About Vaginal Discharge
The vagina is self-cleaning. A delicate balance of good bacteria and natural fluids keeps the vagina healthy and free from infections. Vaginal discharge is a normal part of this process, since it sweeps out dead skin cells, excess bacteria and irritants. Vaginal discharge is slightly different among individuals and varies in consistency and quantity, depending on the stage of the menstrual cycle. Not only is it unnecessary to douche, but this also in fact raises your risk for vaginal infections.
Normal Discharge
Abnormal Discharge
Slightly abnormal discharges that last for only a few days can be part of the normal cleansing process. The odor may be slightly stronger or the consistency thicker due to hormones, stress, recent sexual activity or irritations like soaps or spermicides. If changes are very pronounced, last more than a few days or are accompanied by other symptoms, medical attention is likely necessary.
Changes That Signal Illness
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Women Health - Vaginal Discharges
Vaginal discharge is normal and varies during your menstrual cycle. Before ovulation (the release of the egg), there is a lot of mucous produced, up to 30 times more than after ovulation. It is also more watery and elastic during that phase of women menstrual cycle . Women may meed to wear panty liners during that time.
Different Types of Vaginal Discharge
White - Thic k, white discharge is common at the beginning and end of your menstrual cycle. White discharge is not accompanied by itching. If itching is present, thick white discharge can indicate a yeast infection .
Clear and stretchy vaginal discharge - This is "fertile" mucous and means you are ovulating.
Clear and watery discharge - This occurs at different times of your mentrual cycle and can be particularly heavy after exercising.
Yellow or Green discharge - May indicate an infection, especially if thick or clumpy like cottage cheese or has a foul odor.
Brown discharge - May happen right after periods, and is just "cleaning out" your vagina. Old blood looks brown.
Spotting Blood/Brown Discharge - This may occur when you are ovulating/mid-cycle. Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a pregnancy test.
A normal vaginal discharge consists of about a teaspoon (4 milliliters) a day that is white or transparent, thick to thin, and odorless. This is formed by the normal bacteria and fluids the vaginal cells put off. The vaginal discharge can be more noticeable at different times of the month depending on ovulation, menstrual flow, sexual activity and birth control.
It is not uncommon for the normal vaginal discharge to be dark, brown or discolored a day or two following the menstrual period .
If you are having any of the symptoms below, please visit to your doctor.
Pain
Itching
Discomfort
Rash or sores alone or with a vaginal discharge
Summary Of Difference Types Of Vaginal Discharge
GRAPHICS
Vaginal discharge is the term for fluid or mucus that comes from the vagina. Vaginal discharge is a common concern among women, and leads many women to see their healthcare provider. Some amount of vaginal discharge is normal, unless it occurs with itching, burning, or other bothersome symptoms. Most experts recommend an examination to determine the cause because different causes can have similar symptoms.
FEMALE ANATOMY
Before discussing vaginal discharge, it is important to have a basic understanding of the female reproductive anatomy (figure 1 ).
Vaginal discharge is not usually noticeable until it exits the vagina, which is the passage from the uterus to the outside of the body. At the top end (inside) of the vagina is the cervix, while the lower end (outside) leads to the vulva and labia. The vulva is the name for the skin around the vaginal opening.
IS MY VAGINAL DISCHARGE NORMAL?
Vaginal discharge is made by the skin cells of the vagina and cervix under the influence of the female hormone, estrogen. Women who are menopausal normally have minimal vaginal discharge as a result of lower levels of estrogen.
In women who are premenopausal, it is normal to have about one-half to one teaspoon (2 to 5 mL) of white or clear, thick, mucus-like, and mostly odorless vaginal discharge every day. However, the amount and consistency of the discharge varies from one woman to another. The amount can also vary at different times during the menstrual cycle. It may become more noticeable at certain times, such as during pregnancy, with use of birth control pills/patch/vaginal ring, near ovulation, and in the week before the menstrual period.
Normally, discharge contains vaginal skin cells, bacteria, and mucus and fluid produced by the vagina and cervix. A normal discharge often has a slight odor and may cause mild irritation of the vulva. This discharge helps to protect the vaginal and urinary tract against infections and provides lubrication to the vaginal tissues.
WHEN TO SEEK HELP FOR VAGINAL DISCHARGE
Vaginal discharge is common and normal. However, vaginal discharge with the following signs and symptoms is not normal and should be evaluated by a healthcare provider:
Itching of the vulva, vaginal opening, or labia
Redness, burning, soreness, or swelling of the vulvar skin
Foamy or greenish-yellow discharge
Bad odor
Blood-tinged vaginal discharge
Pain with intercourse or urination
Abdominal or pelvic pain
CAUSES OF ABNORMAL VAGINAL DISCHARGE
The most common causes of vaginal discharge include:
A vaginal infection (yeast or bacterial infection, trichomonas)
The body's reaction to a foreign body (such as a forgotten tampon or condom) or substance (such as spermicide, soap).
Changes that occur after menopause can cause vaginal dryness, especially during sex, as well as a watery vaginal discharge or other symptoms. (See "Desquamative inflammatory vaginitis" .)
Do I need to be examined? — It is not usually possible to know if vaginal discharge is normal or not without an examination. A physical examination is the most accurate way of determining the cause of abnormal vaginal discharge. Do not begin treatment at home before being examined because self-treatment can make it more difficult to make an accurate diagnosis.
Before the examination, the healthcare provider may ask questions, such as:
Do you have pain in the back, abdomen, or pelvis?
Do you have a new sexual partner?
When was your last menstrual period?
Do you take any medications (prescription, herbal, non-prescription)?
Have you recently used pads, tampons, douches, "feminine hygiene" products, or lubricants?
During the examination, the healthcare provider will examine the entire outer genital area and will perform an internal examination. He/she will take a sample of the discharge to test for infection. It is useful for the provider to measure the pH or acidity of the secretions; bacterial vaginosis and trichomoniasis cause the pH to be higher than normal.
Treatment — In some cases, it is possible to make a diagnosis and begin treatment immediately, based upon the examination. In other cases, the provider may recommend delaying treatment until test results are available. (See "Patient information: Vaginal yeast infection (Beyond the Basics)" and "Patient information: Bacterial vaginosis (Beyond the Basics)" .)
Sexual partners of women with a sexually transmitted infection, such as chlamydia, gonorrhea, or trichomonas, need evaluation and treatment. For other infections, such as yeast or bacterial vaginosis, the sexual partner does not need treatment. (See "Patient information: Chlamydia (Beyond the Basics)" and "Patient information: Gonorrhea (Beyond the Basics)" .)
If treatment is needed, you should avoid having intercourse until the treatment is completed.
Can I treat myself? — Many women would prefer to avoid seeing their healthcare provider. However, self-treatment can delay getting the correct diagnosis, be costly, or even cause worsened symptoms. In most cases, a physical examination should be performed before any treatment is used. In particular, you should not douche to get rid of the discharge because douching can make the discharge worse if it is due to an infection.
HEALTHY HYGIENE
Abnormal vaginal discharge may be more likely to develop in women who practice certain habits, such as those who use:
Douches
Pantyliners every day
"Feminine hygiene" sprays, powders, or rinses
Bubble baths or other scented bath products
Tight or restrictive synthetic clothing (eg, thongs, synthetic underwear)
Healthier practices include the following:
Use water or unscented non-soap cleanser to wash genitalia, use warm (not hot) water and the hand (not a washcloth)
Do not douche or use feminine hygiene products; if odor or discharge is bothersome, see a healthcare provider
Avoid hot baths with scented products; plain warm water is preferred
Wear cotton underwear; avoid thongs and lycra underwear
Rinse genitals with water and/or pat dry after toileting; avoid use of baby wipes or scented toilet paper
WHERE TO GET MORE INFORMATION
Your healthcare provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our web site (www. uptodate. com/patients ). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.
Patient level information — UpToDate offers two types of patient education materials.
The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
