Vaginal discharge

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 9, 2015
StartSymptomsVaginal discharge

Vaginal discharge is a completely normal part of the way that the female reproductive system works, and the majority of the time it is perfectly normal. Discharge allows the vagina and the cervix to move unwanted bacteria and dead cells out of the body, preventing irritation and infection. However, it is important to understand when normal discharge turns into something to be concerned about.

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Definition & Facts

Normal vaginal discharge ranges from clear as water in color to a milky-white. It typically has little to no odor and it is usually thin with a slippery texture. Depending on where a woman is in her menstrual cycle, the discharge will fluctuate within this normal range. The amount of discharge will increase if a woman is ovulating, breastfeeding, or is sexually stimulated.

Discharge becomes something to worry about when its color, odor, or texture changes. If it becomes darker with a brown, yellow, pink, or greenish tinge, if it has a noticeable odor that is significantly unusual, and/or if it has a thick or cheesy consistency, it is considered to be abnormal discharge. Depending on the cause, this change in discharge is frequently accompanied with other symptoms as well, such as vaginal burning or itching.

Causes

Changes in the normal balance of bacteria within the vagina are what cause abnormal discharge to occur. Some of these changes can be caused by benign situations, such as starting birth control pills, taking an antibiotic or other prescription medication, using scented soaps or body wash, pregnancy, child birth, or menopause.

However, the discharge can also be an indicator of something more sinister. Injury to the vaginal tissue, bacterial infections, yeast infections, chlamydia, gonorrhea, trichomoniasis, pelvic inflammatory disease, vaginitis, diabetes, and cervical cancer can all change the level of bacteria in the vagina, causing abnormal discharge.

Most of these diseases will also be accompanied by other symptoms, making it easier to identify what the issue is. Because abnormal discharge can be an indicator of a variety of different issues—some of which are severe—it is important to take notice and search for the cause whenever there is a change in vaginal discharge.

When to see a doctor

If the cause of the abnormal discharge is obvious, such as having a yeast infection, it is not necessary to go to the doctor’s immediately. There are many different types of over-the-counter medications, such as Monistat®, that can be used to treat yeast infections, and other causers of abnormal discharge and vaginal irritations.

It can also be helpful to switch to an unscented soap until the discharge is gone. If the vaginal tissue has been injured, it is important to abstain from intercourse for at least a week, or until the injury has healed. It can also be beneficial to use cold compresses to relieve any itchiness or swelling while the area is healing.

Monitor the type of discharge carefully; with any benign issue, it should return to normal within a few days, after the bacteria level inside of the vagina has had time to adjust. If after a week the abnormal discharge is persisting, or has worsened, it is time to consult a doctor. A doctor will be able to perform a physical exam of the area, as well as a Pap smear and a blood test, to determine the exact source of the issue.

Treatment & Therapy

The treatment recommended by doctors will vary depending on what is causing the problem. For minor issues, such as bacterial infections, chlamydia, gonorrhea, and pelvic inflammatory disease, antibiotic pills or creams will be prescribed. Ofloxacin, ceftriaxone, doxycycline, and azithromycin are among the most common medications prescribed for these conditions.

With chlamydia, two of these are usually prescribe, one as a single dose, and one as a daily capsule. Trichomoniasis can usually be successfully treated with either metronidazole or tinidazole. However, since it is a small organism, it can require follow-up appointments with a doctor and additional treatments. More severe problems, such as diabetes and cervical cancer, will require a variety of different medications, lifestyle changes, and follow-up visits with a doctor.

Treatment for diabetes will involve monitoring blood sugar levels, taking insulin injections, eating a healthier diet, and exercising more frequently. Until blood sugar levels have been stabilized, it is possible for abnormal vaginal discharge to persist. Treatment for cervical cancer will vary drastically depending on the severity and how wide-spread the cancer is. Generally, both chemotherapy and radiation therapies are used during the course of the treatment. Because of the location of this cancer, it is possible for abnormal discharge to continue until the cancer has entered into remission.

Prevention & Prophylaxis

Regardless of what the issue is, there are a few things that can be done to help speed up the success of the treatments and prevent abnormal discharge from reoccurring.

  • Wash the vagina every day with a mild soap to keep it clean and free of bacteria.
  • Avoid using overly-perfumed soaps and body wash, and avoid changing the type of soap that is used frequently as well.
  • Never use a douche, unless specifically instructed to do so by a doctor. The vagina is a self-cleaning organ and attempting to clean the inside of it by artificial means can remove needed bacteria.
  • Always make sure to wipe front-to-back to avoid bringing any unwanted bacteria into the vaginal region.
  • Avoid wearing clothing that is overly tight because the vagina needs to have air circulation around it to prevent bacteria from growing. For this same reason, it is best to wear 100% cotton underwear.
  • If using a lubricant, always make sure that it is water-based. Using a chemical-based lubricant can cause irritation to the vaginal tissue.
  • During menstruation, change pads and/or tampons frequently. A build-up of menstrual blood in and around the vagina can lead to irritation and infection.

It is important to be very aware of what normal vaginal discharge looks like and when it occurs in the menstrual cycle. Not knowing this can lead to overlooking important signals that the body sends indicating that there is an issue that needs to be addressed.