Yellow discharge on the second day after menstruation

Vaginitis, or inflammation of the vagina, is a group of conditions that cause vulvovaginal symptoms such as itching, burning, irritation, and abnormal discharge. The vagina of a normal healthy woman has a natural defense function against the invasion of pathogens due to the characteristics of its anatomical tissue. For example, the closure of the vaginal opening, the close contact of the anterior and posterior walls of the vagina, the proliferation of vaginal epithelial cells and the keratinization of surface cells under the influence of estrogen, and the balance of vaginal acidity and alkalinity inhibit the reproduction of alkaline-adapted pathogens. The cervical mucus is alkaline. When the natural defense function of the vagina is destroyed, pathogens can easily invade and cause vaginal inflammation.

Under normal circumstances, aerobic bacteria and anaerobic bacteria live in the vagina, forming normal vaginal flora. If the ecological balance between the vagina and the bacterial flora is disrupted for any reason, conditional pathogens may also form. Common clinical conditions include: bacterial vaginosis (accounting for 22% to 50% of symptomatic women), candidal vaginitis (17% to 39%), Trichomonas vaginitis (4% to 35%), senile vaginitis, and vaginitis in young women. Generally, the drug treatment for vaginitis is mainly external use. Patients with pelvic inflammatory disease or recurrent vaginitis can take oral medications. If necessary, couples can be treated together. Note that long-term oral antibiotics may inhibit normal flora and cause secondary fungal infection. 1. The principle of treatment for bacterial vaginosis is to use anti-anaerobic drugs, mainly metronidazole, tinidazole, and clindamycin. Caution: Disulfiram-like reactions may occur with both oral and topical metronidazole. (1) Oral medication: Metronidazole is the first choice. (2) Local drug treatment. (3) Sexual partners do not require routine treatment.

2. Candidal vaginitis (1) Eliminate the cause: If you have diabetes, you should be treated actively and stop using broad-spectrum antibiotics, estrogen and cortisol in time. Change your underwear frequently, and wash used underwear, basins, and towels with boiling water. (2) Topical medications: miconazole suppositories, clotrimazole suppositories, and nystatin suppositories. (3) Systemic medications (for patients with recurrent attacks or who cannot take vaginal medication): fluconazole, itraconazole, and ketoconazole. Fluconazole has a lower risk of hepatotoxicity and should be used instead of ketoconazole. (4) Sexual partners should be tested and treated for Candida albicans. (5) Pregnancy complicated by Candida vaginitis is mainly treated with local treatment, and oral azole drugs are contraindicated.

3. Trichomonas vaginitis (1) Local vaginal medication: Metronidazole vaginal effervescent tablets or 0.75% metronidazole gel, 1% lactic acid or 0.5% acetic acid solution flushing can relieve symptoms. (2) Systemic medication: Metronidazole can be used for initial treatment, but the medication should be discontinued if side effects are detected. Do not drink alcohol during the use of metronidazole and within 24 hours of stopping the medication, and do not drink alcohol during the use of tinidazole and within 72 hours of stopping the medication. The efficacy and side effects of metronidazole and tinidazole are similar, including possible disulfiram-like reactions. Do not breastfeed while taking medication. (3) Sexual partners should receive treatment at the same time and avoid unprotected sexual intercourse before recovery. 4. The principle of treatment for senile vaginitis is to supplement estrogen, enhance vaginal immunity and inhibit bacterial growth. 5. The principles of treatment for vaginitis in young girls are to keep the vulva clean, treat symptoms, and select antibiotics targeting the pathogens.

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