Vaginal discharge – do I have to worry?
However, often this isn’t a topic you would openly discuss with your friends or even your doctor.
You may have questions such as “ Is it normal discharge? Why does my discharge always vary in amount and colour? Should I see a doctor? When should I be worried?”. These are perfectly common and normal questions to ask as vaginal discharge varies from individual and they can be quite confusing.
Usually there is really nothing to worry about unless your vaginal discharge is associated with itching, pain or bad smell. Having vaginal discharge is normal in all women. But of course, it will be helpful to know what normal discharge is or looks like.
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.
Normal and ovulation discharge
Clear, whitish, thin or thick odorless discharge are usually normal and shoudn’t be alarming. It can happen at any time during your menstrual cycle. This discharges means your reproductive organs are ‘cleansing’ the vagina and cervix, getting rid of dead cells and bacteria which is being transported by these discharges.
Somewhere around the 14th day of your cycle (i.e when an egg is released from your ovary -termed ovulation), you may notice clear colourless and elastic discharge resembling egg white. It is usually much more in amount than your usual vaginal discharge. This is a good sign for those who are trying to concieve as this when you are most fertile.
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 having bright red blood discharge during menses, you can also have dark brown discharge which usually occurs towards the end of your menstruation or 1-2 days after menstruation. This is the leftover menstrual blood in the vagina which was not completely cleared. It is brown as dead blood cells turn brown. Sometimes, this dark brown discharge can also be seen during your mid cycle when ovulation occurs and is normal.
InfectionsClick here for details on STD Screening for Women
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.
Other type of infections that you could get which could cause abnormal vaginal discharge includes chlamydia, ureaplasma and mycoplasma.
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 a good personal hygiene.
Although less frequently red discharge or spotting is a more serious case. When this is noted, question yourself: Have you had any unprotected intercourse recently? 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, it may be due to cancers. This is the time when you should be worried and tell your doctor.
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Dr (Ms) De Souza
MD (Russia), MMed (Obs&Gyn)