Normal vagina flora varies with ambient pH, age, hormonal status, sexual activity, contraception, various medications, antibiotics and surgical interventions. The main microorganisms that make up this flora can be found in aerob and anaerobic facultatively, respectively (+) rod; lactobacilli (Döderlein bacilli), Bacteroides, Peptococci, Corinobacterium, S.epidermidis, Peptostreptotkok, group B and D Streptococci, E.coli and Eubacterium. As can be seen, there are many microorganisms in the normal vaginal flora, including Gardnerella vaginalis, Candida albicans and Trichomonas vaginalis. However, the absence of Neisseria gonorrhoeae, Herpes simplex and HPV (Human Papiloma Virus) is remarkable.
Although the term "leukorrhea" means terminologically white discharge, today it is used for almost every kind and color discharge. The most common cause of leukorrhea is infectious vaginitis. Here, the most frequent factors are in order of frequency; Gardnerella vaginalis are Candidae, Trichomonas vaginalis and gonococcus. Apart from that, excessive vaginal discharge may occur in the vagina due to foreign body, viral agents (Herpesvirus, Human papilloma virus), atrophic vaginitis and parasite. Why is cervicitis in 20-25% of patients with vaginal discharge (cervical infection). N.gonorrhoeae, C.trachomatis, Herpes simplex, T.vaginalis may be active in infectious cervicitis, respectively.
In addition to these, vaginists, especially those seen in prepubertal and postmenopausal period and which can not be identified as a specific factor, are called nonspecific vaginitis.
In addition, excessive vaginal discharge can be observed in cases such as ovulation (increase in the rate of water in the cervical mucus at the time of ovulation), coitus, vaginal adenosis, cervical ectopia, eversion and anovulation (due to the constant estrogen effect, the increase in the amount of cervical mucus).
The most important step in approaching a patient presenting with discharge is undoubtedly the correct diagnosis. This is especially important in recurrent vaginitis. The characteristics of the three main vaginitis agents are shown below.