Ladies (and curious gentlemen), today's topic may not be the sexiest one, but it's an important aspect of every woman's health: vaginal discharge. Vaginal discharge is something that many women are curious about and want to discuss, but feel reluctant bringing up. That's why we at Buoy Health wanted to learn more about this natural body process, what's normal, and what to watch out for.
To get the skinny on vaginal discharge, we reached out to Renita Kim, MD MPH, an Obstetrics and Gynecology resident at Brigham and Women’s Hospital and Massachusetts General Hospital. Here's what Dr. Kim had to say.
What is vaginal discharge?
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.
The skin inside the vagina and the cervix are always going to produce some kind of discharge. It is a normal or physiological bodily function that keeps 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.
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Discharge colors and what they mean
There are a lot of types of vaginal discharge, grouped based on their color and consistency. It’s hard to isolate the color alone, as one 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:
Yellow vaginal discharge is usually normal, but here are a few signs that it's not. Generally, a yellow discharge is abnormal when it is:
This form of discharge may be an indication of trichomoniasis infection, which is frequently transmitted through sexual intercourse. This is especially true if the discharge is yellow-greenish. Although many women with chlamydia or gonorrhea have no symptoms at all, those that do may experience this type of discharge.
Yellow discharge after sex
As mentioned above, a thick, chunky or foul-smelling yellow discharge, especially accompanied by itchiness, is a sign of STI after sex. The STIs could be trichomoniasis, Gonorrhea and Chlamydia for yellow discharge. HPV usually results in a bloody, brown or watery discharge with an odor. Please read further about the STIs in detail in "Causes of Abnormal Discharge" below.
Green vaginal discharge is usually abnormal and suggestive of an infection. A thick, chunky and foul-smelling discharge is not normal but could be a sign of sexually transmitted disease like trichomoniasis.
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 discharge
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.
If a woman has brown vaginal discharge while she is menstruating or towards the tail end of a period, it should be normal. A late discharge at the end of your period can look brown instead of red. This is probably just blood in the discharge or spotting in between periods. If you experience spotting the normal time of your period and you have not had unprotected sex, it could be an indication that you are pregnant. See more on spotting. Brown discharge or spotting during early pregnacy could be a sign of miscarriage. You should see a doctor to make sure.
Brown discharge post menopausal
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 a pelvic exam and Pap smear so that your gynecologist will examine you for cervical abnormalities.
Normal vaginal discharge vs abnormal discharge
Normal vaginal discharge
Normal or “physiologic” discharge is healthy and something that you would expect to have every day. When you work out or engage in other physical activities, the tendency is for your discharge to increase. You’ll typically notice:
- A clear discharge
- A whitish discharge
- No foul odor
- Watery vaginal discharge
- Thin or stringy vaginal discharge
- During ovulation: A little bleeding, which when mixed into normal vaginal secretions causes a brown discharge.
- Varied volume: 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.
For women that are currently pregnant, they tend to experience more discharge than average. So much and it could actually feel so wet that they feel like are urinating or leaking urine. Sometimes there can be so much discharge that some women think they might have broken their water.
Abnormal vaginal discharge
Signs of abnormal vaginal discharge are:
- Postmenopausal discharge that is brown in color: This could be a sign of organ issues such as cancer. Go see a doctor.
- Thick discharge
- Foul smelling discharge
- Green discharge
- Itchy discharge
These are signs of an infection or STI. Read below on causes.
Lastly, if you're pregnant:
- Bloody discharge: During early stages of pregnancy, this could be signs of a miscarriage.
Causes of abnormal discharge, odor or itching
The major cause of abnormal vaginal discharge (i.e. itching, foul-smell, thick discharge) is infection, including sexually transmitted infections. Here are a few causes:
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-smelling and occasionally fish-like odor. In some instances, however, it doesn’t have any significant symptom. Women who 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 usually 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-smelling odor. It can as well result to pain, inflammation, and itching. However, a few people would not experience any symptoms.
Yeast Infection Discharge
A yeast infection is a fungal infection that results in white, cottage cheese-like vaginal discharge. It also results in burning and itching sensations. It is normal to have yeast in your vagina but, if it grows out of hand it could result in yeast infections. This type of condition frequently occurs when you are having any of the conditions below:
- Taking birth control pill
- Taking 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 in 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 in cervical cancer. Although, it may not come with symptoms, this type of cancer can result in 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 through HPV testing.
Types of vaginal discharge
Lastly, some additional textures that are important:
Thick white discharge
A thick consistency, especially one that has a cottage cheese texture, is a sign of yeast infection. This is particular true if the patient feels an itch following the discharge.
Clear and Stretchy Discharge
When your discharge is clear and stretchy or looks like mucus instead of water, it is a sign that you are possibly ovulating. This is a healthy and perfectly normal discharge.