Leukorrhea and Recurrent Vaginitis — Korean Medicine Treatment for Spleen-Deficiency-with-Damp-Descending
Table of Contents
The relationship between leukorrhea (帶下) and vaginitis
Leukorrhea (daeha, 帶下) refers to vaginal discharge, and a small amount is normal. However, excessive volume, yellow or greenish color, foul odor, or accompanying itching indicates pathological discharge (daeha-byeong, 帶下病). Vaginitis has various causes — candida, bacterial, or trichomonas — and even with antibiotics or antifungals, the recurrence rate reaches 40–50%. This is because the underlying vaginal environment is not improved.
Spleen deficiency with damp descending (脾虛濕下注) — the root cause of recurrence
Korean medicine sees the root cause of leukorrhea as spleen deficiency with damp descending (biheoseup-haju, 脾虛濕下注). When the transport-and-transformation function of the spleen (bi, 脾) weakens, water-damp (suseup, 水濕) is not properly metabolized, and gravity carries it down to the lower jiao (haecho, 下焦), accumulating in the uterus and vagina. This damp environment becomes a breeding ground for pathogens, leading to recurrent vaginitis. Therefore, simply killing the bacteria is not enough — the spleen-stomach must be strengthened to remove damp at the root.
Wandae-tang (完帶湯)
Wandae-tang is the representative formula for treating leukorrhea. Atractylodes (baekchul, 白朮) and Chinese yam (sanyak, 山藥) reinforce spleen qi; ginseng (insam, 人蔘) and licorice (gamcho, 甘草) replenish primordial qi; cangzhu (changchul, 蒼朮), citrus peel (jinpi, 陳皮), and plantago seed (chajeonja, 車前子) dry damp; and bupleurum (siho, 柴胡) and schizonepeta (hyeonggae, 荊芥) circulate liver qi. The name means "making the belt complete" — restoring the binding function of the belt vessel (daemaek, 帶脈) to prevent damp from descending.
- Yellow discharge with odor: Add phellodendron (hwangbaek, 黃柏) and dioscorea hypoglauca (bihae, 萆薢) for clearing heat and draining damp (清熱利濕)
- Severe itching: Use sophora root (gosam, 苦參) and cnidium fruit (sasangja, 蛇床子) externally as a sitz-bath wash
- Clear and watery discharge: Add deer-antler frost (nokgaksang, 鹿角霜) and psoralea (bogolji, 補骨脂) to warm and tonify kidney yang (溫補腎陽)
Sitz baths and lifestyle management
Sitz baths with a decoction of sophora root, cnidium fruit, phellodendron, and kochia (jibuja, 地膚子) improve the vaginal environment and relieve itching. Wear breathable cotton underwear and avoid tight-fitting pants. Overuse of feminine washes destroys the normal lactobacillus flora; rinsing the external genitals with water alone is preferable. Sugar-rich diets promote candida overgrowth, so be mindful.