One of the most frequently experienced medical symptoms of girls and women is abnormal vaginal discharge. It can be pretty scary if you don’t know what is causing it. Below is a list of the major causes of vaginal discharge along with the specific characteristics of the discharge that can help distinguish it from other causes.

There can also be an increase in the amount of vaginal discharge that is perfectly normal. Normal vaginal discharge is usually clear or milky and doesn't smell bad. Possible causes for an increase in the amount of normal vaginal discharge include emotional stress, ovulation, breastfeeding, and sexual excitement.

The Top 10 causes of abnormal vaginal discharge are:

• Bacterial vaginosis (BV)
  The most common cause of abnormal vaginal discharge, BV occurs when bacteria that normally live in the vagina overgrow, causing a grey discharge and fishy odor that tend to worsen after sexual intercourse. You may also experience itching or burning and a slight redness and swelling of the vagina or vulva. BV is not sexually transmitted and can be treated with antibiotics.
  
  
• Vaginal yeast infection
  Yeast is a fungus that can normally be found in very small amounts in a healthy vagina. If the yeast overgrows, it can cause a yeast infection, which is the second most common cause of abnormal vaginal discharge. Yeast infections may cause a white, cottage cheese-like discharge along with an intense itching sensation, although not everyone with a yeast infection will have the discharge. There may also be swelling around the vulva and sexual intercourse is often painful. The discharge associated with a yeast infection does not usually smell bad; at worst it may smell faintly starchy. Yeast infections are more common in women using antibiotics, who are pregnant, have diabetes, or stay hot and sweaty for long periods. Yeast infections can be treated with antifungal medication medicine you put into your vagina, or with oral medicine.
  
  
• Trichomoniasis
  Trichomoniasis is an infection caused by the bacterium Trichomonas vaginalis. It causes copious, thin, bubbly discharge that is yellowish or greenish in color. It is usually associated with an unpleasant odor and pain and itching during urination. Trichomoniasis is often most apparent after your period. You can be infected but have no signs for a long time. Trichomoniasis is usually contracted through unprotected sex with someone who is infected. It can be treated with oral antibiotics.
  
  
• Chlamydia
  Chlamydia is the most common sexually transmitted disease (STD) in the United States and is caused by the bacterium, Chlamydia trachomatis. Chlamydia often causes no symptoms, but if untreated, may cause damage to the reproductive organs. The vaginal discharge sometimes associated with Chlamydia is milky or yellow and mucus-like with a mild but unpleasant odor. Other symptoms may include painful urination, lower abdominal pain, and painful sexual intercourse. Chlamydia is easily treatable with antibiotics.
  
  
• Gonorrhea
  Gonorrhea is a sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the female reproductive tract. Most women who are infected have no symptoms. If symptoms do occur, they may include a cloudy, yellow or green, pus-like vaginal discharge along with a burning sensation when urinating, persistent lower abdominal pain, and spotting between periods. Complications of untreated gonorrhea include pelvic inflammatory disease and sterility. Most cases of gonorrhea can be treated with common oral antibiotics.
  
  
• Genital herpes
  A recurrent outbreak of genital herpes (i.e. not the very first herpes outbreak you experience) may be accompanied by a watery vaginal discharge. Sometimes herpes sores may not be visible in women, so a change in discharge may be the only clue. Often it will be accompanied by itching and burning, pain when urinating, and the presence of oozing blisters.
  
  
• Forgotten tampon or foreign body
  If a foreign body is left in the vagina, it will cause a foul-smelling black discharge. This can become dangerous if the infection spreads to the body or blood causing toxic shock syndrome or sepsis.
  
  
• Infected IUD
  An infected intrauterine device (IUD) may cause a pus-like cervical discharge along with mild uterine tenderness. Removal of the device should stop the discharge and the pain.
  
  
• Atrophic vaginitis
  After menopause, levels of estrogen change dramatically and this can cause changes in vaginal tissues called atrophic vaginitis. A thin, watery discharge, sometimes blood-tinged, may sometimes occur, along with inflammation of the vagina and thinning and shrinking of the vaginal tissues. It only occurs in women who are post-menopausal or whose ovaries have been surgically removed. Symptoms may be aleviated with the use of topical estrogen creams.
  
  
• Cervical or vaginal cancer
  Cancers of the lower reproductive tract in women may rarely be the cause of excess vaginal discharge. Early symptoms of cancer may include a continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling.

For more information about sexually transmitted diseases in women or about women's health, join the Healia Health Community for STDs or the Healia Health Community for Women's Health. To learn more, read the Healia Health Guide to Chlamydia or the Healia Health Guide to Genital Herpes.

<sub>Sources: National Library of Medicine, MedlinePlus Medical Encylopedia, Vaginal Discharge, Updated 8/07. http://www.nlm.nih.gov/medlineplus/ency/article/001345.htm
American Academy of Family Physicians, Vaginal Dischage: Changes That may be Signs of a Problem, Updated 1/08. http://familydoctor.org/online/famdocen/home/women/reproductive/vaginal/194.html

Photo: d'n'c, Flickr, Creative Commons</sub>

In its annual report "Sexually Transmitted Disease Surveillance, 2007," the CDC finds that sexually transmitted diseases (STDs) are on the rise in the U.S. In addition, the CDC points out that these diseases continue to take a disproportionately heavy toll on women and racial minorities.

The report finds that the number of cases of the most common STD chlamydia climbed to an all-time high of more than 1.1 million in 2007, equal to a rate of 370 cases per 100,000 people, up 7.5 percent from the previous year. While this increase is concerning, CDC researchers note that the increase may be at least partially explained by increased testing due to federal guidelines that recommend STD screening  for sexually active women age 25 and under. The percentage of young women being tested for the infection rose by more than ten percent between 2003 and 2007.

On the other hand, the number of reported cases still vastly underestimates the true number of people infected with chlamydia each year; according to experts, the actual number of cases may be closer to 3 million. The number of cases of gonorrhea held steady from 2006 to 2007 at around 350,000 cases, but as with chlamydia, experts believe the true number of cases may be much higher.

The reason so many cases of gonorrhea and chlamydia go unreported is that they often have no obvious symptoms, but they can lead to complications if left untreated. While both chlamydia and gonorrhea are easily treatable with antibiotics, up to 40 percent of women with untreated gonorrhea or chlamydia infections may develop pelvic inflammatory disease, a condition that causes 50,000 women to become infertile each year. Untreated chlamydia or gonorrhea can also cause ectopic pregnancy, chronic pelvic pain, and other serious health problems.

What’s more, while these diseases can infect men, women make up an estimated three-quarters of all chlamydia cases and they have a higher risk of getting gonorrhea than men. Infected men may also show no symptoms of an infection and may unknowingly pass the diseases on to their sexual partners.

According to the report, syphilis, a disease once on the verge of being eradicated, is making a comeback, with the number of U.S. cases up 15 percent from 2006 to 2007. While the overall number of syphilis infections remains low (around 12,000 cases in 2007), gay and bisexual men represent 65 percent of those cases according to the CDC. Syphilis can be treated easily in the early stages, but if left untreated it can progress to cause serious, even fatal complications such as strokes.

Huge racial disparities also exist in STD cases. While African Americans represent around 12 percent of the U.S. population, in 2007 blacks accounted for about 70 percent of reported gonorrhea cases and almost half of all chlamydia and syphilis cases (48 percent and 46 percent respectively). According to the CDC, this is likely related to the high rate of poverty among blacks, as studies have shown one of the most important social determinants of sexual health to be socioeconomic status.

When they do occur, symptoms of gonorrhea in men include a burning sensation when urinating, or a white, yellow, or green discharge from the penis, sometimes accompanied by painful or swollen testicles. chlamydia symptoms are similar: some men may also feel a burning during urination or have a discharge. In women, in the rare cases in which symptoms of gonorrhea do occur they are mild and may include painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. chlamydia symptoms in women may cause pain in their lower abdomen or notice a burning sensation or a pus-like discharge during urination.

The CDC recommends annual chlamydia screening for all sexually active women under 26 years old, and supports U.S. Preventive Services Task Force recommendations to screen high-risk, sexually active women for gonorrhea. For more information about STDs, visit the CDCs STD Web site. IF you have questions about STDs but are too shy to ask them in person, join the Healia Health Community for STDs and ask the community, or ask the experts on Healia Health Communities.


_{Photo: trec_lit, Flickr, Creative Commons}

The Centers for Disease Control and Prevention (CDC) recently compiled a list of the top states with the highest reported cases of AIDS. Although most cases of HIV/AIDS occur outside the United States, more than a million people were living with AIDS in the U.S. as of 2003. The CDC estimates that as many as 24-27% of people infected with HIV were unaware of their infection. CDC statistics on HIV and AIDS in the U.S. report data by age, race, state, and transmission category.

The top 10 states with most reported cases of HIV and/or AIDS in 2006 are:

1. New York (5,495 reported cases)
2. Florida (4,932)
3. California (3,960)
4. Texas (2,998)
5. Pennsylvania (1,893)
6. Maryland (1,626)
7. Georgia (1,605)
8. Illinois (1,382)
9. North Carolina (1,229)
10. New Jersey (1,065)

Discuss AIDS with other people in the HIV/AIDS community in Healia Communities.


_{Data source: CDC HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States and Dependent Areas, 2006.http://www.cdc.gov/hiv/topics/surveillance/basic.htm#area}

_{Photo: Alex Castella,Flickr, Creative Commons}

Today is World AIDS Day, a day when individuals and organizations from around the world come together to build awareness of the global AIDS epidemic. This year marks the 20th anniversary of World AIDS Day, which was inaugurated in 1988 by the World Health Organization (WHO).

This year, both President Bush and President-elect Obama commented on the progress made in the battle against HIV/AIDS and the importance of continued action to combat HIV infection in developing countries. An estimated 33 million people are infected with HIV worldwide and 2 million die of AIDS each year.

Bush highlighted recent gains made in the treatment of people who are infected with HIV, the virus that causes AIDS. In 2003, President Bush launched the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) to combat global HIV/AIDS, pledging $15 billion to treat 2 million people infected with HIV worldwide over five years. Today Bush announced that the goal had been reached a few months ahead of schedule, highlighting a bright spot of his tenure before he leaves office next month. In July, Bush signed a new law expanding PEPFAR, committing up to $48 billion more over five years to treat and prevent AIDS, tuberculosis, and malaria in sub-Saharan Africa and elsewhere

Obama commended Bush on efforts to fight world AIDS and pledged he would continue the PEPFAR program when he takes office, adding that he would also embark on new efforts to address the disease in the United States as well. Obama noted that AIDS is a very real problem in the United States and that the country needs to recommit itself to addressing the domestic AIDS crisis with a strong national strategy of education, prevention, and treatment.

The U.S. Centers for Disease Control and Prevention (CDC) has estimated that about 1.1 million people in the United States currently are infected with HIV. The CDC also said more people are becoming infected each year than previously estimated, with 56,300 new HIV infections in the U.S. in 2006. Previous estimates put the number of new infections at about 40,000 a year.

The best way to prevent HIV infections is to always practice safe sex, such as using a latex condom. Health experts recommend getting tested for HIV if you have never been tested, as well as after engaging in any risky behaviors. Knowing your HIV status can help keep you from unknowingly spreading the disease and, if you are HIV positive, allows you to begin treatment with medications to prevent the development of AIDS for many years. For more about how you can help combat AIDS in the U.S. and worldwide, visit the World AIDS Campaign. For more information about HIV and AIDS, join the conversation at the Healia Health Community for HIV/AIDS.

_{Photo: ivalladt, Flickr, Creative Commons}

The HPV vaccine known as Gardasil may not be just for females anymore. A recent study shows that the vaccine, currently approved to prevent genital warts and cervical cancer in females, also prevents genital warts in males.

The phase III study involved nearly 4000 males aged 16 to 26 from several countries. The researchers report that Gardasil was about 89% effective in preventing genital warts and that it also appeared to prevent a precancerous condition called penile/perineal/perianal intraepithelial neoplasia or PIN.

The vaccine targets four types of the Human Papillomavirus, two that cause most cases of genital warts in both males and females, and two that are responsible for about 70 percent of cervical cancers. One of the major arguments for vaccinating males against HPV is that it could prevent the spread of the virus, potentially eliminating many of the nearly 12,000 cases of cervical cancer diagnosed in U.S. women each year. However, since the vaccine is not cheap – about $375 for three doses given over six months – many males might not want to be immunized if the only benefit to them is genital wart prevention.

But the vaccine might also have a direct cancer benefit for males. Even though cervical cancer makes up nearly 80% of cancers caused by HPV, the virus also causes penile and anal cancers in men. Additionally, recent studies suggest that HPV now causes as many cases of oral and throat cancer as tobacco and alcohol do. Making Gardasil available to boys and young men might also prevent many cases of these cancers in men.

The FDA is awaiting further information from Merck, the makers of Gardasil, before approving the vaccine for use in males. To find out more, see our earlier blog post Gardasil: an overwiev or stop by the Healia Health Community for HPV or the Healia Health Community on Cervical Cancer.

_{Photo: NathanF, Flickr, Creative Commons}

Doctors in Germany say that an HIV-positive patient given a bone marrow transplant appears to have been cured of his HIV infection. The patient, a 42-year-old American man living in Germany, received the transplant to treat leukemia and nearly two years later shows no sign of either HIV infection or cancer. The doctors stressed that this may be an unusual case and further investigation is needed to confirm the results.

While bone marrow transplants have been explored as a way to treat HIV infections in the past, this time the researchers used a new twist. They sought out a bone marrow donor who had a rare genetic mutation that seems to make people resistant to HIV infection. About one in 1000 Europeans and Americans inherits the Delta 32 mutation from both parents, which turns off a protein called CCR5 that the HIV virus needs to infect cells.

A bone marrow transplant involves administering high doses of radiation to kill off the patient’s own infected bone marrow cells and disable the immune system, then replacing it with donor bone marrow. The treatment is very risky and can be fatal as often as 20 to 30 percent of the time. As a result, bone marrow transplants are unlikely to become first-line treatments for HIV infections. However, the finding that it may be possible to induce HIV resistance by mutating CCR5 opens the door for similar studies using techniques such as gene therapy.

To find out more about HIV infection, visit the Healia Health Community for HIV/AIDS.

_{Photo: C. Goldsmith, Wikipedia, Creative Commons}