a week ago i started having discharge and i am really moody and i seem to start crying over the littlest thing

Question

i know that i am not getting ready to start my period only because that is not for another 2 1/2 weeks, i have never felt like this i mean i never cry and it seems like i just cry for no apparent reason i just want to know what is going on with me?

Answer 1

Take a test. However to get pregnant, you usually have to have sex two weeks before your period so I don't how you could be pregnant. And, you usually don't have emotional symptoms until you are about 7-8 weeks. PMS can come really early sometimes.

Answer 2

Ask the patient about itching, odor, color of discharge, painful intercourse, or spotting after intercourse.

Yeast causes intense itching with a cheesy, dry discharge.

Gardnerella causes a foul-smelling, thin white discharge.

Trichomonas gives irritation and frothy white discharge.

Foreign body (lost tampon) causes a foul-smelling black discharge.

Cervicitis causes a nondescript discharge with deep dyspareunia

Chlamydia may cause a purulent vaginal discharge, post-coital spotting, and deep dyspareunia.

Gonorrhea may cause a purulent vaginal discharge and deep dyspareunia.

Cervical ectropion causes a mucous, asymptomatic discharge.

Physical Exam
Inspect carefully for the presence of lesions, foreign bodies and odor. Palpate to determine cervical tenderness.

Yeast has a thick white cottage-cheese discharge and red vulva.

Gardnerella has a foul-smelling, thin discharge.

Trichomonas has a profuse, bubbly, frothy white discharge.

Foreign body is obvious and has a terrible odor.

Cervicitis has a mucopurulent cervical discharge and the cervix is tender to touch.

Chlamydia causes a friable cervix but often has no other findings.

Gonorrhea causes a mucopurulent cervical discharge and the cervix may be tender to touch.

Cervical ectropion looks like a non-tender, fiery-red, friable button of tissue surrounding the cervical os.

Infected/Rejected IUD demonstrates a mucopurulent cervical discharge in the presence of an IUD. The uterus is mildly tender.

Chancroid appears as an ulcer with irregular margins, dirty-gray necrotic base and tenderness.

Pelvic Exam Video

Pelvic Exam Variations Video



Laboratory
Obtain cultures for chlamydia, gonorrhea, and Strept. You may test the vaginal discharge in any of 4 different ways:

Wet Mount Video

Test the pH. If >5.0, this suggests Gardnerella.

Mix one drop of KOH with some of the discharge on a microscope slide. The release of a bad-smelling odor confirms Gardnerella.

Examine the KOH preparation under the microscope ("Wet Mount"). Multiple strands of thread-like hyphae confirm the presence of yeast.

Mix one drop of saline with some discharge ("Wet Mount"). Under the microscope, large (bigger than WBCs), moving micro-organisms with four flagella are trichomonads. Vaginal epithelial cells studded with coccoid bacteria are "clue cells" signifying Gardnerella.

Read more about how to perform a wet mount.

Treatment

In addition to specific treatment of any organism identified by culture or other test...

Any patient complaining of an itchy vaginal discharge should probably be treated with an antifungal agent (Monistat, Lotrimin, etc.) because of the high likelihood that yeast is present, and


Any patient complaining of a bad-smelling vaginal discharge should probably be treated with Flagyl (or other reasonable substitute) because of the high likelihood that Gardnerella is present.

Ectropion, Erosion or Eversion
This harmless condition is frequently mistaken for cervicitis.

Ectropion, erosion or eversion (all synonyms) occurs when the normal squamo-columnar junction is extended outward from the its; normal position at the opening of the cervix.

Grossly, the cervix has a red, friable ring of tissue around the os. Careful inspection with magnification (6-10x) will reveal that this red tissue is the normal tissue of the cervical canal, which has grown out onto the surface of the cervix.

Cervical ectropion is very common, particularly in younger women and those taking BCPs. It usually causes no symptoms and need not be treated. If it is symptomatic, producing a more or less constant, annoying, mucous discharge, cervical cauterization will usually eliminate the problem.

When faced with a fiery red button of tissue surrounding the cervical os, chlamydia culture (in high-risk populations) and Pap smear should be performed. If these are negative and the patient has no symptoms, this cervical ectropion should be ignored.

Cervicitis
Inflammation or irritation of the cervix is rarely the cause of significant morbidity. It is mainly a nuisance to the patient and a possible symptom of underlying disease (gonorrhea, chlamydia).

Some patients with cervicitis note a purulent vaginal discharge, deep dyspareunia, and spotting after intercourse, while others may be symptom-free. The cervix is red, slightly tender, bleeds easily, and a mucopurulent cervical discharge from the os is usually seen.

A Pap smear rules out malignancy. Chlamydia culture and gonorrhea culture (for gram negative diplococci) are routinely performed.

No treatment is necessary if the patient is asymptomatic, the Pap smear is normal, and cultures are negative. Antibiotics specific to the organism are temporarily effective and may be curative. Cervical cautery may be needed to achieve permanent cure.

Chlamydia
This sexually-transmitted disease is caused by "Chlamydia trachomatis". It very commonly locates in the cervical canal although it can spread to the fallopian tubes where it can cause PID.

Most women harboring chlamydia will have no symptoms, but others complain of purulent vaginal discharge, deep dyspareunia, and pelvic pain. There may be no significant pelvic findings, but a friable cervix, mucopurulent cervical discharge, pain on motion of the cervix, and tenderness in the adnexa are suggestive.

The diagnosis is often made on the basis of clinical suspicion but can be confirmed with chlamydia culture. Such cultures are frequently performed routinely in high-risk populations.

Treatment is:

Recommended Regimens

Azithromycin 1 g orally in a single dose
OR
Doxycycline 100 mg orally twice a day for 7 days.

Alternative Regimens

Erythromycin base 500 mg orally four times a day for 7 days,
OR
Erythromycin ethylsuccinate 800 mg orally four times a day for 7 days,
OR
Ofloxacin 300 mg orally twice a day for 7 days,
OR
Levofloxacin 500 mg orally for 7 days.

Read the CDC Treatment Guidelines for Chlamydia

Foreign Body
Lost and forgotten tampons are the most common foreign body found in the vagina, although other objects are occasionally found. Women with this problem complain of a bad-smelling vaginal discharge which is brown or black in color. The foreign body can be felt on digital exam or visualized with a speculum.

As soon as you suspect or identify a lost tampon or other object in the vagina, immediately prepare a plastic bag to receive the object. As soon as it is retrieved, place it in the bag and seal the bag since the anaerobic odor from the object will be extremely penetrating and long-lasting.

Have the patient return in a few days for follow-up examination. Normally, no other treatment is necessary, but patients who also complain of fever or demonstrate systemic signs/symptoms of illness should be evaluated for possible toxic shock syndrome, an extremely rare, but serious, complication of a retained tampon.

Gardnerella (Hemophilus, Bacterial Vaginosis)
The patient with this problem complains of a bad-smelling discharge which gets worse after sex. Cultures will show the presence of "Gardnerella Vaginalis," the bacteria associated with this condition. While this problem is commonly called "Gardnerella," it is probably the associated anaerobic bacteria which actually cause the bad odor and discharge.

The diagnosis is confirmed by the release of a bad odor when the discharge is mixed with KOH ("whiff test"), a vaginal pH greater than 5.0, or the presence of "clue cells" (vaginal epithelial cells studded with bacteria) in the vaginal secretions.


Treatment is:

Recommended Regimens (CDC 2002)

Metronidazole 500 mg orally twice a day for 7 days,
OR
Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once a day for 5 days,
OR
Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days.

Alternative Regimens (CDC 2002)

Metronidazole 2 g orally in a single dose,
OR
Clindamycin 300 mg orally twice a day for 7 days,
OR
Clindamycin Ovules 100 g intravaginally once at bedtime for 3 days.

Read the CDC Treatment Guidelines for Bacterial Vaginosis

Watch a video showing Clue cells

Gonorrhea
This sexually-transmitted disease is caused by a gram negative diplococcus. The organism grows easily in the cervical canal, where it can spread to the fallopian tubes, causing PID. It may also infect the urethra, rectum or pharynx.

Many (perhaps most) women harboring the gonococcus will have no symptoms, but others complain of purulent vaginal discharge, pelvic pain, and deep dyspareunia. There may be no significant pelvic findings, but mucopurulent cervical discharge, pain on motion of the cervix, and tenderness in the adnexa are all classical.

The diagnosis is often made on the basis of clinical suspicion but can be confirmed with chocolate agar culture or gram stain.

Treatment is:

Answer 3

have you been having sex?? are your boobs sore/bigger?? are you feeling sick?? maybe you are prgnt