Monday, 27 April 2015


The clinic can be quite a case load, different faces with different stories.
Temi is a 26 year old lawyer with the dream job at a reputable law firm in Lagos. She is 5ft 5inches, quite the damsel, with a full figure.
She is an interesting young lady with a zest for life that is quite infectious. She loves to party and has this philosophy for life “One can be young but once”.
About two months ago, while getting ready to soak in a bubble bath as was routine on fridays after work, she noticed a greyish discharge on her underpants. Looking with disinterest, she dumped the pants in her laundry bag.

Over the course of the month, the discharge had become quite consistent, increasing in quantity, thick with a raw pap-like texture and not particularly foul smelling.
” Hmmm!!! What is this again?” she pondered.
Two weeks later, She started to feel this occasional itch in her panties. It was an embarrassing one, because she has to use the restroom at such moments.
Dammy, the new intern had begun to wonder as once in a while she notices Temi tapping a pen at the V of her trousers. In public places, this can be quite the challenge.
” How can I be embarrassing myself like this?” she asks herself as she stands in front of her dressing mirror, getting ready for work.
Her mind starts to drift.
“Temi the fire fly” as she is called by her friends has always been known to live life on the fast lane. She has also been seen in the circles of very wealthy men with very promiscuous histories.
Currently, she is in a relationship with Jide who is a practicing Medical Doctor in Lagos but has being out of the country for the past 3 months on a short course. She is in love with him and hopes he will ask her to marry him soon.
On the side, she is having an affair with Chief Ojikari, a well known business mogul who controls a sizable amount of the real estate on the island, has his hands in oil and gas sector and is quite an elder statesman where the politics of the state is concerned.
Jide usually insists on using a condom but Chief is adverse to the idea.
In the past 3 months, she has being on contraceptive pills and has been consistent. She recalls that two months ago, She had recurrent episodes of fever and cough for which she took over-the-counter, self prescribed medications twice, using antibiotics, with each course lasting between two to three weeks.
She starts to panic, different scenarios come to mind: Could this be the aftermath of all the unprotected sex? Has Chief used her for some kind of sexual ritual causing her to have these symptoms? She couldn't believe that she was scared to the point that she lost all her skeptic tendencies, she couldn't believe she was actually considering the diabolic.
What of Jide? What happens when he eventually returns? Could this be the dreaded HIV/AIDS, or any of the other STDs…. Olorun maje oo!!!
She snatches up her bag, runs to her Range Rover Evoque, raves the engine like a mad woman and drives to the hospital where her law firm has medical retainership, to seek expert management.
On this particular day, she could care less about getting a scratch on the car, which she nicknamed “my baby” in the crazy Lagos traffic with insane motorists.
Chief bought the car as a roll-around for his daughter who had promised to return to the country sometime ago but then changed her mind at the final minute. A red colored Evoque with a white roof seemed a little too girly to be parked in his compound with all his family living abroad. The likes of the Rolls Royce Phantom, Bentley, Maybach, lined up inside the compound made the Evoque look like a little girls toy.
On one of Temi’s visit to the house, Chief gave her the car to run a few errands with and never bothered to get the keys back.
When it was her turn for consultation, she walks in, takes a seat and the above was her story.
Vaginal discharge is a very discomforting and embarrassing problem in the lives of so many women.
Some suffer in silence, while the majority of the enlightened few, seek medical attention.
It is very important for women to be conscious of their bodies and attentive to changes that take place. Some important details which will aid the clinician include;
Onset: When was it first noticed?
Colour: Is it greyish, greenish, bloody, etc
Odour: Is it foul smelling or not? Does it smell fishy? The character of the odour may give a clue to the offending organism.
Itchy: Is there an urge to itch or not?
Rashes: Are there rashes in the vulva area or not?
The causes of vaginal discharge include but are not limited to: Candidiasis, Trichomoniasis, Bacterial vaginosis, Cervical cancer etc
There are a number of risk factors associated with the development of vaginal discharge and they include:
Chronic use of steroids including oral contraceptive pills (These act as immunosuppressants).
Chronic use of antibiotics (These could alter the normal useful organisms in the vagina encouraging the growth of Candida albicans which is an opportunistic infection).
Immunosuppressive medications like the anticancer drugs
HIV/AIDS (an immunosuppressive condition)
Diabetes mellitus(an immunosuppressive condition)
Vaginal douching and use of vaginal products. (The vagina is self cleansing, it does not require extra help besides maintaining a good level of personal hygiene. Some of the products contain chemicals that are too harsh for the vaginal epithelium).
Pelvic inflammatory disease
Complications of vaginal discharge depending on the causative factor include:
Persistent Discomfort
Low self esteem
Sores on other areas of the body
Pelvic inflammatory disease
Formation of bands and adhesions as a result of ascending infections
Genital sores
Certain cancers(courtesy of HPV-associated infections resulting in certain rectal and cervical cancers).
In Temi’s case, she was assessed as having a high risk behaviour and some investigations were requested, inclusive of which were: A HIV test, High vaginal swab HVS, endocervical swab microscopy,culture and sensitivity among others.
Fortunately, she was found to be HIV negative and was counseled with regards to her sexual behaviour. She was asked to return in three months for confirmation of her HIV status because she could possibly be in the window period of a HIV infection.
A diagnosis of Candidiasis was made and she was counseled on the risk factors. Contributory risk factors in her case included; Long term use of oral contraceptives and also her past history of long use of antibiotics.
She was followed up and today, she is a happier woman. She is now an advocate of safe sex and decent living. She got married to Jide two saturdays ago. Chief Ojikari offered to pay for their honeymoon to any part of the world they would wish to go, but she turned down the offer. They have not been in contact since.
Your questions and Comments will be welcomed.
Do Stay Safe and Live Clean with Dr. Ibuchukwu Orabueze

1 comment:

  1. Very creative and informative write up Dr IB, keep it up. In addition, vaginal discharge can also be caused by degenerating fibroid in post menopausal women