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Female Urethral Discharge Symptoms, Causes & Common Questions

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Last updated March 15, 2021

Female urethral discharge quiz

Take a quiz to find out what's causing your discharge.

Female urethral discharge is usually the first sign of an infection known as urethritis. The causes of white particles in urine, or mucus in urine, is known as gonococcal urethritis, which can also cause pain and burning in the urethra. Read below for more related symptoms, causes, and treatment options.

Female urethral discharge quiz

Take a quiz to find out what's causing your discharge.

Take female urethral discharge quiz

Symptoms of female urethral discharge, pain, or burning

The urethra is the slender, muscular duct that drains urine from the bladder to the outside of the body. One of the first symptoms of infection or inflammation of the urethra will be a discharge. In women, the lining of the urethra changes in response to the hormones which control her monthly cycle. This provides some protection from serious disease but also leaves women susceptible to chronic, low-level bacterial invasion of the urethra.

It can sometimes be difficult to tell whether the discharge is coming from the urethra or the vagina or both. Inflammation of the urethra is also called urethritis or female urethral syndrome.

Characteristics: [1,12]

  • Frequent urination.
  • Burning on urination.
  • Urgency of urination, meaning it is very difficult to wait.
  • Itching and discomfort within the urethra.
  • Lower abdominal pain or discomfort.
  • Low-grade fever.
  • A discharge of white or clear mucus may be evident when first urinating in the morning, making the urine appear cloudy. The same discharge may be noticed on underclothes. The more severe the infection, the darker and heavier the discharge.
  • Pain or discomfort during sex.
  • In some women, urethritis may seem to have few or no symptoms.

Who is most often affected by female urethral discharge symptoms?

  • Women who are sexually active, especially with multiple partners.
  • Women at or near menopause, when estrogen levels decline and the lining of the urethra may become drier and thinner.
  • Women who also have a vaginal infection often develop urethritis as well, and vice versa. [13]

Is female urethral discharge serious?

  • A mild case of urethritis can be easily treated by your medical provider, especially if caught early.
  • Urethritis of any type can readily spread to the vagina.
  • An infection in the urethra can spread upward to other organs such as the bladder or kidneys and may also reach the uterus and fallopian tubes. This can cause serious illness and sometimes leads to sterility.

Causes of urethral discharge in women

Many conditions can have urethral discharge as a symptom. The most common are those involving bacteria transmitted during sex, as well as hormonal changes during a women's cycle and allergies to certain foods and substances.

Most common cause types:

  • Bacterial infection with the gonococcus bacteria, which is acquired during sexual activity. This form of the illness is called gonococcal urethritis.

Less common cause types:

Infection of the urethra with other organisms, most of which are also acquired during oral, anal, or vaginal sex. This form of the illness is called non-gonococcal urethritis or nonspecific urethritis.

  • Chlamydia trachomatis, which is often found concurrently with gonococcal urethritis.
  • Trichomonas vaginalis, which is a tiny parasite transmitted through sexual activity.
  • Herpes simplex, which is caused by a virus and is also a sexually transmitted infection.
  • Yeast infection, which can spread from the vagina to the urethra.
  • E. coli, which is found in feces and can easily spread from the rectum to the urethra.

Least common cause types:

  • Irritants to the outside of the urethra:
  • Hormonal changes due to the normal variation in a woman's estrogen cycles each month. At some points, the lining of the urethra is thinner and therefore more susceptible to irritation and/or infection.
  • Use of a urinary catheter, which may cause irritation or injury to the urethra and therefore allow bacteria to get through the mucus membranes.
  • Urethral diverticula are bulging pouches, or pockets, that form along the outside of the urethra. These pouches become filled with urine but do not drain properly, sometimes allowing bacteria to grow and causing symptoms of urethritis.

This list does not constitute medical advice and may not accurately represent what you have.

Symptoms of menopause

Menopause is the name for the natural process by which the menstrual cycle (period) stops happening in a woman. Usually, the process is gradual (takes months or years) and occurs from the age of 45 to 55 years. Menopause is officially diagnosed once a woman stops having a period for 12 months continuously. A woman with menopause will notice a decrease in the number and regularity of her periods until they completely stop. In addition, she may notice a number of symptoms that occur as a result of decreased estrogen levels, such as hot flashes, changes in mood, sleep problems, vaginal dryness, changes in libido, and changes in sexual function. Certain medications exist that can decrease these symptoms.

Rarity: Common

Top Symptoms: fatigue, delay in or irregular periods, vaginal discharge, anxiety, trouble sleeping

Symptoms that always occur with symptoms of menopause: delay in or irregular periods

Urgency: Self-treatment

Female urethral discharge quiz

Take a quiz to find out what's causing your discharge.

Take female urethral discharge quiz

Yeast infection

A vaginal yeast infection, also called genital/vulvovaginal candidiasis, is actually caused by the fungus Candida albicans and is very common. The organism is a normal inhabitant of the mouth, gastrointestinal tract, and vagina.

Antibiotics can kill off the healthy bacteria in the vagina, allowing overgrowth of the fungus. Women who are pregnant, on the birth control pill, or diabetic are more prone to yeast infections, as are those who have weakened immune systems. It can also be transmitted through sex or through mouth-to-genital contact.

Symptoms include itching, burning, pain, and soreness inside the vagina and on the external tissues (the vulva,) and a thick, white vaginal discharge.

If not treated, the yeast infection can become "complicated," severe, and difficult to cure.

Most yeast infections are diagnosed simply through the patient's description of symptoms. Recurrent infections may be diagnosed through pelvic examination and vaginal swab.

Treatment often is just an over-the-counter cream, though oral anti-fungal medications are sometimes prescribed.

Vaginal trichomonas infection

Trichomonas vaginalis infection (or "Trichomoniasis" or "trich") is a common sexually transmitted disease caused by a parasite of the same name. It affects over 3 million people per year, but only about 30% have any symptoms.

You should go see your primary care doctor in the coming days. He or she may order a number of tests to identify if the bug is actually the cause of your symptoms. Treatment involves prescription metronidazole or tinidazole.

Urinary tract infection

A urinary tract infection, or UTI, can involve any or all parts of the urinary system but most often affects the bladder and urethra.

Bacteria from the gastrointestinal tract – especially Escherichia coli (E. coli) – are the most common cause of UTIs. These bacteria spread from the anus to the urethra. Sexual activity can do this, but a UTI is not considered a sexually transmitted disease.

Women are more at risk for UTI than men. Due to female anatomy, the urethral opening is a short distance from the anus. Anyone who uses catheters to urinate is also prone to UTIs.

Common symptoms of less-serious UTIs include lower abdominal discomfort and pressure; burning or discomfort on urination; and cloudy or discolored urine.

Left untreated, the infection could spread to the kidneys and cause a medical emergency.

Diagnosis is made by having the patient describe the symptoms and by testing a urine sample for bacteria.

UTIs are caused by bacteria and so can be treated with antibiotics.

Prevention involves good hygiene and drinking plenty of water.

Symptoms of menopause

Menopause, or "change of life," refers to the time when a woman no longer has menstrual cycles and can no longer bear children.

It is a normal occurrence and usual happens between ages 45 to 55. Menopause can be artificially induced by surgical removal of both ovaries, and by chemotherapy and/or radiation therapy for cancer.

Symptoms usually begin many months before periods actually stop. There will be irregular periods, vaginal dryness, hot flashes, weight gain from slower metabolism, and dry skin.

If not treated, some symptoms may affect quality of life. Hot flashes and hormonal imbalances can disrupt sleep, sexual function, and emotional health.

At menopause, risks of heart disease, osteoporosis, and urinary incontinence increase. Because periods can become irregular while pregnancy is still possible, testing is advisable before any medical treatment is done.

Menopause is diagnosed when an entire year has gone by without the woman experiencing a menstrual period. Blood testing for hormone levels can confirm menopause.

Treatment can be done for any troublesome symptoms, including hormone replacement therapy to ease hot flashes.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease: fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Normal case of vaginal discharge

It is perfectly normal for every woman to have a clear or thin white vaginal discharge which is more or less constant.

The body protects the vaginal tissues by producing this light mucus from glands in the cervix and in the vaginal walls. This keeps the tissues lubricated so that they do not dry out and become irritated, and keeps the tissues slightly acidic because that helps to kill off any harmful germs.

The discharge is also a cleaning mechanism, clearing away any dead cells or bacteria as it moves out of the vagina. Douching is not necessary for normal discharge.

Vaginal discharge may change at different stages of life. During pregnancy, it becomes white and milky in appearance.

During and after menopause, the discharge lessens due to the drop in estrogen levels. If the dryness causes irritation or difficulty with sexual activity, a gynecologist can recommend an appropriate remedy.

Normal vaginal discharge never causes itching or has a foul smell, and is never any color other than clear or white.

Rarity: Common

Top Symptoms: vaginal discharge, mild vaginal discharge, white/gray vaginal discharge, clear vaginal discharge, severe vaginal discharge

Symptoms that always occur with normal case of vaginal discharge: vaginal discharge

Symptoms that never occur with normal case of vaginal discharge: vaginal itch or burning, painful urination, severe vaginal discharge, vaginal pain, abdominal pain (stomach ache), bleeding after sex, missed period, vulvovaginal odor

Urgency: Wait and watch

Female urethral discharge quiz

Take a quiz to find out what's causing your discharge.

Take female urethral discharge quiz

Disseminated gonococcal infection

Gonococcal cervicitis is an inflammation of the cervix – the passageway at the lower end of the uterus – caused by the bacteria Neisseria gonorrhoeae, or gonorrhea.

Gonorrhea is a sexually transmitted disease (STD) and spreads through unprotected sexual contact.

Symptoms include abnormal vaginal discharge, pain or discomfort during sex, and vaginal bleeding after sex. However, some women have few or no symptoms.

If not treated, gonococcal cervicitis can lead to further infection of the reproductive tract and to pelvic inflammatory disease, which can cause sterility.

Diagnosis is made after a cervical swab is taken and tested.

Treatment is through a course of oral antibiotics. Women diagnosed with gonococcal cervicitis should be further tested for other common STDs such as chlamydia and trichomoniasis, as they are often found at the same time.

The best prevention for gonorrhea is the use of a condom during sex, as well as testing of all sex partners so that they can be treated and not re-infect anyone.

Cervicitis in general can be prevented by not exposing the cervix to douching or other irritants.

Rarity: Ultra rare

Top Symptoms: fatigue, joint pain, fever, chills, moderate fever

Urgency: Primary care doctor

Chlamydia infection

Chlamydia is a common bacterial infection that is spread through unprotected sex. Each year, over 1 million Americans are diagnosed with this STD.

You should visit a physician to confirm the diagnosis where an antibiotic will be prescribed.

Bacterial vaginosis

Bacterial vaginosis is an inflammation of the vagina due to overgrowth of the bacteria which are normally present.

It is not considered an STD (sexually transmitted disease) but nearly all cases are found in women after unprotected sexual contact, especially with multiple partners.

Frequent douching is also a factor.

Male partners do not carry this condition, but it can spread between female partners.

Common symptoms include an itchy, foul-smelling discharge that may look grayish or greenish, as well as burning during urination. However, some women have no symptoms.

The greatest risks of bacterial vaginosis are secondary. The symptoms can be similar to actual STDs and so should not be ignored. This condition makes a woman more vulnerable to actual STDs, as well as to pelvic inflammatory disease and to infections following any gynecologic surgery.

Pregnant women with bacterial vaginosis are at risk for premature or low-birth-weight babies.

Diagnosis is made through symptoms, and/or pelvic exam and vaginal swab.

Treatment consists of oral medication, and sometimes a cream or gel that is inserted into the vagina.

Rarity: Uncommon

Top Symptoms: vaginal itch or burning, vulvovaginal odor, bloody vaginal discharge, white/gray vaginal discharge, thick vaginal discharge

Urgency: Primary care doctor

Atrophic vaginitis

Atrophic vaginitis is a condition causing dryness of the vagina. It is caused by a drop in estrogen levels, which happens due to menopause, stress, medication side effects, and childbirth. Other symptoms include painful sex and vaginal soreness.

You should consider visiting a medical professional to discuss your symptoms. Atrophic vaginitis is evaluated with a review of your symptoms and a pelvic exam. Once diagnosed, it can be treated with estrogen replacement, moisturizers, and lubricants. Avoiding douching and perfumes may help dryness from worsening.

Treatments for urethral discharge, pain, or burning

Seek immediate treatment in the emergency room or call 911 if:

  • You have severe and intractable pain in the lower abdomen and/or urethral area, especially if accompanied by fever.

Schedule an appointment for:

  • Symptoms of an infection which has spread into the urinary or reproductive tract.

In addition to those listed above for urethritis, these symptoms include:

Urethral discharge remedies that you can try at home:

  • Practice good hygiene, including wiping only from front to back after using the toilet and always wearing clean clothes.
  • If you are prone to vaginal or urethral infections, it's best not to wear thong underwear.
  • Always use condoms during sexual activity.

Questions your doctor may ask about female urethral discharge

  • Are you sexually active?
  • Do you feel pain when you urinate?
  • When was your last menstrual period?
  • What color is the discharge?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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