What is the cause of the discharge and how can I do away with it?

Dr Flo, I am 23 years old and I have been having discharge from my private area since I started menstruating at age 12. I have tried treating it but it doesn’t disappear. Sometimes I have an ache around my navel, a very painful one, and sometimes I have abdominal pain. I also feel pain on the left side of my pelvis, just before my periods or after doing a lot of work which requires bending. However, these pains are not frequent. I had an ultrasound done, but nothing was found. The discharge is white and it doesn’t smell, but when exposed to water while I am taking a bath, it has an unpleasant smell. What is the cause of the discharge and how can I do away with it?

Nelly

Dear Nelly,

The glands in the vagina and cervix normally produce fluid that helps to keep the vagina moist and also washes away dead cells and bacteria, keeping you clean and infection-free. This fluid, or discharge, becomes noticeable at puberty, and changes in colour, amount and smell depending on the menstrual cycle and other hormonal changes like contraceptive use or pregnancy.

You will need to monitor yourself, so that you know what is normal for you throughout your cycle and any deviation from this in terms of colour, consistency or smell, and itching and/or pain, would be cause for concern.

Anything that changes the normal bacterial balance within the vagina can cause an abnormal discharge e.g. use of antibiotics, use of hormonal medication, diabetes, and using douches, bubble baths, and scented soaps. The discharge can also change if you have an infection e.g. yeast infection, trichomoniasis, other sexually transmitted infections or pelvic inflammatory disease. If the discharge is bloody, you also need to be screened for cervical cancer.

It would be advisable for you to see a doctor so that a sample of your discharge can be taken and analysed and a Pap smear done. If any infection or abnormality is found, you will be treated appropriately. If nothing abnormal is found, you will know that it’s just the normal discharge.

To avoid infections, keep the area clean, wipe from front to back after using the toilet, wear cotton underwear, avoid excessively tight underclothes like tights and bikers, and avoid scented soaps, feminine products and douches.

Pain in the lower abdomen before your periods is most likely due to ovulation, or due to the hormonal changes in the second half of the cycle, which disappears after your periods.

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Doc, help me get rid of  this chronic backache Dr Flo, I feel pain at the base of my spinal cord, at the pelvic region. I have always had this pain, and it never subsides. I can’t do jobs that require me to bend for long or that require me to exert myself or lift heavy items. What could this be and how can I manage it?

Clinton

Dear Clinton,
The lower back supports the upper body, and helps with movements of the lower part of the body. Because it gets a lot of mechanical stress and strain, it can easily get injured. It is made up of bones, joints, ligaments, muscles, inter-vertebral discs, nerves and the spinal cord. If any of these are injured in any way, you can get lower back pain. If the pain lasts for more than three months, it is called chronic lower back pain. It can be mechanical pain, that is, pain in the muscles, joints or ligaments that is triggered by movement, physical activity, posture or loading. It can also be radicular pain, which is the pain that develops when a nerve is compressed or inflamed, causing pain in the back and/or in the thighs and legs. The pain may also be due to problems with the discs, arthritis, or from infections and even tumours.

You need to have a MRI scan of the lower back done so that you can know the exact cause of the pain. You can use medication to reduce the pain and inflammation. You would also benefit from physiotherapy. Avoid working while bending or lifting heavy things. A lumbar support may also benefit you (it looks like a slimming belt and is sold in hospitals, pharmacies and in some supermarkets). Lastly, maintain good posture at all times.

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Dr Flo, I have swollen lymph nodes on the left side of my neck. Two years ago, I had a similar lump on the right side, but it disappeared after I sought medical attention and the doctor drained the abscess. What causes my lymph nodes to swell and which medication should I take?

Martin

Dear Martin,
Lymph nodes are part of the immune system. They have immune cells that help to filter disease organisms and any other abnormal cells from the lymphatic fluid, which is filtered from blood. The lymph nodes will usually “react” when they come into contact with any of these organisms or cells. This includes all kinds of infections and diseases, and even cancer. Usually, the lymph nodes in a particular region will react to a problem in that region, so if the lymph nodes in the neck are swollen, then there could be a problem in the neck, the teeth, the gums, the mouth, the throat, the nose, the ears or a skin infection. They can enlarge quite fast and even become painful. The lymph nodes themselves can also get infected.
If the swollen nodes are only in one area, or two areas near each other, and there are no other serious symptoms, then usually, they reduce in size, and may even disappear within a month. If there is a specific cause for the swelling e.g. an abscess, a throat infection, etc, treating the cause will usually lead to the lymph nodes shrinking. If the nodes are swollen for long, or in multiple sites in the body, you need to undergo tests to find the underlying cause. The lymph node will be excised in the laboratory to see what it has, and you will be treated based on what is found.
Unless there is an obvious cause e.g. tooth decay, throat infection, etc, it would not be advisable for you to buy medication over the counter to treat the enlarged nodes.

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