Sexually Transmitted Diseases (STD) are diseases contracted sexually after contact with bodily fluids like blood, semen and vaginal fluids. People with STDS may not present with any symptoms and some may present with genital discharge, itch, growth at genital area and ulcers.
Genital discharge refers to discharge from the penis in male and discharge from the vaginal in females. It can be due to sexually transmitted infection in some cases and it can be non-sexually transmitted causes. Treatment is dependent on the diagnosis. We will discuss all the causes of male and female genital discharges as well as their treatments in this blog.
To aid the attending doctor to clinch the correct diagnosis, patients will be ask a comprehensive set of questions to identify the possible causes. The questions that will be asked in history taking include:
1.History of discharge: When does it start and how long has it been? As for the discharge, what is the color, odor and which site (vagina, penile area, pharynx, rectum and eye) does it involve? Has the patient has similar episodes before and what’s the diagnosis then? Are there other systemic symptoms such as fever, eye symptoms and joint pain?
2.Sexual History: This is important especially to determine if the genital discharge is due to sexually transmitted diseases. It is important to enquire about the patient’s sexual orientation, number of partners involved, whether they engage in commercial sex workers also venue for meeting partners. Enquiries on whether their partners have any symptoms or signs as well as if their partners have any sexually transmitted disease are important history.
3.Medical history: Personal medical history of HIV, diabetes and skin conditions are important as they may predispose patients to genital discharge. Medications history, menstrual history and obstetrics history are also important questions to be asked.
4.Travel History: The geographical area whereby the sexual intercourse occurs is important as some countries are associated with certain conditions.
After the doctor has taken the above comprehensive history, the next step is the clinical examination of the patient. This involves:
1.Genital Examination: The Genitalia and peri-anal area will be examined for any rash, ulcer, growth and discharge.
2.Lesion Examination: Any abnormality found at the genitalia will then be examined to characterize its appearance, color, consistency and size involved. The discharge will be examined for its color, odor and characteristics.
3.Lymph nodes: The groin lymph nodes will be examined for any lymph node enlargement, tenderness and how big are they.
4.General Examination: check the pharynx, eyes and joints as certain conditions like Reiter syndrome may involve them.
Causes of genital discharge in males
1.Sexually transmitted disease :
2.Non-sexually transmitted causes: urinary tract infections, post instrumentation during surgery, phimosis or strictures.
Each individual condition will be discussed further in the other pages.
Causes of vaginal discharge in women
1.Sexually transmitted diseases : Gonorrhoea, Chlamydia trachomatis, Trichomoniasis, herpes Simplex Virus.
2.Physiological discharge: Commonest cause as part of normal physiology during mid-menstrual cycle.
3.Non-sexually transmitted causes: Bacterial vaginosis, Candidiasis.
4.Others: Trauma post sex or instrumentation post-surgery, pelvic inflammatory disease, atrophic vaginitis (post-menopausal), forgotten tampon or foreign body or IUCD and female genitalia cancers.