Everything You Need to Know About Vaginal Discharge
It can tell you a lot about what's going on in your body.
It’s safe to say most people probably don’t pay close attention to their vaginal discharge. But as it turns out, you can learn a lot about what’s going on in your body just by being aware of its colour, texture, and odour.
Here, an expert explains what’s normal and when there’s a reason to be concerned.
What is vaginal discharge?
Vaginal discharge is made up of skin cells, cervical mucus, bacteria (lactobacillus), and a bit of yeast. This fluid flows out of the vagina — the canal that connects the cervix (opening to the uterus) and the vulva (the external genitalia) — as a natural way of self-cleaning. “Its purpose is to keep the vagina moist and protected from sexually transmitted infections (STIs) or irritation,” says Dr. Yolanda Kirkham, a gynecologist at Women’s College Hospital in Toronto, Ont.
What does normal discharge look like?
For the most part, a woman should produce about four millilitres of discharge per day. Normal discharge is either clear or milky-white, with a mild, non-offensive odour; however, it can vary throughout the menstrual cycle because of our natural hormonal fluctuations, and with age. “It starts after puberty when there is estrogen from our ovaries and decreases during perimenopause and menopause when there is no more estrogen,” Kirkham says. The good news is that our period cycle tends to follow a fairly predictable pattern.
Usually, after your period, when you’ve shed your uterine lining, there’s very little discharge. But as you reach the middle of your menstrual cycle, you’ll start to get a very clear and stringy-like discharge, says Kirkham. This lasts for 24-48 hours and indicates ovulation. For people who are trying to get pregnant, this is an important window in which to try and conceive. Then, closer to the time of your period, your discharge will develop into a whiter and thicker consistency.
If you’re not ovulating (i.e., you’re pregnant or on certain kinds of birth control), you will not have the same discharge cycle. While pregnant women tend to notice a heavier amount of discharge due to an increase in estrogen levels, those on birth control may experience changes in discharge, she says.
Kirkham also notes that a change in discharge can occur when you’re turned on. “If you’re aroused, discharge will become more clear and slippery,” she says. Otherwise known as transudate, this fluid is from filtered blood that seeps through the vagina walls to help facilitate sexual pleasure.
When to talk to a doctor about discharge
It’s important to familiarize yourself with your discharge so that you can tell when something is off, says Kirkham. Although your vaginal discharge isn’t something you should normally be worried about, there are certain consistencies that should prompt a call to your family doctor.
Thick, white discharge
If you experience a thick, white discharge that resembles cottage cheese and does not have an odour, it could be a yeast infection. Although you have a bit of yeast already in your vagina, “it can overgrow during times of pregnancy, with diabetes, if you have a compromised immune system, or are on certain birth control,” she says. This can be treated by over-the-counter vaginal creams or oral medication. However, if you’re itchy on the outside skin of the vulva, as opposed to inside of the vagina, it’s probably not a yeast infection. It could be lichen simplex chronicus or lichen sclerosus, which are non-contagious skin conditions of the vulva.
Prepubescent girls should also be examined if they have any vulva or vaginal itching. “When you’re a child and you haven’t hit puberty yet, you don’t have estrogen,” says Dr. Kirkham, so that means no yeast infections.
(Related: 22 Myths Gynecologists Want You to Ignore)
Brown, pink or red discharge
Brown, pink or red discharge can occur from friction after sex, just before or after your period, or from implantation bleeding in early pregnancy. Kirkham warns that any postmenopausal bleeding should definitely be checked by a professional — it could be caused by vaginal dryness, from lack of estrogen or (less commonly) uterine cancer.
A pasty, grey discharge with a fishy odour is likely caused by bacterial vaginosis (BV). “It’s made worse after the normally acidic vagina is exposed to a basic material like ejaculate or menstrual blood,” she says. If it doesn’t bother you, it doesn’t necessarily need to be treated. But if it does, Kirkham advises seeing a doctor and treating BV with antiprotozoal (metronidazole), antibiotic (clindamycin), a medical-grade vitamin C formulation, or boric acid suppositories.
Green and frothy discharge
While gonorrhea and chlamydia are the most commonly known STIs to cause abnormal discharge, the lesser known trichomoniasis, which is caused by a parasite, is another one to be aware of. This STI can cause copious amounts of green, frothy and malodorous discharge, Kirkham says.
STIs can lead to pelvic inflammatory disease (PID), an infection of the female reproductive organs, if not dealt with properly. Typical signs of PID are foul-smelling discharge, abdominal pain, fever, and painful sex. “This is really important to treat to prevent scarring in the fallopian tubes and fertility difficulties in the future,” she cautions. Treatment requires antibiotics for two weeks.
How to maintain a healthy vagina
For starters, be wary about having sex without a condom, warns Kirkham. With STIs, “you can be asymptomatic, so that’s why it’s important to use condoms and also get regular testing beforehand,” she says. It’s as simple nowadays as a urine test, according to Health Canada.
And, remember: Less is more. The vagina doesn’t need any soap, cleansing products, douches, or steaming. Dr. Kirkham suggests a daily “vagina spa” — a rinse or soak in warm water — to help maintain good hygiene. “Some of the worst irritations or infections people get is when they overwash, use multiple treatments or products, or try things they saw on the Internet like vinegar, garlic, or essential oils,” she says. “The vagina is delicate, so it’s important to treat it as such.”