Is it normal for a nine-year-old girl to have secretions in her underwear?

If a nine-year-old girl suddenly finds secretions on her underwear, it is not considered abnormal. The specific situation can only be determined after a gynecological examination. Generally speaking, it is physiological leucorrhea, which will occur in all girls. If it occurs too early, it may be a case of precocious puberty. However, there are also a small number of patients who have pathological leucorrhea.

Normal leucorrhea is white, paste-like or egg white-like, sticky, has no fishy smell, and is in small amount. It is called physiological leucorrhea. Due to the action of the pelvic floor muscles, the female vaginal opening is closed and the front and back walls are tightly attached. The moisture in the leucorrhea keeps the female vagina moist. This moist environment can reduce the friction between the front and back walls of the vagina and protect the vaginal walls from damage. At the same time, this moist state makes women's vagina lubricated and elastic, which is beneficial to improving the quality of sexual life.

1. Pathological leucorrhea

When there is inflammation of the reproductive tract such as vaginitis and acute cervicitis or cancer occurs, the amount of leucorrhea increases significantly and the properties change, which is called pathological leucorrhea.

1. Cheese-like or tofu-like leucorrhea: It is candidal vaginitis, often accompanied by severe vulvar itching or burning pain.

2. Thin, purulent, yellow-green, foamy, foul-smelling leucorrhea is characteristic of Trichomonas vaginitis, accompanied by vulvar pruritus.

3. Grayish white, thin, fishy-smelling leucorrhea is a characteristic of bacterial vaginosis, accompanied by mild vulvar itching.

4. Purulent leucorrhea: yellow or yellow-green in color, sticky, and often has a foul odor, caused by bacterial infection. It can be seen in gonorrheal Neisseria vaginitis, acute cervicitis and endocervicitis, vaginal cancer or cervical cancer complicated by infection. Purulent leucorrhea can also be caused by uterine cavity pyometra or foreign bodies retained in the vagina.

6. Watery leucorrhea: Vaginal discharge that is thin, watery or rice-like and has a fishy odor. It is seen in advanced cervical cancer, vaginal cancer or submucosal fibroids with infection. Intermittent discharge of clear, yellow-red or red watery leucorrhea should be considered as a possible cause of fallopian tube cancer.

7. Bloody leucorrhea: There is blood mixed in the leucorrhea, and the amount of blood varies. Cervical cancer, endometrial cancer, cervical polyps, cervical columnar epithelium ectopia with infection or uterine submucosal fibroids should be considered. Insertion of an intrauterine device can also cause bloody leucorrhea.

2. pH value

pH value examination is an important examination item for abnormal leucorrhea. The normal pH value of the vagina is between 3.8 and 4.4, which is slightly acidic and can prevent pathogenic bacteria from multiplying in the vagina. The vaginal pH of patients with Trichomonas vaginitis is 5.0-6.5. The vaginal pH of patients with bacterial vaginosis is >4.5.

3. Leucorrhea cleanliness

The vaginal secretion smear is observed under a microscope, and the vaginal cleanliness is determined by the number of vaginal bacilli, white blood cells (WBC) and miscellaneous bacteria. There are 4 levels:

Grade I: There are a large number of vaginal bacilli and epithelial cells, no miscellaneous bacteria or white blood cells, and the field of vision is clear, indicating that it is normal secretions.

Grade II: There are moderate amounts of vaginal bacilli and epithelial cells, a small amount of white blood cells and miscellaneous bacteria, and it is still normal vaginal secretions.

Grade III: A small amount of vaginal bacilli and squamous epithelium, but a relatively large number of miscellaneous bacteria and white blood cells, indicating milder vaginal inflammation.

Grade IV: There are no vaginal bacilli, only a few epithelial cells, a large number of white blood cells and miscellaneous bacteria. It indicates relatively severe vaginal inflammation, such as candidal vaginitis and Trichomonas vaginitis.

Grades I to II are normal, while grades III to IV are abnormal leucorrhea, indicating vaginal inflammation.