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Iran J Public Health, Vol. 46, No.2, Feb 2017, pp.

268-269 Letter to the Editor

An Insight to How Estate Women in Sri Lanka Manage

Abnormal Vaginal Discharge
*Ilankoon IMPS 1, Goonewardena CSE 2, Fernandopulle RC 3, Perera PPR 4

1. Dept. of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
2. Dept. of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
3. Dept. of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
4. Dept. of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

*Corresponding Author: Email:

(Received 15 Sep 2016; accepted 10 Oct 2016)

Dear Editor-in-Chief
Women living in estate communities in Sri Lanka Many women use self-treatment with over-the-
are vulnerable to many unhealthy practices due to counter preparations for vaginal discharge prior
the low socio-economical status, structural and to consulting a doctor due to many reasons (1).
social inequalities. Further, the presence of stig- Thus, this descriptive qualitative study was aimed
ma and discrimination may discourage women to assess how women living in estate communi-
from revealing their reproductive and sexual ties in Colombo District, Sri Lanka manage ab-
health issues and thereby increase the possibility normal vaginal discharge, including their cultural
of transmitting diseases. Abnormal vaginal dis- practices and health seeking behaviors. Three
charge is a common gynaecological complaint Focus Group Discussions (FGDs) were con-
among women in reproductive age. Persistent ducted in August 2015 in two estates and all
vaginal discharge can cause considerable distress groups comprised of six to ten women with a
to many women (1). total of 20 women.
Physiological reasons for increased vaginal dis- Majority of the study sample consisted of Indian
charge are high estrogen levels during mid-cycle, Tamils (n=17, 85%) and the predominant reli-
pregnancy and due to sexual arousal. Pathological gion was Hindu (n=15, 75%). Most were edu-
causes can be infective (Sexually Transmitted In- cated up to grade 11 (65%, n=13) i.e. compatible
fections (STIs) and non-STIs) and non-infective with secondary sophomore in the US, but there
(genital tract malignancy, fistulae, allergic reac- were 30% with just primary education. Most of
tions and atrophic vaginitis associated with me- the women have had a previous history of vaginal
nopause) with the most common being the infec- discharge and they perceived it as a usual or normal
tive agents (2). Differentiating the normal and condition. Transcribed verbatim data were analyzed
abnormal vaginal discharge is essential in early using qualitative content analysis and six themes
detection of pathological discharge in order to related to vaginal discharge concerns emerged
prevent the possible complications of delayed namely difficulty in differentiating normal from ab-
treatment for reproductive tract infections such normal vaginal discharge, lack of knowledge on
as infertility, ectopic pregnancy, an increased risk causative factors, cultural influences, and beliefs,
of HIV transmission and infant death. unstable/ limited source of income, fear of disclos-
ing and lack of support system.

268 Available at:

Imps et al.: An Insight to How Estate Women in Sri Lanka …

Majority of women living in estate communities options had been tried and had failed (5) which
work in rubber estates full time for earning and were similar to the findings of this study.
they find difficulties in accessing additional health Women living in estate communities in Sri Lanka
information. They had poor knowledge and have culturally sensitive practices and poor health
health seeking behaviors related to vaginal dis- seeking behavior related to abnormal vaginal dis-
charge. Similarly, most of them had ignored their charge. This shows the importance of planning
health problems due to different factors like health education interventions concerning the
home responsibilities, domestic chores, children, sociocultural context to improve their health
and excessive burden of work at home (3). seeking behaviors. Women had fear of disclosing
Women have difficulty in differentiating normal health matters related to reproductive and sexual
from abnormal vaginal discharge. Lack of aware- health due to possible stigma and discrimination
ness was a theme described in another study (3). from the society. Therefore, providing additional
Majority of the participants ignored this problem, health support services in order to prevent
and thus they did not share it with another per- transmission of STIs and to prevent unhealthy
son (3). gynecological practices is essential.
In the present study, women perceived body
heat, STIs, heavy work and consumptions of hea- Acknowledgments
ty food as the causes for excessive vaginal dis-
charge while some other studies found melting The authors thank all the participants, Public
bones (3), existing pressures of poverty and eve- Health Midwives for their support and the Uni-
ryday pressures (4), infectious causes (5) as causa- versity Grant (ASP/06/RE/MED/2013/31),
tive factors indicating the different cultural University of Sri Jayewardenepura for financial
beliefs. Further women have used different home support. The authors declare that there is no con-
remedies such as “polpala” (Aerva lanata) herbal flict of interest.
drink or “Neeramulliya” (Asteracantha longifolia
Linn) herbal drink, king coconut, Sauw (sago) References
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