You probably don’t think much about vaginal discharge, except perhaps to lament it bleaching your favourite knickers.
However, the fluid – which most people with vaginas have – plays an important role in gynaecological health.
Not only does discharge keep our vaginas clean and moist, it also helps protect against infection.
‘Vaginal discharge is the natural result of cells shedding in the cervix and vaginal canal and fluid secretions, the process which lubricates and cleans the genital tract,’ says Dr Christian Phillips, consultant gynaecologist and urogynaecologist, adviser to Team GB gymnasts and WUKA women’s health expert.
Discharge itself is perfectly normal and varies from person to person in quantity, consistency, and odour. But as it’s impacted by bacteria and hormones, changes in the way it looks or smells can indicate health issues.
These include STIs, conditions affecting pH, and in rare cases cancer (although this typically occurs in elderly people) so it’s important to know your normal and keep an eye on potential symptoms.
That way, if your discharge seems different to usual, you can visit your GP or gynaecologist to get to the bottom of things.
Often there’s nothing to worry about: certain changes signal pregnancy or ovulation, while others suggest you’re using cleansing products that create an imbalance with your natural flora and fauna (something that’s easily remedied by discontinuing use).
Nonetheless, there’s no harm in getting better acquainted with your body so you can recognise when something is off.
Here are the most common changes in vaginal discharge to look out for and what they mean.
Clear discharge, with a gel-like consistency
Although ‘normal’ discharge will vary from person to person, it generally features a fluid or mucus consistency and is transparent or slightly white with no strong smell.
Dr Ashfaq Khan, consultant obstetrician and gynaecologist and founder of Harley Street Gynaecology, tells Metro.co.uk: ‘The amount of discharge can vary as it is affected by your hormone levels, but it should always be relatively odourless, clear or white, and runny or slightly thicker.’
More discharge than usual
While there’s no right or wrong amount of discharge, if you notice more than usual it could be down to factors such as pregnancy, breastfeeding, ovulation or sexual arousal. Some people with PCOS also produce more discharge.
‘External hormonal influences such as hormonal contraceptive pills can impact the appearance of your discharge,’ adds Dr Christian.
‘If you are on the combined oral contraceptive pill and you notice an increased amount of discharge, switching to the progesterone only pill can help to reduce the flow.’
More discharge for a short time with no other symptoms is rarely cause for alarm, but it’s best to see your GP if this change is long-lasting or you also experience itching, pain, blisters or sores, or additional changes.
Grey and smelly discharge
Dr Ashfaq explains: ‘Signs of an infection include a stronger, fishy smell, which can happen with Bacterial Vaginosis (BV).
‘This occurs when there is an imbalance of bacteria in the vagina and is usually treated with antibiotics.
‘It’s particularly important to see your GP or gynaecologist if you suspect BV as it can increase your chances of developing an STI and can cause complications in pregnant women.’
BV can also give your discharge a greyish appearance due to a collection of bacteria, white blood cells, and cellular waste products. It’s also often accompanied by itching and burning.
Some people report grey discharge due to chlamydia or gonorrhoea, though these STIs don’t always cause symptoms. If in doubt, get checked out.
Slippery and watery discharge
At certain times during the month you may find your discharge is wetter or stretchier, with a texture similar to raw egg white.
This is due to the body’s production of oestrogen before ovulation (when you’re at your most fertile) as the thinner consistency makes it easier for sperm to reach the uterus.
‘Around the time of ovulation – the middle of the cycle – the discharge may become slippery and stretchy, as biologically the body is preparing to facilitate the sperm reaching the egg,’ explains Dr Christian.
‘Then, after ovulation, the ovaries produce progesterone which causes less discharge to be made and what discharge is there will be thicker.’
Thick, lumpy and white discharge
‘A thicker, lumpier, white discharge often likened to “cottage cheese”, along with itching, is symptomatic of thrush,’ says Dr Ashfaq.
Further symptoms include pain or discomfort (particularly while peeing or during sex) but a yeast infection, unlike BV, won’t typically cause changes to the way discharge smells.
Dr Ashfaq adds: ‘Thrush is a fungal infection caused by yeast or Candida, which is also triggered by an imbalance of bacteria in the vagina. Treatment is usually given by way of anti-fungal cream, vagina pessaries or tablets.’
Frothy and green or yellow discharge, with a strong smell
According to Dr Ashfaq, if your discharge ‘becomes frothier and turns green or yellow and smellier, the diagnosis could well be trichomoniasis.’
He explains: ‘Trichomoniasis is an STI that can cause problems in pregnancy and is known to sometimes trigger an early labour.
‘Medication is in the form of pills, which can take up to three months to eradicate the infection entirely.’
Symptoms of trichomoniasis can take weeks or months to show up, and include soreness, swelling and itching around the vagina as well as pain when urinating or having sex.
A brownish hue to your discharge is caused by old, dried blood. It can happen at the end of your period as your body tries to flush out residual blood, as well as during ovulation, following a pelvic exam, or after starting a new form of contraception.
While it’s not a definitive sign, some women experience brown ‘spotting’ when they first become pregnant, as the fertilised egg nests into the uterus. It’s worth taking a pregnancy test if you miss your next period, yet this is good advice regardless of discharge changes.
If your discharge is brown with no smell, it’ll likely clear up on its own. If there is a smell, however, it could be caused by a foreign object such as a tampon that’s been left inside you. As ever, consult a medical professional if you’re unsure.
Red discharge is most commonly due to a period, with the colour ranging between deep burgundy and bright crimson.
Bleeding between periods may be cause for concern if it’s not normal for you, potentially signalling a cervical infection or miscarriage.
Those on hormonal contraceptives may also experience ‘withdrawal bleeding’ after coming off the pill or between packets, along with ‘breakthrough bleeding’ which is a side effect of certain contraceptives.
A pinkish hue is also caused by blood, just in smaller concentrations mixed with your cervical fluid.
It’s common around your period – especially if you have a light flow or your period tends to last less than two days – and ovulation, as well as after implantation or on certain contraception methods.
Pink discharge could be a sign of low oestrogen if it occurs at different times during your cycle, and may be accompanied by symptoms like insomnia, mood swings, trouble concentrating and weight gain.
Ovarian cysts like dermoid cysts and cystadenomas can cause pink discharge too, so get checked out by your doctor if you also notice bloating or pelvis pain.
Dr Ashfaq adds: ‘Diagnosis of a change in discharge isn’t always obvious. Over the counter testing kits are available but the accuracy of these could be questionable and it is vital that a correct diagnosis be made – particularly if you are pregnant – in order to prescribe the right treatment.
‘To keep your vagina as healthy as possible, it’s important to maintain a balanced diet and exercise regularly. Avoid using perfumed products when washing your genital area as this can affect the delicate pH balance. Avoid douching and if possible, sleep naked to allow air to circulate around your vagina.
‘Using condoms during sex will also help to protect you against STIs.’
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