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Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection.
Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven’t been diligent about your personal hygiene.
None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition.
Types of Vaginal discharge and infections
The vagina serves as a passageway between the outside of the body and the inner reproductive organs. The pH balance of the vagina is acidic, which discourages infections from occurring. This acidic environment is created by normally-occurring bacteria. A healthy vagina produces secretions to cleanse and regulate itself, similar to how saliva cleanses and regulates the environment of the mouth. These vaginal secretions are normal vaginal discharge. Any interference with the delicate balance of vaginal secretions sets up an environment conducive to infection.
Normal Vaginal Discharge – All women have some vaginal discharge. Normal discharge may appear clear, cloudy white, and/or yellowish when dry on clothing. It may also contain white flecks and at times may be thin and stringy. Changes in normal discharge can occur for many reasons, including menstrual cycle, emotional stressors, nutritional status, pregnancy, usage of medications – including birth control pills, and sexual arousal.
Effects of the Menstrual Cycle – The menstrual cycle affects the vaginal environment. You may notice increased wetness and clear discharge around mid-cycle. The pH balance of the vagina fluctuates during the cycle and is the least acidic on the days just prior to and during menstruation. Infections, therefore, are most common at this time.
Signs of Abnormal Discharge – Any changes in color or amount of discharge may be a sign of a vaginal infection. Vaginal infections are very common; most women will experience some form of a vaginal infection in their lifetime. If you experience any of the symptoms below, this may be a sign of vaginal infection:
- Discharge accompanied by itching, rash or soreness
- Persistent, increased discharge
- Burning on skin during urination
- White, clumpy discharge (somewhat like cottage cheese)
- Grey/white or yellow/green discharge with a foul odor
Causes of Vaginal itching and discharge
Glands in the cervix and the walls of the vagina normally produce a clear mucus. This is very common among women of childbearing age.
- These secretions may turn white or yellow when exposed to the air.
- The amount of mucus produced varies during the menstrual cycle as hormone levels in the body change.
The following factors can increase the amount of normal vaginal discharge:
- Feeling stressed
- Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle)
- Sexual excitement
Different types of infections may cause itching or a discharge in the vagina. These include:
- Infections spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis.
- Vaginal yeast infection, caused by a fungus.
- Normal bacteria that live in the vagina that overgrow, causing a gray discharge and fishy odor. This is called bacterial vaginosis (BV). BV is not often spread through sexual contact.
Other causes of vaginal discharge and itching may be:
- Menopause and low estrogen levels, which may lead to vaginal dryness and other symptoms (Atrophic vaginitis).
- Forgotten tampon or foreign body, which may cause a foul odor.
- Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams, which may irritate the vagina or the skin around the vagina
Less common causes include:
- Cancer of the cervix or vagina
- Skin conditions, such as desquamative vaginitis and lichen planus
Signs and Symptoms of Vaginal Discharge
Vaginal discharge may range in color from clear to gray, yellow, greenish, or milky-white and may have an unpleasant smell. The symptoms and character of vaginal discharge depend upon the specific condition that is the cause of the discharge.
- Bacterial vaginosis: Not all women with bacterial vaginosis will have symptoms, but bacterial vaginosis typically produces a discharge that is thin and grayish-white in color. It is usually accompanied by a foul, fishy smell.
- Trichomonas: Trichomonas infection produces a frothy, yellow-green vaginal discharge with a strong odor. Associated symptoms can include discomfort during intercourse and urination, as well as irritation and itching of the female genital area.
- Gonorrhea: Gonorrhea may be not produce symptoms in up to half of infected women, but it can also cause burning with urination or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area.
- Chlamydia: Like gonorrhea, Chlamydia infection may not produce symptoms in many women. Others may experience increased vaginal discharge as well as the symptoms of a urinary tract infection if the urethra is involved.
- Vaginal yeast infection: A vaginal yeast infection is usually associated with a thick, white vaginal discharge that may have the texture of cottage cheese. The discharge is generally odorless. Other symptoms can include burning, soreness, and pain during urination or sexual intercourse.
How do I know if my discharge is unhealthy?
Any sudden change to your discharge may indicate a vaginal infection. You should be aware of how your discharge naturally varies throughout your cycle and what isn’t normal, but obvious warning signs of infection are:
- a change in colour or consistency
- a sudden bad smell
- an unusually large amount of discharge
- another symptom alongside the discharge, such as itching outside your vagina or pain in your pelvis or tummy
- unexpected bleeding from the vagina
If you’re not sure whether your discharge is normal and are worried about it, see your GP or nurse. Read about sexual health for general information and advice.
How is abnormal discharge treated?
How you are treated will depend on what’s causing the problem. For example, yeast infections are usually treated with antifungal medications inserted into the vagina in cream or gel form. Bacterial vaginosis is treated with antibiotic pills or creams. Trichomoniasis is usually treated with the drug metronidazole (Flagyl) or tinidazole(Tindamax).
Here are some tips for preventing vaginal infections that can lead to abnormal discharge:
- Keep the vagina clean by washing regularly with a gentle, mild soap and warm water.
- Never use scented soaps and feminine products or douche. Also avoid feminine sprays and bubble baths.
- After going to the bathroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection.
- Wear 100% cotton underpants, and avoid overly tight clothing.
Home Care Treatments
Keep your genital area clean and dry when you have vaginitis.
- Avoid soap and just rinse with water to clean yourself.
- Soak in a warm, not hot, bath may help your symptoms. Dry thoroughly afterward.
Avoid douching. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.
Other tips are:
- Avoid using hygiene sprays, fragrances, or powders in the genital area.
- Use pads and not tampons while you have an infection.
- If you have diabetes, keep your blood sugar levels in good control.
Allow more air to reach your genital area. You can do this by:
- Wearing loose-fitting clothes and not wearing panty hose
- Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Cotton increases air flow and decreases moisture buildup.
- Not wearing underwear at night when you sleep.
Girls and women should also:
- Know how to properly clean their genital area while bathing or showering.
- Wipe properly after using the toilet always from front to back.
- Wash thoroughly before and after using the bathroom.
Always practice safe sex, and use condoms to avoid catching or spreading infections.