Discharge from the vagina
Substances emitted from the vagina can vary in consistency (thick, pasty, thin), color (clear, cloudy), and smell (normal, odorless, bad odor).
Having some amount of vaginal discharge is normal, especially if you are of childbearing age. Glands in the cervix produce a clear mucus. These secretions may turn white or yellow when exposed to the air. These are all normal variations.
The amount of mucus produced by the cervical glands varies throughout the menstrual cycle. This is normal and depends on the amount of estrogen circulating in your body.
Vaginal discharge that suddenly differs in color, odor, or consistency, or significantly increases or decreases in amount, may indicate an underlying problem like an infection. If abnormal vaginal discharge is due to a sexually transmitted disease (STD), your sexual partner(s) will likely require treatment as well.
The following situations can increase the amount of normal vaginal discharge:
- Sexual excitement
- Emotional stress
- Ovulation (when you produce and release an egg from your ovary in the middle of your menstrual cycle)
These conditions can lead to abnormal vaginal discharge:
- Vaginal yeast infection - the discharge is generally cheesy white with redness and itching. Vaginal yeast infections may be related to antibiotics, birth control or other estrogen pills, pregnancy, diabetes, or a weakened immune system.
- Bacterial vaginosis - an infection that causes a grey discharge and fishy odor that worsen after sexual intercourse.
- Trichomonas - a sexually-transmitted parasite that causes yellowish-grey or green discharge and intense itching.
- Other infections and sexually transmitted diseases like Chlamydia or gonorrhea.
- Forgotten tampon or foreign body.
To help prevent and treat vaginal discharge:
- Keep your genital area clean and dry.
- Avoid douching. While many women feel cleaner if they douche after menstruation or intercourse, it may actually worsen vaginal discharge because it removes healthy bacteria lining the vagina that are there to protect you from infection.
- Use an over-the-counter cream or vaginal suppository, IF you know that you have a yeast infection.
- Try to reduce stress.
- Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when on antibiotics to avoid a yeast infection.
- Use condoms to avoid catching or spreading sexually transmitted diseases.
- Keep your blood sugars under good control if you have diabetes.
If the discharge is caused by a sexually transmitted disease, your sexual partner (or partners) must be treated as well, even if they have no symptoms. Failure of partners to accept treatment can cause continual reinfection which may lead to a serious problem like infertility.
Call your health care provider if
Call your doctor right away if:
- Your discharge is associated with fever or pain in your pelvis or abdomen.
- You have been exposed to a sexual partner with gonorrhea, Chlamydia, or other sexually transmitted disease.
- You have increased thirst or appetite, unexplained weight loss, increased urinary frequency, or fatigue - these may be signs of diabetes.
Also call if:
- A child who has not reached puberty has vaginal discharge.
- You think that your discharge may be related to a medication.
- You are concerned that you may have a sexually transmitted disease or you are unsure of possible exposure.
- Your symptoms worsen or last longer than 1 week despite home care measures.
- You have blisters or other lesions on your vagina or vulva.
- You have burning with urination or other urinary symptoms - you may have a urinary tract infection.
What to expect at your health care provider’s office
Your doctor will take a medical history and perform a physical examination including a pelvic exam.
Medical history questions may include:
- When did the changed or abnormal vaginal discharge begin?
- Do you have the same amount and type of vaginal discharge throughout the month?
- What does the discharge look like (color and consistency)?
- Is there an odor?
- Do you have pain, itching, or burning?
- Does your sexual partner have a discharge as well?
- Do you have multiple sexual partners or sexual partners that you do not know very well?
- What type of birth control do you use?
- Do you use condoms?
- Is there anything that relieves the discharge?
- Have you tried over-the-counter creams? Have they helped?
- Do you douche? What kind of douche do you use?
- Do you have any other symptoms like abdominal pain, vaginal itching, fever, vaginal bleeding, rash, genital warts or lesions, or changes in urination like difficulty, pain, or blood?
- What medications do you take?
- Do you have any allergies?
- Have you recently changed the detergents or soaps that you use?
- Do you frequently wear very tight clothing?
Diagnostic tests that may be performed include:
- Cultures of your cervix.
- Examination of vaginal discharge under the microscope.
Treatment depends on the underlying condition. Suppositories or creams may be ordered and antibiotics may be prescribed. Oral medication for fungus or Trichomonas may be used in difficult cases. Your sexual partner(s) may also need treatment.
by Gevorg A. Poghosian, Ph.D.