Vaginal discharge – do I have to worry?
Many women are confused when it comes to vaginal discharge. Questions such as, “Is it normal?” “When should I be worried?” “Why does it always vary in amount and colour?” “Should I see a doctor?” are common but most of them would rather keep to themselves.
Unless vaginal discharge comes with itching, pain and bad smell, there is really nothing to worry. This is a natural occurrence in all women. But of course, it would be wiser to know what a normal discharge looks like.
Clear or whitish, thin or thick odorless discharge wouldn’t be alarming. It happens usually at the beginning and end of a menstrual cycle. This means your reproductive organs are ‘cleansing’ the vagina and cervix, releasing dead cells and bacteria by means of fluid as transport. Somewhere around the 14th day of your cycle (i.e. when an egg is released from your ovary – termed ovulation), you may note clear colorless and elastic discharge resembling egg white. It is usually much more than normal in amount. You might need to replace your panty liners more frequently. Sometimes, white and more watery discharge can be found after heavy physical activities, when you are sexually excited or sometimes when you feel extremely tired.
Besides white, discharge can be of gray, green, yellow, pink, red (not during menses) or even dark brown colour. Brown discharge which occurs 1-2 days after menstruation is normal. This is the leftover menstrual blood in the vagina which is not completely cleared. It is brown as dead blood cells turn brown. Sometimes, it can be seen in mid cycle during ovulation.
Before proceeding any farther, let us realize that a normal healthy vagina is never free from a type of bacteria known as ‘lactobacillus’. When balanced in amount, it is a ‘friend’ and ‘protector’ of the vagina. Its role is to protect the vagina from infection by releasing certain proteins and maintaining a vaginal pH of 4.5. Once the bacterial count decreases, vaginal pH changes and various infections of the vagina can occur. Green, yellow, gray and white, thick, cottage-cheese like discharge, usually with odor, itching and pain are signs of infection.
Bacterial vaginosis (vaginal infection caused by bacteria) is one of the most common causes of gray, foul fishy-smelling vaginal discharge. Redness of the vulva, itching and burning sensation during intercourse may accompany. Green, thick fishy-smelling discharges are commonly caused by gardnerella infections. Gonorrheal infections are manifested by cloudy yellow discharge often accompanied by pelvic pain and frequent urination. Trichomoniasis (a parasitic infection) gives yellowish frothy discharge with bad odor. This is usually transmitted through unprotected sex. These infections are commonly treated with over-the-counter antibiotics, most effective one being metronidazole in forms of tablets, vaginal gel/creams and suppositories.
White, cottage-cheese-like discharge often accompanied by itching is due to yeast infection known as candidiasis. Most are dealt with fluconazole and other similar antifungals which can be purchased at any pharmacy. If you are pregnant, consult a doctor before taking any medications. Pay attention to your personal hygiene. Changing your panty liners frequently, keeping your feminine area cool and dry by avoiding tight clothing and linen panties may help prevent from such infections.
We must not overlook some other simple facts that may lead to changes in normal conditions of vagina. Decreased bacterial count and an increased vaginal pH more than 4.5 are the main culprits causing infection. You may not notice that using fragrant soaps, vaginal douching and frequent bubbly baths may be some of the causes. For those who are sexually active, sticking to one partner is the best prevention, as STDs are often associated with such infections. Pregnancy and menopause may sometimes lead to imbalanced vaginal conditions due to hormonal changes. It is then best to maintain your hygiene strictly.
Although less frequent, red discharge or spotting is a more serious case. When this is noted, question yourself: Have you had any unprotected intercourse a few days ago? If yes, this may be a sign of pregnancy and you might want to do a pregnancy test. Spotting during early pregnancy may mean miscarriages or threatened abortion. Some other reasons are vaginal tear and lacerations during rough intercourse, and, if you are more than 40, may be due to cancers. This is the time when you should be worried and tell your doctor.
Dr (Ms) De Souza
MD (Russia), MMed (Obs&Gyn)