Vaginal Discharge

Vaginal discharge is the fluid or mucus produced by the vagina. Some vaginal discharge is normal as it plays an important role in keeping the vagina clean and healthy. A normal vagina has a slightly acidic pH which is important in protecting the cervix and uterus (womb) from infection. It also helps balance the natural bacteria and flora that live in the vagina.

Small amounts of clear fluids pass out of the vagina every day, removing dead cells helping to keep the vagina clean and lubricated. Normal vaginal discharge is clear or milky in colour and has no odour (smell).

Sometimes the colour and odour may change, and this may or may not indicate a problem. The amount of vaginal discharge you produce varies from person to person and it’s important to know what is normal for you, so that you can be aware of any changes. It's normal for the amount, consistency, and colour of vaginal discharge to change throughout your monthly cycle. While every woman is different, these are some typical changes that can occur throughout your menstrual cycle.

While some changes in your vaginal discharge may be part of your natural cycle, other changes can indicate a problem such as a sexually transmitted infection (STI) bacterial, or fungal infection. Sexually transmitted infections are infections that are transmitted from one person to another during sexual intercourse. Common STIs include chlamydia, trichomoniasis and gonorrhoea.

Chlamydia can often go undetected as many people do not experience any symptoms, but sometimes there may be an increase in vaginal discharge which is often yellow in colour and has a strong odour.

Trichomoniasis can cause changes in vaginal discharge such as an increased amount or a change in consistency. It is often watery or frothy with a strong odour and can be clear, yellow, or green.

Gonorrhoea can also go undetected, as around half of women do not show any symptoms, but there may be an increase in vaginal discharge which is usually thick and yellow or green. Bacterial or fungal infections like bacterial vaginosis or Candida Albicans (thrush) can cause changes in vaginal discharge. These are not STIs but occur when there is an imbalance in the bacteria and fungi that normally live in the vagina. Common things that trigger this imbalance include:

• a new sexual partner (or multiple partners)
• having an intrauterine device (IUD)
• using perfumed products like soaps, shower gels, and deodorants around your vagina
• douching (spraying water into the vagina)
• sexual activity

Bacterial vaginosis occurs when there is an overgrowth of the bacteria that normally live in and around the vagina. It causes an increase in watery vaginal discharge with a strong fishy smell and is often greyish-white in colour. Bacterial vaginosis is not an STI, but it can be triggered by sexual activity and can be passed between female sexual partners.

Candida albicans (thrush) is a common condition that is caused by an overgrowth of the fungi that normally live in small amounts in the vagina and vulva. It is characterised by itching, pain at the entrance of your vagina during sex, and a thick white discharge (like cottage cheese) which may have a yeasty smell. Thrush is not classed as an STI, though it can be passed on during sex. Candida fungi thrive in warm, moist environments and an overgrowth can be due to wearing tight, non-breathable fabrics like nylon and polyester. Taking antibiotics or having conditions such as diabetes or a weakened immune system may increase your risk of getting thrush. Changes in your vaginal discharge can happen for other reasons such as pelvic inflammatory disease, pregnancy and more serious conditions like cervical cancer. If you have a change in your vaginal discharge that’s not normal for you it’s a good idea to contact your doctor to find the underlying cause.

The colour of your vaginal discharge can tell you a lot about your health. Some colour changes are a normal part of your monthly menstrual cycle while others may indicate a problem.

Pale yellow discharge without a strong odour is usually normal discharge and nothing to worry about, but darker yellow or yellowish-green may indicate an infection. Make an appointment with your GP or sexual health clinic if your discharge has a strong smell or there is a change in the amount or consistency.

White or cream discharge is usually normal, but if there is a strong odour or a thick, cottage cheese-like consistency it may indicate a thrush infection.

Brown discharge often occurs towards the end of your period and is normally the vagina cleaning out the remains of old blood. Sometimes however brown discharge can be a sign of an STD or bacterial infection or a condition like polycystic ovarian syndrome (PCOS) or endometriosis. Make an appointment with your health care provider if you have any other symptoms or if your discharge gets worse or doesn’t go away.

Green discharge usually indicates a sexually transmitted infection such as trichomoniasis or gonorrhoea. It is usually accompanied by a strong, unpleasant smell and may be thicker than usual. It can also happen if you have forgotten a tampon inside your vagina. If you are experiencing green vaginal discharge make an appointment with your GP or sexual health clinic.

Grey or greyish white discharge can be a sign of bacterial vaginosis. It may also be watery and accompanied by a strong fishy odour.

Pink discharge normally contains a small amount of blood and can occur in the days before your period, as spotting (breakthrough bleeding) between periods. If you are experiencing breakthrough bleeding, make an appointment with your GP who will run some checks to find the underlying cause. Pink discharge can also occur after sexual intercourse if the vagina or cervix are injured or irritated during sex. In addition, some women experience light bleeding during implantation (when an embryo implants in the womb at the start of pregnancy). Implantation bleeding may be pink or red in colour. Take a pregnancy test if you think you may be pregnant. If you have bleeding during or after sex or have bleeding in pregnancy it’s always best to contact your doctor for a review.

Red or bloody discharge can be your normal menstrual period, but bleeding between periods, unusually heavy bleeding, or bleeding after menopause should be checked by your GP. Clear discharge is normal healthy discharge. It may increase around ovulation (when your body releases an egg) and during pregnancy.

Abnormal vaginal discharge can be unpleasant and irritating but is not usually dangerous and is easily treated with medication. The medication used to treat your vaginal discharge depends on the cause, so you will need to make an appointment with a doctor or sexual health clinic to get an accurate diagnosis and the right treatment. If you have a suspected STI without any symptoms of pelvic inflammatory disease and you are not pregnant you can order an STI test online via Superdrug Online Doctor.

Some STDs can have long-term health effects if left untreated, so it's important to get treated right away. If you are worried about your vaginal discharge you can make an appointment with your GP or go to a walk-in sexual health clinic. Sexual health clinics are confidential, and you do not have to give your real name. If you are under sixteen your parents and GP will not be told anything without your consent unless the doctor or nurse feels you or someone else is in danger.

To diagnose the cause of your vaginal discharge a doctor or nurse will ask you some questions about your symptoms, general health, and any sexual partners. They will examine your vagina and may take a swab of the discharge which will be sent away for analysis.

Bacterial or sexually transmitted infections are normally treated with antibiotic tablets, gels, or creams. It's important that you tell any sexual partners about your diagnosis if this is recommended by your doctor or nurse so they can get treatment too.

Thrush is treated with anti-fungal medications. It may be a tablet that you take by mouth, a pessary that you insert into your vagina, or a cream that you apply to your vagina and vulva to relieve itching.

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 week of your pregnancy, your discharge may contain small amounts of jelly-like pink 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 can be 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.

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 using water-based lubrication before sex, trying vaginal moisturisers and wearing loose-fitting cotton underwear. Sex with enough foreplay is a good way to stimulate natural lubrication in the vagina, and the use of some topical oestrogen creams can also help.

In addition to getting treatment for existing vaginal discharge, there are some things you can do to prevent it from recurring:

• Wash your vulva and vagina with plain water and avoid using soaps, shower gels, and perfumed products that can disrupt the pH balance.
• Avoid douching (washing inside your vagina).
• Wear cotton underwear that allows your skin to breathe and prevents the build-up of excessive heat and moisture.
• After using the toilet, wipe from front to back to avoid spreading bacteria from the anus to the vagina.
• Avoid wearing tight-fitting or non-breathable fabrics for long periods of time.
• Use condoms if you have sex
• Keep up to date with your smear tests
• Book to see a midwife or your GP early if you are pregnant