What is Vaginal Discharge?
Vaginal discharge is fluid which comes from your vagina. In most cases it’s quite normal and actually helps to prevent and defend against infection.
It’s usually clear or milky and can change to slightly thicker and slimy during ovulation or when sexually aroused. It won’t smell nasty and can vary in the amounts you produce, particularly during pregnancy and breastfeeding or menopause.
However, should you notice a change in the colour, smell or texture of the discharge then there may be a problem. (1)
Causes
There are several causes of changes in vaginal discharge. They include:
Bacterial Vaginosis
All women have bacteria in their vagina which can vary from person to person. These good bacteria are in the most part lactic acid bacteria. Along with other bacteria they help keep a mildly acidic environment in the vagina which protects against germs.
If the acidity level is reduced then the amount of good bacteria drops allowing other vaginal flora to build up. The bacteria responsible for bacterial vaginosis is usually one called gardnerella vaginalis.
Signs of bacterial vaginosis include a grayish white discharge which will smell unpleasant and very fishy. The smell can be stronger during menstruation or after sex. (2)
Trichomoniasis
Trichomoniasis is a sexually transmitted disease that is the most prevalent in the US affecting about 3.7 million people. Women are more likely to have this disease than men.
The parasite responsible for this is called trichomonas vaginalis. It can be transmitted from person to person during sex. 70 percent of people with this disease will not display any symptoms.
In women it can cause redness, soreness, itching or burning in the genital area and discharge both increases and has a thinner consistency. It can vary from clear and white to yellow or greenish and will smell of fish. (3)
Yeast Infection
Yeast infections can also be called thrush or candidiasis. There is a type of fungus called candida which is found in the vagina and other parts of the body in minor amounts.
Symptoms of candidiasis appear when there is an overgrowth of this yeast in the vagina as a result of acidity hormonal changes. It presents as genital itching or burning and vaginal discharge will be white and the consistency of cottage cheese. (4)
Gonorrhea
Gonorrhea is a sexually transmitted bacterial infection. Women often display no symptoms and can be unaware they have this condition. It can be contracted by anyone who is sexually active, although risks can be reduced by using condoms.
If left untreated complications can be serious and include scar tissue on fallopian tubes, infertility and long term pelvic pain. Gonorrhea can also be passed onto babies born to an infected mother.
Indications of this disease are pain or burning when urinating, bleeding in between periods and an increase in vaginal discharge. (5)
Chlamydia
This is another sexually transmitted bacterial disease. Again women can have little or no symptoms and will not know they have the condition.
Long term complications of chlamydia include endometriosis and pelvic inflammatory disease. Babies can contract the condition in the birth canal.
Symptoms if present are unusual, but could include vaginal discharge and pain when urinating. (6)
Pelvic Inflammatory Disease
This disease affects the reproductive organs and is often a complication of untreated sexually transmitted diseases. It can also be caused by an intrauterine contraceptive device (coil) however, this is not as common.
Although not everyone experiences symptoms they include: pain in the lower abdomen, a burning feeling when urinating and unusual pungent vaginal discharge. (7)
Human Papillomavirus and Cervical Cancer
Both HPV and cervical cancer affect the cells of the cervix at the top of the vagina. Whilst a less common cause of unusual discharge they may produce blood or a brownish discharge between periods. (8)
Douche
Douching involves cleansing the vaginal passage with a liquid like water or a soap solution. This practice causes imbalance in the bacteria in the vagina and can lead to a number of health complications.
The first indication of these complications, like pelvic inflammatory disease or bacterial infections, can be abnormal vaginal discharge. (9)
Irritation or Allergies
Many products that we use to bathe or shower contain perfumes, you can even get scented toilet rolls. Use of these can cause allergies or irritation which will lead to unusual vaginal discharge. (10)
Other Causes
There are other factors that can cause an imbalance in the vagina and lead to abnormal discharge. These include, tampons or condoms that may have been left in the vagina and taking antibiotics. (11)
Symptoms
The main symptoms for concern are any changes to vaginal discharge which are not normal for you. These include changes in color from clear or white to yellow or greenish, and changes in texture and thickness. Also, pay particular attention to a cottage cheese appearance or a nasty smell.
There are occasions when abdominal pain and bleeding or sores can accompany the changes in discharge.
You may also experience itching, burning or pain when urinating and may bleed between periods or after sex. Pelvic pain and an increase in discharge should also not be ignored.
You should see your doctor or visit a clinic that deals with sexually transmitted diseases if you notice any change. (12)
Diagnosis
Your doctor will initially take your medical history and ask you about your symptoms and how long you have had them. They are also likely to inquire about your sexual habits and partners.
A pelvic examination will consist of looking at the vagina and cervix (an internal examination). They will also check your abdomen by pressing on the uterus and ovaries to see if they can detect any abnormalities in the organs or tissues. (13)
It may be that initial results are inconclusive and if this is the case there are further tests that can be done, these include:
pH Test
The acid levels (pH) in the vagina should ideally be between about three and a half and four and half. Your doctor can check this by taking a sample of the discharge and using a paper sensitive to pH levels. (14)
Sexually Transmitted Disease Test
A sample of discharge is taken for laboratory examination to determine the presence of bacteria that can cause infection. (15)
PAP or Smear Test
This test takes a sample of cells from the cervix to be examined for human papillomavirus or abnormal cervical cells. (16)
FAQ
What is vaginal discharge? Vaginal discharge is fluid which comes from your vagina. It is quite normal and helps to clean and moisten the vagina. This works as a protective barrier preventing and fighting off infections. It’s usually thin, clear or milky and can change to slightly thicker and slimy during ovulation or when sexually aroused.
What causes vaginal discharge? There are several causes for abnormal vaginal discharge which include bacterial infections and imbalances, and sexually transmitted diseases.
How do doctors test for vaginal discharge? Swabs and samples will be taken for laboratory examination to determine the cause of the discharge if it’s not apparent. Your doctor can obtain these during a pelvic examination.
When should you go to the doctors with vaginal discharge? Any changes in your vaginal discharge need investigation therefore a visit to the doctors is advisable. This is especially prudent if you think you may have been in contact with a sexually transmitted disease.
Can you prevent abnormal vaginal discharge? We have learnt that vaginal discharge is normal and there are things you can do to help keep it healthy. After using the toilet, wipe from front to back to help stop bacteria transferring from the rectal area to the vagina. Cotton underwear will allow your genital area to breathe and keep cooler. Nylon pantyhose, leotards, swimwear and lycra leggings should not be worn for long periods of time. Wash your nether regions daily but avoid heavily perfumed products and don’t douche.
What can relieve vaginal discharge? There are over the counter medications you can get to relive the effects of a yeast infection. Speak to your pharmacist about the options, but if you are unsure of the cause see your doctor.
What treatments are there for abnormal vaginal discharge? After diagnosis most abnormal vaginal discharge can be treated with either anti fungal creams or antibiotics. (17)
What is considered to be normal vaginal discharge? Every woman is different and what might be normal for one may not be for another. Suffice to say that as women you know your body and if something doesn’t seem right the seek medical advice. (18)
Summary
Vaginal discharge is fluid which comes from your vagina. It is quite normal and helps to both clean and moisten the vagina, keeping your genital region healthy. It can change in thickness and quantity depending on the time of the month.
Any change to what appears normal for you should be investigated, especially a change in color or odor. The presence of itching, redness, swelling, pain or burning sensations when urinating are further warning signs.
Whilst unpleasant and possibly embarrassing, many treatments are available to relieve the symptoms and allow you to get on with life.