Ladies (and curious gentleman), our topic today is maybe not the sexiest topic, but nonetheless, an important and healthy one: vaginal discharge. Vaginal discharge is a topic that many women are curious about and want to discuss, but feel nervous or weird bringing it up to even their closest friends. Here’s what we have to say: vaginal discharge is normal and every female has it. It is not gross and it is not something to be ashamed of. After all, it is part of the female body whether you like it or not.
What is vaginal discharge? Essentially, it is just a mix of cervical mucus and vaginal secretions. “Normal” vaginal discharge looks and feels different for many women. Most of the time, you have nothing to worry about, because your vaginal discharge is normal. However, there are certain types that are abnormal and could be a sign of an infection.
To get the real lowdown, we reached out to Renita Kim, MD MPH, an Obstetrics and Gynecology resident at Brigham and Women’s Hospital and Massachusetts General Hospital to further discuss vaginal discharge.
What is vaginal discharge?
Let’s jump right in. Tell us about vaginal discharge and what the different characteristics mean.
In general, discharge generally comes from the vagina and cervical mucus. What that means is that the skin inside the vagina and the cervix are always going to produce some kind of discharge. What I, as a physician, consider discharge to be, is a normal or physiological bodily function that helps keep the vagina healthy. However, sometimes the discharge can have certain colors, odors, or textures that can be a sign of either physiologic changes or an infection.
Can you dive more into what you mean by normal vaginal discharge?
Normal, or “physiologic” discharge is healthy and something that you would expect to have every day. You’ll typically notice a clear or whitish discharge without any foul odor. The texture may vary and be thin, watery, or stringy, and this can depend on the time of the month. The volume might change as well - you might have a little bit every day, or nothing on some days and a lot on other days. Basically, there is a wide range of what is normal but it is important to know what is normal for your body.
What is your process for understanding vaginal discharge if a patient comes in concerned?
There are a few things that I generally do as a doctor to understand whether vaginal discharge is normal or abnormal, Certain factors, such as color, can be very important. Some of the other facts I need to know beforehand are:
- Is the female patient premenopausal or postmenopausal?
- Is she pregnant?
- Does she have any other complaints along with the discharge, such as fever or abdominal pain?
- Has she had any itching?
- Does it have a foul or fishy odor?
- Has she had a fever?
- Does she feel anything funny down there like a bump or a rash?
- Is this vaginal discharge only occurring during intercourse?
- Has she had any unprotected sex or any new sexual partners?
- How long has she been having this?
There are several other questions that I need to know that qualify the discharge to know that even despite the color, if it is normal or abnormal.
Discharge color and types
What are the types of vaginal discharge and what does the color of vaginal discharge mean?
There are a lot of various types of vaginal discharge. These types are grouped based on their color and consistency. A few types of vaginal discharge are normal, but others may be a sign of an underlying condition that needs to be treated. What the color signifies really depends on the situation. It’s hard to isolate the color alone, as even white discharge can be abnormal, depending on what else is happening with the patient. There’s no way to make a diagnosis based on the color alone, but you would have to take into account certain factors like a patient’s age, behaviors, menstrual cycle, and other symptoms. But basically, the colors can mean the following:
Not necessarily abnormal. A little bit of white discharge, particularly at the start or end of your menstrual cycle, is normal. However, if the discharge is followed by itching and if it has a thick consistency with a cottage cheese texture, it could mean there is a yeast infection. I would say a milky white discharge can be anything from normal to suggestive of an infection depending on if there is anything else going on, such as itching, odor, or pelvic pain. If there are any of these other symptoms, it could be a sign of bacterial vaginosis or an STI.
Clear and Watery
Sometimes a woman may experience a clear and watery discharge .This is completely normal and can happen at any time of the month. It may be particularly heavy after walkouts.
Clear and Stretchy
When your discharge is clear and stretchy or looks like mucous instead of water, it is a sign that you are possibly ovulating. This is a healthy and perfectly normal discharge.
Brown or bloody discharge
If a woman has brown discharge while she is menstruating or towards the tail end of a period; it may be normal. A late discharge at the end of your period can look brown instead of red. This is probably just some blood in the discharge. You may as well witness a tiny bloody discharge between your periods. Depending on when it happens, it could even be spotting in between periods. If you experience spotting the normal time of your period and you have not long had unprotected sex, it could be an indication that you are pregnant. Spotting at an early phase of pregnancy can be a sign of miscarriage.
So, if this happens you should see a doctor, but it may not necessarily be a sign of infection or miscarriage. However, if a patient is postmenopausal, this could raise concern for a potential cancer of the female organs. In uncommon occasions, brown or bloody discharge could be a signal of advanced cervical cancer. This is why it’s significant to get yourself checked every year. Go for routine pelvic exam and Pap smear, so that your gynecologist will examine you for cervical abnormalities.
This can also be normal, but could potentially be a sign of an infection. Generally, when a yellow discharge is thick, chunky, or when it has a bad smell is abnormal. This form of discharge may be an indication of the infection known as trichomoniasis, which is frequently transmitted through sexual intercourse. Although many women with chlamydia or gonorrhea have no symptoms at all, those that do may experience this type of discharge.
I would say this is usually abnormal and suggestive of an infection. A yellow or green thick, chunky and foul smelly discharge is not normal but could be a sign of sexually transmitted disease like trichomoniasis.
I think there is nothing specific about these 4 colors that are scary in and of themselves, but you would have to take into account certain factors like where the patient currently is in her reproductive cycle.
Does your vaginal discharge change depending where you are in your menstrual cycle?
Yes. In some cases, ovulation will cause a little bleeding, which when mixed into normal vaginal secretions causes a brown discharge.
Causes of vaginal discharge, normal and abnormal
Normal vaginal discharge is a healthy bodily function. It is mostly the means taken by your body system to clean and protect the vagina. When you work out or engage in other physical activities, the tendency is for your discharge to increase. Also you would tend to experience additional discharge sexual arousal, ovulation, when you use birth control pill, and when you are suffering from emotional stress.
On the other hand, the major cause of abnormal vaginal discharge is infection.
Bacterial vaginosis is a common bacterial infection. This infection can result to excessive or a boost in your vaginal discharge. It usually comes in a strong, foul-smelly and occasionally fish-like odor. In some instances, however, it doesn’t have any significant symptom. Women commonly receive oral sex or who have many sexual partners tend to have more of this type of infection.
This is second type of infection. It is usually caused by a single celled organism known as protozoan. The infection is normally contracted during sexual interactions, but it can as well be transmitted by sharing towels or bathing suits. This infection usually comes in a yellow or green color and has a foul smelly odor. It can as well result to pain, inflammation, and itching. However, a few people would not experience any symptoms.
A yeast infection is a fungal infection that results to white, cottage cheese-like vaginal discharge. It as well results to burning and itching sensations. It is normal to have yeast in your vagina but, if it grows out of hand it could result to yeast infections. This type of condition frequently accurs when you are having any of the conditions below:
- when you suffer from stress
- when you suffer from diabetic condition
- when you are making use of birth control pill
- It can occur when you are pregnant
- when you are under antibiotic medication particularly if you have used it for more than 10 days
Gonorrhea and Chlamydia
Gonorrhea and chlamydia are sexually transmitted infections. They can create an abnormal discharge, which is frequently yellow, greenish, or cloudy in color.
Pelvic Inflammatory Disease
Pelvic inflammatory disease is an infection that is frequently transmitted through sexual contact. It exists when bacteria disperses round the vagina and into other parts of the woman’s reproductive system. It may result to a heavy and distasteful smelling discharge.
Human Papillomavirus (HPV) or Cervical Cancer
The human papilloma virus (HPV) infection is cancer of the cervix. It is normally transmitted through sexual contact. It can result to cervical cancer. Although, it may not come with symptoms, this type of cancer can result to a bloody, brown, and/or watery discharge with a bad odor. Cervical cancer can readily be prevented or discovered when you go for normal annual pap smears routine checks and through HPV testing.
Discharge and pregnancy
Does pregnancy affect vaginal discharge?
Absolutely! For women that are currently pregnant, they tend to experience more discharge than average. So much, it could actually feel so wet that they feel like are urinating or leaking urine. Sometimes there can be so much that some women think they might have broken their water!
Discharge and age
Does a woman’s age have any effect on vaginal discharge?
I would say for women that are older and post-menopausal, vaginal discharge should be discussed with a doctor to understand what it could mean. If it is just a thin, white discharge with no other associated symptoms, this probably is just normal physiologic discharge, similar to what she had going into menopause. However, if there is anything else abnormal about it, I would recommend speaking to a doctor. If there is any bleeding, unusual color, or symptoms such as itching, odor, or more production after intercourse, I would give your doctor a call and make an appointment to be checked.
Discharge and STIs
Can abnormal vaginal discharge mean it is a sexually transmitted infection (STI)?
Some types of abnormal vaginal discharge could definitely be a sign of a sexually transmitted infection. That said, many patients who have chlamydia or gonorrhea have no symptoms at all. That is why it is so important for women to get tested for STIs even when everything feels OK.
This will be so helpful to our female readers! A lot of women feel uncomfortable discussing this with anyone, even the people closest to them. It isn’t the easiest topic to bring up in a casual conversation with friends. You could say “Hey, my throat is killing me, what should I take?” But it’s hard to casually say over a cup of coffee, “Hey, I have white discharge, do you know what that means?”
I think a lot of women are very shy when it comes to talking about vaginal discharge, but it’s important to know that it is normal and healthy to have it. Even if it’s not a topic women discuss casually with their friends, I would encourage them to be as open as possible with their doctors. For us, the little details are very helpful in figuring out what is going on. More information can help us determine whether someone can just make a clinic appointment or if she should go to an emergency room.
If you were trying to give a woman some comforting information or advice on vaginal discharge, what would it be?
I would say, most of the time, discharge is either totally normal or easily treatable. Generally, it requires a very short exam with your gynecologist to figure out the cause of the abnormal discharge.
Last question, Doctor. What would you like our female reader to know about discharge?
I would say discharge is a good thing – it’s healthy – and it’s important to know what is normal for your body. There is no need to clean out the inside of the vagina with things like douches or soap. In fact, I would highly recommend against trying to clean that area too thoroughly because that discharge is what is keeping your vagina really healthy. Discharge is filled with lots of protective bacteria, and disrupting that environment with things like douches and soap can actually lead to more infections.
Dr. Kim, thank you so much for taking the time out of your day to educate us on this important topic.
I can’t believe I just had a 30 minute conversation about vaginal discharge, but this is what I do. It’s great, and I hope this clears up a lot of questions for people!
More on Dr. Kim
Can you please describe yourself in three words?
Data-driven, determined, and compassionate.
What drew you to your specialty? What’s a fact about your specialty most people don’t know?
I love being able to provide care for women - from menstruation through menopause - especially since women are so often caregivers for others. Ob/Gyns are surgeons!
So, ladies and gentleman, there you have it. To summarize our point: vaginal discharge is a normal physiological part of our bodies. It is important to know what’s normal for you so that if something changes, you know when to see a doctor. We encourage you to get the dialogue going and share your knowledge about vaginal discharge with your friends, family, and loved ones. The more you know, the healthier you are!
A few words from Buoy
Here at Buoy, we strive to provide technology with heart and care for our users. With the help of Dr. Kim, we wanted to provide you not only with the knowledge, but confidence and deeper understanding of vaginal discharge. Take this information and share it with your friends, because vaginal discharge shouldn’t be a taboo subject. At the end of the day, we’re all women who have the same questions and information.
Buoy is a machine learning system checker. Using A.I., we use algorithms to get symptoms accurate and provide next steps in what the triage level should be. Visit our site to check out more blogs about healthcare topics and use our A.I. to learn more about your own health!Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.