Vaginal discharge: Problems, symptoms, diagnosis & treatment

Dr Louise Hayes Dr Louise Hayes MBBS (Lond.) FRCOG, Consultant in Gynaecology & Women’s Health Published May 1st 2023

Vaginal discharge is good. It tells you your body’s working as it should, to protect you from infection and keep your vagina healthy and clean. But an abnormal discharge could indicate a problem you need help with. But what’s an ‘abnormal’ discharge? And when should you ask someone about it?

Is my vaginal discharge anything to worry about?

Almost certainly not. ‘Normal’ vaginal discharge is like a sort of cleaning fluid. It’s naturally dispensed from glands in your cervix and vagina, and its job is to leave your body gently, washing out dead cells as it goes, to keep you healthy and clean.

As with many other aspects of health, people’s experience differs widely. Some women’s discharges are slight enough that they’re not even aware of them. Others’ are heavier, but for them, absolutely normal.

Many women’s discharges change due to specific causes – typically becoming pregnant, going on the pill, or when they’re unusually sexually active. And many find it varies at different times, with more mucus a couple of weeks into their cycle, which stays until their next period.

In short, ‘normal’ discharges vary, but they’re part of your body’s natural housekeeping, and far from being anything to worry about, they’re a sign that all is well.

So, what is ‘normal’ vaginal discharge?

Again, experiences vary, and ‘normal’ covers quite a wide range of:

  • Texture – anything from watery and sticky to thick and pasty
  • Colour – clear, milky white or off-white
  • Smell – your vaginal discharge may smell, but it shouldn’t smell bad
  • Amount – varies greatly person to person; sudden changes might suggest issues

Essentially, along with pretty much every other woman, you’ll come to know what’s normal for you, and so long as it stays that way, all’s well. Your heads-up that something might need looking into would be a sudden change in that ‘normal’.

When should I talk to a doctor about my discharges?

As described above, there are a number of reasons your discharges can change, many of them completely normal and nothing to be concerned about. But be alert to changes in:

  • Texture – discharge that is lumpy or foamy
  • Colour – dark yellow, brown, green or grey
  • Smell – fishy or offensive smells
  • Amount – sudden changes from your ‘normal’

Any such symptoms, alone or in combination, and often accompanied by itching, burning or soreness, could suggest an infection.

There are three infections that can cause changes in your discharges: yeast infections, bacterial infections, and trichomoniasis.

Yeast infections tend to cause:

  • White, cottage cheese-like discharge
  • Swelling and pain around the vulva
  • Intense itching
  • Painful sexual intercourse

Bacterial infections (vaginosis) tend to cause:

  • White, grey, or yellowish discharge
  • A fishy odour, stronger after sex or your period
  • Itching or burning
  • Some redness and swelling of the vagina or vulva

Trichomoniasis tends to cause:

  • A watery, yellowish, or greenish bubbly discharge
  • An offensive smell
  • Pain and itching when you wee

Bacterial vaginosis is the single most common cause of abnormal discharges. It is not an STI (sexually transmitted infection) but a natural overgrowth of bacteria in the vagina. Often, the symptoms will be mild, and the condition will simply disappear of its own accord. If not, antibiotics will take care of it, though many women suffer repeated or persistent bouts of bacterial vaginosis. Talk to your doctor if you’re concerned.

After bacterial vaginosis, thrush is the next biggest cause. Due to a yeast infection, thrush can be persistent and recurrent, and can cause itching, pain, redness, general soreness in the area. Many women experience worse discomfort during sex, or while weeing.

If you suffer symptoms such as:

  • Abnormal vaginal bleeding
  • A sore, ulcer, rash, or lump that appears around the vagina, vulva or anus
  • Pelvic pain, either constantly, only during sex or when you wee

It’s likely that you have an STI – most likely chlamydia or gonorrhoea, possibly a pelvic inflammatory disease, which occurs when the infection has moved up the genital tract.

Such conditions are usually easily treated with a course of antibiotics, either swallowed or inserted into the vagina.

How do doctors check vaginal discharge?

Your doctor will probably start by asking you about your symptoms, how long you’ve been having them, whether this is new to you or something you’re all too familiar with, and any aspects of your recent experience that may suggest possible causes.

They’ll probably ask you about birth control – condoms can be a very effective protection against STIs, but some women react badly to them, and may need to look into other birth control options. And they may well ask you about your sexual history – long term, and recent.

Your discussion may be enough to tell them what’s wrong, and enable treatment (eg antibiotics) to be arranged without any need for further queries or tests.

If not, they may want to do a physical examination, using fingers and possibly a simple instrument called a speculum, to explore your womb, ovaries and fallopian tubes for any tenderness, and for discharges which can be swabbed and sent away for testing.

If you have been sexually active the doctor may offer you a full STI screen, with blood tests as well as swabs, and may also suggest testing your sexual partner(s).

The results of such examinations should tell the doctor what the issue is, and enable treatment, usually by way of prescription or even over-the-counter medicines. If any uncertainty remains, they may refer you for ultrasound scans, or send you to a specialist for further investigation.

What else can cause abnormal vaginal discharge?

Sometimes discharges prove to be down to a misplaced tampon or other foreign object left in the vagina. Other unusual but possible explanations for abnormal discharges include:

  • Polyps – small fleshy lumps on your cervix (the neck of your womb). Easy for a doctor or nurse to spot, and easily removed if it’s felt necessary
  • Ectopy – where the covering of the neck of the womb becomes more fragile. Generally minor, and solves itself without treatment
  • Skin conditions like dermatitis, which can lead to discharges and itching

These are all minor conditions, and are either easily treated or don’t actually need any treatment – they just go away all by themselves.

It is also just possible that discharges can be down to cancer, of the womb or of the cervix, but this is very unusual.

Can vaginal discharge be avoided?

As was said earlier, you wouldn’t want to prevent normal vaginal discharge: it’s good for you, and necessary for your sexual health and wellbeing. But abnormal vaginal discharge is best prevented, and various simple, easy solutions can help, such as:

  • Always wiping from front to back, to help prevent anal bacteria spreading to your vagina
  • Wearing cotton underpants, which helps keeps everything healthily airy
  • Avoiding wearing underpants at night
  • Not spending too long in tight pants, swimming suits, biking shorts or leotards
  • Trying a different laundry detergent or fabric softener if you suspect a problem
  • Checking out alternatives to condoms if you think they might be causing a reaction
  • Avoiding hot baths
  • Bathing or showering regularly, and patting your genital area dry
  • Avoiding douching
  • Avoiding feminine hygiene sprays, coloured or perfumed toilet paper, deodorant pads or tampons, and bubble bath

It’s possible, but very unlikely. Vaginal discharge is normal, healthy, and just your body’s way to keep your vagina healthy and clean.

Normal vaginal discharge tends to be white/pale/clear in colour, free of fishy or other offensive odours, and accompanied by no itching, burning or other physical discomfort.

Vaginal discharges can be abnormal in various ways – appearance, smell, amount – and some are no real problem. But if yours changes suddenly, looks discoloured or lumpy, smells rank and/or is causing you discomfort, something’s wrong and needs checking out.

If you have ‘abnormal’ discharges that are causing you concern, and don’t respond to personal hygiene measures and/or behavioural changes (not wearing pants at night, eg), it’s time to see your doctor.

You don’t want to prevent all discharges, and nor should you try. They’re healthy! But to avoid problematic ones, avoid using ‘feminine products’ around the genital area, use clean water or at most the mildest of soaps to clean gently, and be alert to any itching or other signs of problems. As with most things medical, if there is an issue, the sooner it’s dealt with the better.

Meeting with a professional is always recommended when concerned.

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