What is normal vaginal discharge?

Vaginal discharge is a mixture of fluid and cells that are shed continuously through your vagina. Normal vaginal discharge comprises thick cervical mucus, vaginal fluid, shedding vaginal and cervical cells, and bacteria.

Normal vaginal discharge helps keep the vaginal tissues healthy, provides lubrication and protects against infection. The amount, colour and consistency of normal vaginal discharge vary depending on your menstrual cycle, and it can vary from whitish and sticky to clear and watery. Abnormal vaginal discharge — for instance, fluid with an unusual discharge, odour or appearance that occurs along with itching or pain — may be a sign that something's wrong. Most women produce about 4 milliliters of white or clear discharge every day.

Different types of discharge are indicated at different phases of the menstrual cycle, including:

• Increased white discharge indicates that you are near the beginning of the menstrual cycle.
• Clear, stretchy discharge indicates that you are ovulating.
• Clear, watery discharge usually occurs at other times of the menstrual cycle.
• Brown discharge may occur immediately after a period and is a sign of your vagina cleaning itself.

How do I know if my vaginal discharge is abnormal?

Suppose you experience symptoms like foul smell, discomfort, irritation, or burning sensation along with discharge, you must visit a gynecologist at the earliest. This will help you determine the cause for these alterations (fungal, viral or bacterial) and receive the required treatment.

Vaginal discharges can be of different colors such as yellow, green, transparent, white, grey, pink and red - each of these secretions indicate various conditions - some normal while others require medical attention.

• Yellow/green discharge may indicate a bacterial infection, common ones being Chlamydia, Gonorrhea,, particularly if it’s thick, dirty looking or smells different than usual.
• Thin Grey discharge may indicate a common bacterial infection called bacterial vaginosis (BV) which may be caused by an imbalance of “good” and “harmful” bacteria, along with a strong fishy odor.
• Thick, white curd-like or cottage cheese-like discharge, could be due to Fungal infection, commonly called Candidiasis, may be associated with itching, irritation, or soreness in the genitals.
• Women with trichomoniasis may notice Itching, burning, redness or soreness of the genitals, discomfort whilst urination; and a change in their vaginal discharge (i.e., thin discharge or increased volume) that can be clear, white, yellowish, or greenish with an unusual fishy smell.
• Pink discharge may indicate cervical bleeding, vaginal irritation, or implantation bleeding.  

Possible causes for white discharge before your period could be

• Normal reproductive system functioning: White discharge before your period is very normal. At this stage, the normal discharge of your cycle is called “egg white mucus,” because of its thin, stretchy,odorless, and slippery texture.
• Pregnancy: Discharge before your period timeline can be an early sign of pregnancy. This can be hard to identify apart from discharge that is a of your monthly cycle, but it is usually thicker and creamier than “normal” discharge.
• Birth control: Your hormone levels are affected by birth control, leading to an increased discharge. This is a normal side effect of hormonal birth control.
• Sexually transmitted infection (STI or STD): Prominent STIs like Gonorrhea, chlamydia, and trichomonas are most likely to cause discharge. In such cases, your discharge will be more yellow and pus-like. However, these STIs could be asymptomatic. Trichomonas may lead to symptoms, including greenish or yellowish, foul-smelling discharge and itching.
• Bacterial vaginosis: Bacterial vaginosis is an infection occurring when the natural balance of bacteria in your vagina changes. The cause is unknown, but it’s been linked to smoking, douching, and more. Discharge from bacterial vaginosis has a foul smell and a grayish white color.
• Yeast infection (candidiasis): Candidiasis are common and can be caused by increased use of antibiotics. Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on the skin without causing any problems. However, these infections are most likely to happen before you get your period. Discharge from candidiasis is thick and white, causing itching and burning in your vagina and vulva.

Women who are more likely to get vaginal candidiasis include those who:

• Are pregnant
• Use hormonal contraceptives (for example, birth control pills)
• Have diabetes
• Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
• Are taking or have recently taken antibiotics

Difference between arousal secretions and vaginal discharge

The primary purpose of any type of vaginal discharge is to moisturize and clean the vagina. However, even when discharge occurs around ovulation, there may not be enough lubrication for comfortable sex. Ordinary vaginal discharge serves as natural lubrication, but other processes are involved when more moisture is needed.

The genital area becomes engorged with blood when you’re sexually aroused and the vessels expand, letting fluid pass through its walls. The Bartholin’s glands and Skene’s glands both produce extra mucus.This lubrication helps make penetration easier, reducing friction and irritation from sex. The amount of arousal fluid produced depends on the person, their age, hormonal balance, and menstrual phase.

When must you see your doctor?

If you have the following:

• Pain, burning, or other discomfort in and around the vaginal area
• Cottage cheese-texture discharge
• Green, yellow, or dirty looking discharge
• Copious amount of discharge, which is not normal for you
• Strong or foul vaginal odor
• Rash or sores with or without discharge
• Redness, itching, or swelling of genitals
• Bleeding between periods or after menopause
• Spotting after sex regularly
• Burning sensation whilst passing urine
  
  

What happens if left untreated?

If your vaginal discharge is left undiagnosed and untreated, it can lead to other serious health complications such as Pelvic Inflammatory Infection (PID). PID is an infection of internal reproductive organs, which in turn can lead to difficulty in conceiving, recurrent Urinary infections, and Cervical Cancer in the long term.

Treatment for abnormal vaginal discharge

The cause of the abnormal discharge may decide its subsequent treatment. For example, yeast infections are usually treated with the insertion of antifungal medications into the vagina in the form of a cream or gel. Bacterial infections are treated with antibiotic pills/creams, and viral infections with antivirals.

But as we all know - prevention is better than cure, and this stands true even for your vaginal discharge. Here are some easy, quick tips to take care of your vagina.

• Wash the outside of your vagina with warm water using mild soap. Do not use soap directly in the vagina.
• Never use scented soaps, douche, perfume sprays and bubble baths.
• Do not wear your underwear immediately after washing your vagina. Wipe it dry from front to back to prevent bacteria from getting into it and causing an infection.
• Wear 100% cotton underpants, and avoid tight clothing whenever possible.
• Use Barrier contraception (condoms) to reduce the risk of contracting STIs.
• If you’re sexually active, it is recommended that you get annual STI Testing 
• Get your Hepatitis B, HPV Vaccination 

Conclusion

Healthy vaginal discharge keeps the vagina clean, prevents infections, and provides lubrication. It changes its purpose based on the needs of the body. For example, discharge increases during sex to avoid irritation and thickens during ovulation to help the sperm fertilise the egg. You must always be careful of the colours and amounts of vaginal discharge considered normal for you. Your vaginal discharge is often a reflection of your overall health and this makes it crucial to visit a gynaecologist immediately when you notice an abnormality.

Disclaimer: This information is educational and should not be construed as medical advice. Please consult your doctor before making any dietary changes or adding supplements.

Proactive For Her is a digital clinic for women, offering accessible, personalised, and confidential healthcare solutions. We offer out-patient care, diagnostic services and programs for various health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause.