Vaginal discharge - What you need to know

"Abnormal vaginal discharge can be caused by a number of things. If your discharge ever changes suddenly or seems unusual in any way, you should speak to your nurse or doctor."

Dr Louisa Draper

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Vaginal discharge is normal and one of the ways the vagina cleans itself. In most cases, vaginal discharge is completely healthy but can sometimes be an indication of infections like thrush, bacterial vaginosis (BV) or an STI.

Is vaginal discharge normal?
When do I need to see a doctor about unusual discharge?
What can cause vaginal discharge?
STIs and thrush
Vaginal discharge in pregnancy
How does the menopause affect vaginal discharge?

Is vaginal discharge normal?

It is normal to experience some vaginal discharge. Typically, vaginal discharge is the mucous produced by the glands of your cervix and vagina. It is produced in order to help keep your vagina clean and healthy. It does this by flushing away any harmful bacteria and dead cells to prevent infection. Vaginal discharge will usually start a year or two before puberty and will end after menopause.

The amount of vaginal discharge varies from person to person. Healthy vaginal discharge will range from clear to milky white, and the amount, texture and smell will also vary depending on whether or not you are aroused or where you are in your menstrual cycle.

However, changes in your vaginal discharge can be an indication of infection.

When do I need to see a doctor about unusual discharge?

Here’s a handy key to work out whether your discharge is healthy or whether you should seek advice from your nurse, doctor or sexual health professional:

Smell

Normal: It’s totally normal for a healthy vagina to have a scent. Products claiming to ‘clean’ your vagina and improve its scent are unnecessary and the perfumes in them can even be harmful for your vagina’s natural pH balance. Washing with water is sufficient.

When to see a doctor: If your vagina suddenly changes scent or starts to smell strongly. Watch out particularly for a ‘fishy’, strong odour which could be an indication of infection.

Colour

Normal: Healthy vaginal discharge should be clear or whitish. It may look more yellowish when dry, and you might get brownish discharge towards the end of your period.

When to see a doctor: If your discharge ever suddenly changes in colour, or if it is very yellow or greenish, grey or pink.

Amount

Normal: The amount of discharge can vary from lots to very little. It varies from person to person and depending on your menstrual cycle and whether you are aroused.

When to see a doctor: Sudden changes in volume could be an indication of an underlying issue, especially if you have any other symptoms.

Texture

Normal: This will also change depending where you are on your menstrual cycle. The texture can vary from being clear and stretchy to being paste-like.

When to see a doctor: You should see a doctor if you experience discharge with a lumpy or cottage-cheese like consistency, as this could be a sign of infection.

Other symptoms

You should also see a doctor if you experience unexplained or unusual vaginal bleeding, discharge, itching or swelling of the labia, painful urination or stomach pain.

What can cause abnormal vaginal discharge?

Abnormal vaginal discharge can be caused by a number of things. If your discharge ever changes suddenly or seems unusual in any way, you should speak to your nurse, doctor or visit your local sexual health clinic for advice.

These are the some of the main causes of abnormal vaginal discharge and their symptoms:

thrush (yeast infection): itchy and sore vulva, painful urination and/or sex, and either a thin, watery white or a thick, white ‘cottage cheese’ like discharge
BV (bacterial vaginosis): itchy and sore vulva, painful urination, grey or off-white discharge with a fishy smell that is usually stronger after sex
chlamydia (an STI): unusual discharge, pain and/or bleeding during and/or after sex and while urinating, stomach pains
gonorrhea (an STI): irregular bleeding, burning when urinating, greenish yellow or whitish discharge, swollen vulva, itchy and red eyes (conjunctivitis)
trichomoniasis (an STI): sore, swollen or itchy vulva, painful urination, and frothy yellow or green discharge
cervical cancer: smelly discharge, unusual vaginal bleeding, and painful sex
certain medications: you may also experiences unusual discharge when taking the contraceptive pill or certain antibiotics

STIs and thrush

The two most common causes of abnormal discharge are STIs (sexually-transmitted infections), bacterial vaginosis and thrush.

STIs: You are at risk of catching an STI if you are sexually active, especially if you have (or have had) unprotected sex. You should always use condoms with your sexual partners unless you have both been tested and found free of STIs and/or are trying for a baby.

You can get tested for STIs at your doctors, your local GUM or sexual health clinic or you can order a test kit online.

Thrush: Thrush is a type of yeast infection which is not transmitted sexually but which is more common in people that have sex on a regular basis. The symptoms of thrush include a painful, swollen vulva, a thick, white ‘cottage cheese’ or a thin, watery white discharge.

Thrush is treated with an antifungal medication. You can buy it over-the-counter at any pharmacy, from most supermarkets, or have it prescribed by your nurse or doctor.

Vaginal discharge in pregnancy

During pregnancy, it is normal to have more vaginal discharge than usual. Extra discharge is produced by your body because the cervix and internal walls of the vagina get softer during pregnancy, meaning that you are more vulnerable to infection. Discharge increases in order to prevent infections.

Discharge will increase towards the end of your pregnancy, and can at this point be confused with urine. During the last few weeks of your pregnancy, your discharge may contain small amounts of blood and a thicker mucous. This is called a ‘show’ and is when all the mucous that has been stored in your cervix during pregnancy flows from your vagina. This is a sign that your body is preparing for the birth.

However, if your discharge ever starts to smell strangely, is coloured, or if your vagina begins to feel swollen, sore or itchy, you may have an infection. Talk to your midwife or doctor to see if you need treatment.

Thrush is especially common during pregnancy. Thrush can be treated very easily but you will need to discuss treatment options with your midwife or doctor beforehand as some medicines cannot be used during pregnancy. Wearing loose breathable underwear and avoiding perfumed soaps or products and can help to prevent a yeast infection.

If you ever have any vaginal bleeding during pregnancy you should seek advice from your midwife or doctor. It is usually normal to bleed a little during the course of pregnancy but bleeding can sometimes be the sign of something more serious, like miscarriage or problems with the placenta.

How does the menopause affect vaginal discharge?

During and after the menopause there will be lots of changes to your body. One of the main changes is the decline of the hormone oestrogen. Less oestrogen in your body can affect the lubrication of your vagina in what’s known as ‘vaginal atrophy’ which is when the walls of your vagina get thinner, drier and less elastic. These changes can lead to pain during sex, irritation and unusual discharge.

For most people, vaginal discharge will stop entirely following the menopause because of the changes to your hormone levels. However, this is not always the case, and the lack of vaginal lubrication can disrupt the pH levels inside the vagina making it more sensitive to infection.

Talk to your nurse or doctor if you experience the following after menopause as you may have an infection:

watery, irritating and unpleasant smelling discharge
yellow discharge with a ‘fishy’ smell
reddish or brown discharge (seek urgent medical attention)
symptoms of an STI

Reduce the risk of infections by eating healthily, exercising well and wearing loose-fitting cotton underwear. Sex is a good way to stimulate natural lubrication in the vagina, and the use of some topical oestrogen creams can also help.