [4]
Abundant transparent discharge and itching appear in case of increased sensitization of the body, in particular, in allergic vulvitis, which develops as a reaction to detergents, sanitary pads, ingredients of vaginal contraceptives, chemical contraceptives, condom material, etc.
In postmenopause, the etiology of such discharge is due to the gradual atrophy of the vaginal wall, which leads to atrophic vaginitis - with slight clear discharge and vulvar itching. [5]
At the beginning of thrush - urogenital candidiasis - appear transparent discharge with white lumps and itching; further, due to the increased growth of its causative agent, the discharge quickly transforms into thick - white in color and curd-like. [6]
Risk factors
Factors predisposing to increased activity of opportunistic and pathogenic bacteria of the vagina with the appearance of itching and clear discharge are considered to be: uncontrolled use of antibiotics; alkaline pH of the vagina (˂4.3); insufficient hygiene; abuse of spritzing; diabetes mellitus; weakened immunity.
Pathogenesis
The pathogenesis of bacterial vaginosis is due to bacterial infection (most often E. Coli, strepto- and staphylococci), and urogenital candidiasis - yeast-like fungus Candida, which are activated when the vaginal environment is not acidic enough - often due to the same dysbacteriosis, i.e. Lack of lactobacilli.
The mechanism of age-related atrophy of the vaginal wall after menopause is triggered when the levels of female sex hormones, particularly estrogen, decrease.
Transparent discharge without odor or itching
Such discharge should be considered separately, as they do not belong to pathological. Any gynecologist will confirm that in women of childbearing age, clear, odorless and itchless vaginal discharge is a normal physiological phenomenon, indicating the normal process of production by the glands of the cervix and the epithelium of the vaginal walls of a protective slightly acidic mucous secretion that maintains a healthy pH balance and protects the cervical canal from infection.
Such secretions may have a faint sour odor due to the obligate vaginal microflora consisting of lactobacilli.
The amount of discharge depends on the phase of the menstrual cycle and is caused by sex hormones (estrogen), and can also change due to sexual activity, use of hormonal contraceptives or hormone replacement therapy.
Do not refer to pathological and thicker transparent discharge without odor and itching (resembling raw egg white), observed in the middle between cycles and indicating another ovulation, accompanied by an increase in the production of estrogen. And with the onset of the luteal phase of the cycle, when progesterone becomes the regulating hormone, the volume of discharge decreases due to a decrease in the synthesis of cervical secretion.
During pregnancy, depending on the term, clear vaginal discharge and cervical secretion can also be either liquid or thick. Read more - Protein discharge in pregnancy
Outside of pregnancy, an increase in the volume of discharge may be due to the presence of cervical ectopia, when the part of the cervix with the naboth glands (producing mucous secretion) is located closer, and the mucus largely enters the vagina rather than the cervical canal. [7]
However, it should be kept in mind that clear liquid discharge without odor and itching may be the earliest symptom of uterine body cancer, especially if bloody inclusions are present in the watery discharge after physical exertion. [8]
Diagnostics of the itching and clear discharge
Diagnosis begins with anamnesis, recording complaints and routine gynecologic examination.
Tests such as a vaginal smear, i.e. vaginal microflora analysis; bacterial examination and PCR for ureaplasma; general blood and urine tests are needed.
Instrumental diagnosis is most often limited to colposcopy.
On the basis of its results, as well as taking into account the nature of the microbiological composition of vaginal discharge is differential diagnosis, primarily with STDs.
Treatment of the itching and clear discharge
Correct diagnosis allows you to start adequate treatment. Thus, the main drugs used in bacterial vaginosis - systemic antibiotics Metronidazole (twice a day a tablet, duration of intake - seven days) or Clindamycin (prescribed in case of ineffectiveness of Metronidazole or recurrence of infection). Metronidazole is used in the form of vaginal gel, as well as, cream Vagicin or vaginal capsules with clindamycin Vagicline.
Ureaplasma also requires antibiotic therapy, more information - Antibiotics for ureaplasmosis. Vaginal suppositories are also used Genferon.
Antihistamines or itch creams are prescribed to relieve itching.
More information about medications in publications:
Urogenital candidiasis is used to treat urogenital candidiasis:
Vaginal suppositories can also be used for vaginal dysbiosis - probiotic suppositories such as Ginolact.
Complications and consequences
In the presence of bacterial vaginosis or ureaplasma, the spread of the infection higher up - into the uterine cavity - leads to inflammation of the mucous membrane of its wall (endometrium), while ureaplasma can affect the ovaries, fallopian tubes, as well as the urinary tract and bladder.
Cervical ectopia, also called pseudoerosion, can transform into cervical erosion or dysplasia and, in the cystic form, become an obstacle to pregnancy.
In addition, combing of itchy genitalia can be complicated by the accession of streptococcal infection with the development of inflammation.
Prevention
Doctors claim that the main prevention of all female genital problems is a healthy lifestyle, protected sex and personal hygiene. An important role is played by strengthening immunity by natural methods (proper nutrition) and periodic gynecological examinations.
Forecast
Treatment of infections and conditions leading to itching and clear discharge is most often successful, which means the prognosis is positive.
Literature used
Savelyeva, Baisova, Breusenko: Gynecology. Textbook. GEOTAR-Media, 2022
Artymuk N. V.; Belokrinitskaya T. Е. Clinical norms. Obstetrics and gynecology, 2019
Gynecology according to Williams, GEOTAR-Media, 2023