Vaginal discharge is meant to be a natural occurrence as a woman goes through the various phases of her menstrual cycle and pregnancy. At different stages of the cycle discharge may vary in colour, thickness and quantity. Most often these are normal even though they can be signs of abnormalities and disease processes.
However, it can sometimes be difficult to detect if something is going wrong because some vaginal diseases do not present with symptoms. This makes it important to observe and understand the various forms of discharge and what they may be indicative of. The likelihood of a disease is what makes it necessary to seek medical care if you find any strange changes.
Vagina and Secretions
The vagina is the channel between the outside world and internal structures of the female reproductive system. It has elastic walls with inner lining which are regularly lubricated by mucous produced by specialized glands. This makes the vagina accommodating of the penis during sexual intercourse and the movement of a baby during delivery. A group of organisms called normal flora live in the vagina and do not cause harm until the immune system is weakened.
Under normal circumstances these normal flora offer protection from other harmful disease causing organisms. Due to the vagina’s exposure to the outside world, it is prone to entry by foreign organisms and substances. This is why it must maintain an acidic environment to kill as many harmful organisms as possible. The vagina also keeps some of its dangers away through its opening, the vulva. The vulva provides a covering that limits the exposure of the vagina to the world.
Some of its normal flora, the lactobacilli, also produces regular secretions which keep it cleansed. These secretions, often mixed with mucous and skin cells, come out as the discharge women observe. They are frequently only a result of natural processes which are important for the maintenance of good vaginal health.
Vaginal Discharge And The Menstrual Cycle
Hormones released during the menstrual cycle, influence secretion of different types of mucous. This is a way the body controls pregnancy. Around the period of ovulation, mucous becomes clear, thin and more permeable to allow sperms to pass through readily. This allows the movement of the sperms through the cervix to fertilize the released egg and it is a fertile period. Before this period, mucous is thick and less permeable and protects from infection, one such is cervical mucus. This is non fertile period.
The hormones ensure that sperms are allowed into the womb more readily when there is a high likelihood for pregnancy to occur. Consequently, it is normal to have discharge of varying quality at different periods of the month. In this regard, discharge which is off-white, white or transparent without any accompanying symptoms, in most cases should not cause panic.
Types Of Vaginal Discharge
It is important to understand the varying types of vaginal discharge and their implications. This makes it easier to distinguish the normal from the abnormal.
- White: Whitish discharge is expected at the beginning of a woman’s cycle and often should not cause alarm, in the absence of accompanying symptoms like itching.
- Clear and Watery: This is normal and can occur at any time. It may become excess after exercise.
- Clear and Stretchy: This is normal around the time of ovulation. This mucus texture is good for the passage of sperm across the cervix. It is clear and stretchy and mucous like.
- Brown that follows blood flow: It is not uncommon to observe brown discharge right after blood flow. This is normal and results when mucous and normal vaginal secretions get mixed with blood cells.
- Bloody or brown discharge is common and if it occurs late at the end of periods it looks brown instead of red.
- Bloody discharge between periods is called as spotting, some women experience bloody discharge between periods. If spotting occurs in normal time of period it is a sign of pregnancy.
- Spotting occurred during early pregnancy could be a miscarriage. Rarely bloody or brown discharge could be sign of advanced cervical cancer.
A coloration that deviates from transparent, white, off-white or brown right after blood flow, calls for examination.
- White Discharge accompanied by itching or other symptoms should not be ignored as it may be indicative of a fungal infection.
- Yellow or Green : This often signals an underlying infection and warrants a medical examination.
- Brown that does not follow blood flow: Brown discharge which does not occur after blood flow warrants examination.
White Discharge Types
- Creamy white milky discharge (thin)
- Thick White discharge
- Thick White Clumpy discharge
1. Creamy White Milky Discharge (thin)
During ovulation, estrogen levels are high and women experience heavy thin discharge. Thin, clear and stretchy discharge indicate fertile period and occur during ovulation period.
Creamy white discharge is one of the early signs of pregnancy when it happens after a missed period. Creamy and thin discharge can be completely odourless or with mild odour.
2. Thick White Discharge
Before period, progesterone levels are high and women experience heavy discharge. White, creamy and thick discharge called as Leucorrhoea, is filled with cells and fluid from vagina. Sometimes it may look slight yellow color. This is called as leutal phase in menstrual cycle. Progesterone makes discharge thick, cloudy or white where as estrogen make it thin, clear, watery and stretchy. It can be completely odourless or with mild odour. Thick discharge is infertile cervical mucus and occurs between ovulation and start of period.
Mucus consistency and color aid in natural family planning strategy, by tracking the discharge one can distinguish between fertile and non-fertile periods. Thick white discharge is common and normal before periods and at the start of periods and during the end of periods. Thick creamy discharge is common during early pregnancy and it will help cervix moist, clean and healthy. Non-itchy, odourless discharge soon after having sex is because of excess release of pregnancy related hormones. Vaginal contractions result in secretion of these hormones. Thick discharge is also common during the third trimester of pregnancy.
3. Thick White Clumpy Discharge
It is a cause of concern if vaginal discharge is thick white and clumpy and looking like cottage cheese. It indicates infection.
Diseases That Can Cause White Vaginal Discharge
Bacteria are not the only microorganisms that can live in the vagina and not cause harm. Yeast, a type of fungus also lives there and not causes disease. The vagina is kept healthy, when there are more good bacteria than yeast. These good bacteria are responsible for controlling the growth of yeast. When the proportions of yeast increase beyond the proportion of these good bacteria yeast infections are likely to occur. Genital candidiasis or Genital yeast infection is caused due to Candida albicans excess growth in the vaginal area. Factors that may disturb the control of yeast growth by lactobacilli include:
- Antibiotic treatments
- Weak immune system due to stress, lack of sleep or poor nutrition
- Hormonal imbalance
Yeast infections may be characterized by
- White discharge
- Swelling around the vagina
- Burning sensation during sex or urination.
- Bacterial vaginosis is one of the common bacterial infections among mid-teenage girls and young women. Even though it can be present without symptoms, white discharge can be a symptom in some cases. Many women observe that discharge is accompanied by a strong fishy smell.
- Bacterial vaginitis happens when normal control of the growth of bacteria which live in the vagina and otherwise cause no harm fails. The group of good bacteria called lactobacilli produce secretions that make the vagina acidic and deterrent of growth of other harmful bacteria. Just like yeast infections when this system is disrupted harmful bacteria start to grow in excess and cause infections.
- Pelvic inflammatory disease is a type of bacterial infection spread by sexual contact. It results in heavy discharge accompanied with odour.
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There are other infections that may cause excessive vaginal discharge. They are,
- Sexually Transmitted diseases such as Trichomoniasis, Gonorrhea, Chlamydia infection
- Atropic vaginitis
HPV or Cervical Cancer : it is also spread by sexual contact and caused due to human pipillomavirus and the infection of HPV can lead to cervical cancer.
When To Consult Doctor
Vaginal discharge is normal and common, but if you have any associated symptoms along with vaginal discharge do visit a doctor. Associated symptoms include,
- Abdominal Pain
- Excess discharge
- Weight loss
- Frequent Urination
To understand the cause of discharge, your doctor will ask a number of questions before he examines you. These will include questions about past illnesses, family history and other relevant to a better understanding of what could be wrong. Your doctor may proceed to do a pelvic exam to find out the cause of your discharge. A pelvic exam allows the inspection of the reproductive system, beginning from the external genital area to the internal organs.
Your doctor may also use a cotton swab to take a sample of the vaginal mucous to be examined in the laboratory. The laboratory examination may help identify the causative organism and the type of infection if there is any. If the examination reveals no underlying infection, your doctor may provide counselling and monitor the condition. If you need to be treated the examination findings will inform the best medications for you.
Vaginal Discharge Treatment
In most cases, white discharge is normal and does not require treatment.
When white discharge has been diagnosed to be associated with an infection, treatment for the specific causative organism should be prescribed for relief. Because yeast infections and bacterial vaginitis are the most common conditions associated with abnormal white discharge, antifungal and antibacterial medications may be prescribed.
- Yeast Infections
Yeast infections are treated with antifungal drugs. They may be prescribed in the form of creams, ointments, tablets or suppositories. Depending on whether the infection is complicated or not, treatment may last for just a few days or weeks. Medications include clotrimazole, butoconazole etc. In case of severe infection flucanazole long term prescription is recommended.
- Bacterial Vaginitis
White discharge associated with bacterial vaginitis will resolve with anti-bacterial treatment. Common medications include metronidazole and clindamycin. Your doctor will decide what period and type of treatment is best for you based on your symptoms.
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It is important to comply with the instructions given by your doctor to prevent drug resistance and minimise the risk of recurrence.
These practices may also help with healing:
- Maintaining good vaginal hygiene
- Avoiding tight clothing
- Improving immunity by maintaining a healthy diet, adequate rest
Can White Discharge Be A Sign Of Pregnancy?
Thick or milky white discharge is a common early signs of pregnancy especially when it comes after a missed period. Other accompanying signs that can strengthen the likelihood of pregnancy if you are having a white discharge include nausea and fatigue. Under normal circumstances such a discharge will not have a strong smell. It is also likely to have a thin texture.
Is Milky-White Discharge Normal?
Whilst some women may have white discharge as their earliest sign of pregnancy, others may have what they can describe as milky-white discharge. It is another form of discharge which may indicate that pregnancy has occurred. As explained above, if you observe any of the classic pregnancy symptoms like nausea and fatigue, it increases the likelihood of pregnancy. During ovulation there will be clear or milky and thin discharge. Hence milky white discharge is normal in these cases if not associated with other symptoms.
How Does Tight Clothing Lead To White Discharge?
Tight underwear and clothing increases heat around the genital area. This is favourable for the growth of harmful organisms that cause infections. More commonly, this causes an overgrowth of yeast, and leads to yeast infections. As explained earlier, yeast infections can present with white discharge in association with itching, rash and redness. If you often wear tight clothing, yeast infections can occur and they frequently lead to white discharge.
Can White Discharge During Pregnancy Still Be Caused By An Infection?
It is normal to have increased vaginal discharge during pregnancy. If your discharge is white or milky, this should not be a worry. You should only be concerned about an infection if it has a foul smell and other symptoms of infections. During pregnancy, there is increase in production of certain hormones. This is necessary to maintain the mother’s body and the health of the baby. Therefore, increased discharge results from increased vaginal secretions, and regular clean-up of mucous and old vaginal cells. If the discharge is yellowish, greenish, or brownish, or you are not sure if your white discharge is normal, you should talk to your doctor or healthcare professional.
Can Vaginal Discharge Be Prevented?
Vaginal discharge is most often healthy and not preventable. Normal discharge which may range from clear, white to milky white are not preventable, because they are natural. However any discharge that presents with a strong or foul smell and is yellowish, green or brownish can be prevented. Maintaining good vaginal hygiene is a place to start in preventing vaginal infections and the abnormal discharge they produce.
Can I Examine and Diagnose Myself Of A Vaginal Infection?
Whilst this education seeks to help you to identify signs of disease, it is not advisable to diagnose yourself. Several diseases can present similar symptoms and the expertise of a licensed health professional is important in finding the specific condition and its most effective treatment. Some conditions can lead to serious complications and they cannot be missed. It is even more important to visit the appropriate healthcare professional during pregnancy as any carelessness can harm your baby. Whilst it is perfectly normal to have white discharge in the course of your monthly cycles or during pregnancy, do not hesitate in reporting to your healthcare provider if you have any doubts.
How Can Antibiotic Abuse Lead To Vaginal Discharge?
Antibiotics may kill the good bacteria in the vagina which prevent harmful organisms from growing and causing diseases. Overusing antibiotics can also result in resistance and subsequently diseases might not respond well to medications. When the good bacteria get killed harmful organisms get the chance to grow and cause infections. These infections may in turn result in discharge. If these harmful organisms have become resistant to medications it can become difficult to treat the infection and discharge may prolong. It is advisable to only use antibiotics when they have been prescribed by your healthcare provider.
Can Douching Cause White Discharge?
Douching can kill the good bacteria which live in the vagina. Killing good bacteria allows other harmful organisms to grow and cause infections. Infections can lead to discharge.
Can I Have White Vaginal Discharge During Menopause?
It is normal to have white discharge during menopause. However, it is common to observe a decrease in quantity because of the reduction in production of some hormones. If you have doubts that your discharge is normal, consult your healthcare professional.