This bodily fluid is perfectly normal, but there may be signs that you need to see your doctor. Find out how to tell the difference.
You’ve probably experienced vaginal discharge — most women do. You may have noticed it change throughout your lifetime, especially if you’ve been pregnant or gone through menopause. You may even have been concerned about it.
It’s time to dispel the myths about vaginal discharge. The truth is, it serves an important function in keeping the vagina healthy, by expelling dead skin cells from the lining.
“Vaginal discharge is fluid secreted from glands in the vagina and cervix,” says Evelyn Mitchell, MD, an obstetrician and gynecologist at Keck Medicine of USC and clinical assistant professor of obstetrics and gynecology at the Keck School of Medicine of USC. “Discharge is very normal and healthy to allow removal of old skin and debris that build over time.”
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The discharge is composed mostly of water and contains “good” bacteria that help balance the pH, or acidity, of the vagina, which prevents infection.
“Your vagina is an entire ecosystem of good bacteria that help maintain a normal pH,” Mitchell says.
What’s considered normal
If your discharge is clear to white in color and not itchy or copious, you’ve got nothing to worry about. Normal vaginal discharge can have a mild odor, but it would not be perceived as bad or foul-smelling.
“You should not feel embarrassed or ashamed of your discharge,” Mitchell says. “The amount of discharge can vary from person to person; some women make more discharge than others.”
Vaginal discharge also responds to your hormones. Normal vaginal discharge will vary, depending on timing in relationship to menses, ovulation and medications, such as birth control pills or other forms of contraception, from vaginal rings to intrauterine devices.
Ovulation, for example, may increase the fluid; birth control may reduce it. During pregnancy, when hormones are rampant, discharge may increase; during breastfeeding and menopause, when hormone levels are low, it may decrease.
“Discharge can be used to help predict ovulation,” Mitchell says. “This is helpful to know whether you are pursuing pregnancy or avoiding it.”
She explains that around the time of ovulation, which is typically 14 days after the first day of your period, your discharge will become very thin and slippery, similar to egg white consistency.
Factors outside your body, such as changing your sexual partner or eating different types of foods, may influence it as well.
“Many apps are available to help track your period and discharge throughout your cycle to learn what is normal for you,” Mitchell says. “It’s important to know what your normal is.”
What might be a red flag?
If you notice any unusual changes in color, amount, consistency or odor of your discharge, consider seeing a doctor.
Abnormal vaginal discharge can cause irritation or itching, a foul smell or copious amounts of fluid that necessitates panty liners or pads, so it doesn’t leak through your underwear. A green tinge to your discharge or unusual bleeding may also be causes for concern.
Such changes may indicate an infection. Here are some of the most common ones:
This infection, also known as candidiasis, occurs when yeast in the vagina multiplies beyond the usual amount, causing a lumpy discharge that may be accompanied by itching.
Yeast loves moisture, so preventive measures include wearing breathable underwear with a cotton crotch, wearing loose clothing and changing out of wet or sweaty clothing as soon as possible. Some evidence indicates that eating yogurt, which contains live cultures, may help prevent yeast infections. Drugstore suppositories can help, but be sure to contact your physician before trying one of them.
Bacterial vaginosis (BV)
This infection can produce a “fishy” smell and an increased discharge that may be grayish. It’s not considered a sexually transmitted infection, but it is most common in sexually active women.
“BV is an extremely common condition that is due to a change in the normal microbiome of the vagina and results as an overgrowth of ‘bad’ bacteria,” Mitchell explains.
Physicians don’t know exactly what causes it or how to prevent it, but it’s important to treat BV with antibiotics, as it’s been linked to an increased chance of contracting other sexually transmitted infections.
Bacterial vaginosis can be a recurrent problem for some women, Mitchell adds, especially occurring after intercourse or periods. Fortunately, she says, treatments are very effective.
Sexually transmitted infections (STIs)
Sexually transmitted infections, such as trichomoniasis, chlamydia or gonorrhea, may be mistaken for a yeast infection. Practice safe sex, and see your physician if you think you might have been exposed. These infections are easily treated with antibiotics, but leaving them untreated may lead to more serious conditions.
“If you are sexually active and/or have multiple partners, you should get tested for STIs at least once a year or when you feel you have been exposed,” Mitchell says.
‘DIY’ isn’t the best strategy
You’ve probably heard of products claiming to “clean out” your vagina or keep it “fresh.” They may seem like a good idea, but they can actually have unwanted effects. Douching can throw off the normal pH balance of your vagina and remove good bacteria. Fragranced pads, tampons, panty liners, powders and feminine sprays may cause irritation. Avoid them.
It’s very common for women to self-diagnose when they spot discharge, especially when so many over-the-counter treatments are available. These are convenient but not always helpful.
“Self-treating discharge is not advised, as this can lead to spending more money, delayed treatment, treating the wrong condition and worsening symptoms,” Mitchell says.
If you misdiagnose your condition, you’ll mistreat it. It’s important to see a gynecologist for an exam and diagnosis if you’re unsure of the type of infection you may have, if it’s the first time you’re experiencing these particular symptoms or if you have a new sexual partner. Even if the treatment is available over the counter, a proper diagnosis can optimize healing and help better manage recurrent or persistent symptoms.
There are also steps you can take to prevent vaginal discharge issues, according to Mitchell.
“Vaginal probiotics can be a great way to help keep the pH of the vagina balanced. There are oral pills and vaginal suppositories available over the counter.”
To avoid too much disruption of the pH, “it’s important to maintain daily vulvar care, use protection during intercourse and avoid douching,” she adds.
by Tina Donvito