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Good Day, My Wife, 33 Year Old Women 165 And
Question: Good day, My wife, 33 year old women 165 and 67 kg, without any chronic diseases or diagnozed sicknesses, with reglar menstrual cycles has had a phenomenan regarding a discharge during the night from her vaginal region. She felt light uncomfort yesterday but she thought it was indigestion (and this might still be true). She has undergone a complete gynecological exam a month ago and everything was fine. This discharge occured on the 20th day of her menstrual cycle. Attached to this letter I am sending you the picture of the discharge. She is very worried about it and hence I wanted to check the following: 1. Do we need to worry about this discharge, could it be something serious? 2. Should we go to the emergency service? We cannot go to a regular gynecologist because she was examined a month ago. 3. should we take any further steps? Thank you in advance, Mislav Gorupec
Brief Answer:
Detailed below.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
I have gone through the query and also the attached file. I need a little more information.
1. Did this discharge occur after an intercourse?
2. Is she experiencing any symptoms of infection like itching, burning sensation or pain while passing urine, excessive white discharge etc. these days?
3. Is she on any medication?
4. Does she use tampons?
5. Was any investigation done during the recent check up? If so, please attach reports.
The discharge seems to be a mucoid bloody discharge with no obvious casts or tissue. If she is on contraception, breakthrough spotting is a possibility. Even other wise, transient hormone imbalance can cause breakthrough bleeding. This can occur due to sudden weight changes, stress, infections and use of certain medications. Local conditions like polyps and cysts are another cause, though rare in this age.
Though this is not an emergency situation, I would still ask you to get a clinical evaluation to help plan further management.
Hope you find this information helpful. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
I have gone through the query and also the attached file. I need a little more information.
1. Did this discharge occur after an intercourse?
2. Is she experiencing any symptoms of infection like itching, burning sensation or pain while passing urine, excessive white discharge etc. these days?
3. Is she on any medication?
4. Does she use tampons?
5. Was any investigation done during the recent check up? If so, please attach reports.
The discharge seems to be a mucoid bloody discharge with no obvious casts or tissue. If she is on contraception, breakthrough spotting is a possibility. Even other wise, transient hormone imbalance can cause breakthrough bleeding. This can occur due to sudden weight changes, stress, infections and use of certain medications. Local conditions like polyps and cysts are another cause, though rare in this age.
Though this is not an emergency situation, I would still ask you to get a clinical evaluation to help plan further management.
Hope you find this information helpful. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Hello and thank you for your quick answer.
Below, please find the information You require.
1. The discharge did not occur during intercourse. There was no intercourse for at least 10 days prior to the incident. She had no white discharge during the day before, but she found traces of white and yellowish discharge on her underpants in the morning. This must have occurred during the night. While the discharge occurred during morning urination (or afterwards).
2. She is experiencing no infection symptoms which you described.
3. She is taking no medication at the time.
4. She does not use tampons.
I have uploaded tests results from her recent check ups. Papa tests were fine both times. She had high testosterone. TSH was not 4.35 (it was miswritten). THS was 2.
Some other information which You might find useful is the following:
- she was moderately constipated the day before. Maybe she was pushing hard to pass the bowels. Would this be relevant?
- two days prior (on Tuesday this week) was a national holiday and we went on a one day trip to the seaside. There she bathed in the sea. The beach was on an island so I presume the water could be considered cold. I remember that three years prior she had a discharge after swimming. Could this be connected?
Taking all this into regard, which course of action would You recommend? Should she visit a gynecologist? What are the best/worst scenarios for these kinds of symptoms? How soon should we react*. * I ask this because the waiting lists for appointments can be quite long, sometimes even for more than half a year. I would appreciate to know whether this is an urgent matter because in this case we would go to a private clinic. Even in those clinics it is a good idea to have some initial diagnose so that we may focus our efforts. Please advise.
Thank you in advance.
With regards,
Mislav Gorupec
Below, please find the information You require.
1. The discharge did not occur during intercourse. There was no intercourse for at least 10 days prior to the incident. She had no white discharge during the day before, but she found traces of white and yellowish discharge on her underpants in the morning. This must have occurred during the night. While the discharge occurred during morning urination (or afterwards).
2. She is experiencing no infection symptoms which you described.
3. She is taking no medication at the time.
4. She does not use tampons.
I have uploaded tests results from her recent check ups. Papa tests were fine both times. She had high testosterone. TSH was not 4.35 (it was miswritten). THS was 2.
Some other information which You might find useful is the following:
- she was moderately constipated the day before. Maybe she was pushing hard to pass the bowels. Would this be relevant?
- two days prior (on Tuesday this week) was a national holiday and we went on a one day trip to the seaside. There she bathed in the sea. The beach was on an island so I presume the water could be considered cold. I remember that three years prior she had a discharge after swimming. Could this be connected?
Taking all this into regard, which course of action would You recommend? Should she visit a gynecologist? What are the best/worst scenarios for these kinds of symptoms? How soon should we react*. * I ask this because the waiting lists for appointments can be quite long, sometimes even for more than half a year. I would appreciate to know whether this is an urgent matter because in this case we would go to a private clinic. Even in those clinics it is a good idea to have some initial diagnose so that we may focus our efforts. Please advise.
Thank you in advance.
With regards,
Mislav Gorupec
Brief Answer:
Possibility of infection exists. Clinical opinion is needed.
Detailed Answer:
Hello,
Thanks for writing back.
In the current scenario and given the need for waiting to get a specialist opinion, I would ask you to go for a proper evaluation as soon as possible.
As I mentioned earlier, this is not likely to be a serious situation but, the possibility of infection exists. Hence, examination is needed to plan further management.
It appears that she had vaginosis in the past after exposure to sea water and it is likely to be repeated.
Excessive straining while passing constipated stool does not cause vaginal bleeding unless there is a predisposing reason. In fact, anal bleeding is more likely in such situations owing to tears.
Urinary infection is another cause to be excluded as causing this spotting.
Hope I have answered your query. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Possibility of infection exists. Clinical opinion is needed.
Detailed Answer:
Hello,
Thanks for writing back.
In the current scenario and given the need for waiting to get a specialist opinion, I would ask you to go for a proper evaluation as soon as possible.
As I mentioned earlier, this is not likely to be a serious situation but, the possibility of infection exists. Hence, examination is needed to plan further management.
It appears that she had vaginosis in the past after exposure to sea water and it is likely to be repeated.
Excessive straining while passing constipated stool does not cause vaginal bleeding unless there is a predisposing reason. In fact, anal bleeding is more likely in such situations owing to tears.
Urinary infection is another cause to be excluded as causing this spotting.
Hope I have answered your query. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Thank you for Your advice.
Please be so kind as to council me which tests should be made.
As I understood we should avoid ER, and it is possible that a gynecological exam will not be possible in operative time.
Hence, if we go to a private clinic, it would be beneficial for us to know which tests in precise should be undertaken (which exams).
Could you be so kind and explain me which examinations or tests are used to determine the possibility of infection.
Thank You in advance.
With regards,
Mislav Gorupec
Please be so kind as to council me which tests should be made.
As I understood we should avoid ER, and it is possible that a gynecological exam will not be possible in operative time.
Hence, if we go to a private clinic, it would be beneficial for us to know which tests in precise should be undertaken (which exams).
Could you be so kind and explain me which examinations or tests are used to determine the possibility of infection.
Thank You in advance.
With regards,
Mislav Gorupec
Brief Answer:
Detailed below.
Detailed Answer:
Hello,
Thanks for writing again.
I would suggest a proper gynecological examination which includes local examination, speculum examination and per vaginal examination. Routine urinalysis and vaginal swab should be able to detect any infection. If needed, a sonogram of the pelvis, preferably in the trans-vaginal route, can be asked for.
Please ask her to avoid any vaginal douche.
Hope this helps.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hello,
Thanks for writing again.
I would suggest a proper gynecological examination which includes local examination, speculum examination and per vaginal examination. Routine urinalysis and vaginal swab should be able to detect any infection. If needed, a sonogram of the pelvis, preferably in the trans-vaginal route, can be asked for.
Please ask her to avoid any vaginal douche.
Hope this helps.
regards,
Shanti.V.
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Above answer was peer-reviewed by :
Dr. Yogesh D
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