Harvard Women's Health Watch

By the way, doctor: What can I do about chronic leukorrhea?

Q. I'm a healthy 62-year-old. In the past three months, I've developed a vaginal discharge and discomfort. Tests for vaginal infections have been negative. I've tried douching and sitz baths. I started using vaginal estrogen (Premarin) cream about two months ago. Nothing helps. I'd appreciate your thoughts on this problem, which my gynecologist calls "chronic leukorrhea."

A. Many women have problems with vaginal discharge or pain or irritation of the vulva and vagina. These difficulties can occur during the reproductive years, through the menopausal transition, and beyond. Diagnosing and treating these conditions can be challenging, for several reasons. Some clinicians aren't well enough educated about this important area of woman's health, and even medical experts don't know enough about the normal and abnormal vulva and vagina. Also, patients may be unwilling to bring up vulvar or vaginal symptoms or hygiene.

The most common cause of vaginal discharge and pain in a postmenopausal woman is atrophic vaginitis. This condition develops when vaginal tissues become dry, and then thin, inflexible, and inflamed because of estrogen deficiency. Symptoms usually respond to estrogen in the form of a vaginal cream, tablet, or ring. Estrogen can take two to three months to work, and I wonder if you've seen any improvement by now. Douching is usually not recommended, since it can disrupt the growth of normal vaginal bacteria.

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