What Exactly Is Vaginal Discharge & Why Does It Occur?
Vaginal discharge is a white or clear fluid that comes out of the vagina and plays a role in regulating, cleaning and lubricating the vagina. Discharge is not only a normal bodily function, but a healthy bodily function too. It has antibacterial and antifungal properties and helps sweep bacteria away from the vagina as well as protecting the area from bacteria and lesions. As for why we have it, it’s more abnormal for women to have no discharge at all. The difference is when it steps across the boundary from being a healthy physiological discharge which has antibacterial properties to something more harmful, and problems can arise when you have an overgrowth of certain bacteria or pathogens.
How Can We Tell When Discharge Isn’t Healthy?
The look and consistency of discharge can vary. A healthy discharge is usually clear, white and consistent, whereas unhealthy discharge may have a thick ‘cottage cheese’ consistency, be grey or watery, brown or yellow and in some rare cases, even green. Below is a general guide to follow to understand what each type indicates:
Clear, consistent white discharge: Healthy discharge should be reasonably consistent, be clear or white in colour with a solid consistency that may be slippery.
Thick white discharge: A very thick discharge with almost a ‘cottage cheese’ consistency may indicate that you have thrush, especially if this is accompanied by itching and soreness around the vulva and labia.
Thin, grey watery discharge: If your discharge has a watery consistency and grey colour it may mean that you are experiencing bacterial vaginosis (BV). This is also often accompanied with a characteristically ‘fishy’ smell as well as pain or discomfort in the bladder when urinating, similar to symptoms of cystitis.
Green discharge: A green or slightly yellow discharge may again indicate an infection, with the colouring caused by the body’s inflammatory response. The infection that green discharge often indicates is trichomoniasis, which is an STD. The symptoms may not appear for a month after the infection develops, with other signs including soreness, swelling or itching around the vagina (which may spread to the inner thighs), and pain or discomfort when having sex.
- Brown discharge: Brown discharge may be caused by spotting or breakthrough bleeding. It can also be the result of missing a pill, starting a new hormonal pill or your body flushing out residual blood from your period. In some cases, brown discharge may be an early indication of pregnancy.
What About The Amount Of Discharge, How Much Is Normal?
The amount of discharge varies from woman to woman and there isn’t necessarily a ‘normal’ amount of discharge you should have. However, it is worth noting that it is quite abnormal for women to have no discharge at all. The ‘normal’ range is huge and can vary from as little as 0.5 ml to several mls per day and will also vary depending on the time of the month (in relation to your menstrual cycle) and whether you are pregnant or menopausal. It’s important for women to understand what is ‘normal’ for them. If you notice a drastic difference in your discharge which you haven’t experienced before, it may be a sign of a bacterial or yeast overgrowth. This is particularly true if the changes in your discharge are accompanied by other symptoms such as pain, burning and itching in and around the vagina.
What Can Affect Your Discharge?
Discharge is a result of natural mucous production in the vagina which has a protective or flushing effect which varies during the month. The discharge comes from cervical and vaginal cells. Other than discharge occurring naturally, the below factors can cause discharge too:
Hormones including oestrogen and progesterone: These affect the production of discharge and can have a significant impact during the menopause or pregnancy. It’s likely you’ll see a huge increase in discharge around ovulation, and especially during pregnancy, as it becomes less gelatinous and more liquid-y. The liquid nature of the discharge helps sperm penetrate through the cervix, into the uterus to fertilise the egg. The odour will change slightly, largely because the pH level alters and the whole consistency of the mucus changes along with it.
External factors such as antibiotics and hormonal contraception: This is because the pill can also alter the overall production of vaginal discharge due to the changes that the hormones cause, particularly in the cervix. You could end up with an erosion (an hormonal change on the cervix), which can then lead to much heavier discharge production. It doesn't mean that it's an infection, it's just an excessive physiological discharge, which many women experience. It's not usually irritating or itchy.
- Infections such as thrush and BV: These can also affect production by causing localised irritation and inflammation which upset the natural microbiome.
BV Is A Common Infection, But What Actually Is It?
Bacterial vaginosis is a vaginal infection, caused by an imbalance of good bacteria in the vagina. This allows ‘bad’ bacteria to take hold, which alters the vaginal pH and makes it more alkaline, causing uncomfortable symptoms. Some women may be more naturally predisposed to a higher vaginal pH that can make them more susceptible to BV. BV can also be caused by vaginal douching using strong detergents when washing, hormonal changes associated with menopause, and the pill and antibiotics. Women who have BV will often experience a white or greyish discharge which may be runny alongside a characteristically ‘fishy’ odour which is very distinguishing. Women may also experience pain or discomfort in the bladder when urinating. It's important to understand that BV is not a dangerous infection. It can be a nuisance and may cause irritation for women, yet it’s unlikely to cause any long-term damage or consequences, unlike STIs such as gonorrhea and chlamydia, and is easily treatable with pH modulating gels.
How Can You Tell If You Have An Infection?
A change in your discharge can be a sign that you have an infection, but any kind of discomfort, burning or a new sensation that hasn’t been experienced before is also an indication. Pain with intercourse is a very important symptom too. A change in odour is a much less common sign of infection because, contrary to what many women think, most infections don't have much of an odour (except BV).
When Should You Visit Your GP?
It’s important women should feel comfortable talking about their intimate health and women should seek advice from a pharmacist or GP if anything dramatically changes. The discharge and odour women have is very individual, therefore what’s normal for someone may not be normal for another. If you are concerned about your intimate health and have noticed abnormal changes which last for more than three months you should seek advice from your GP. If you are experiencing vaginal discharge changes and think you might have an infection, you could also try Canesten Self-Test For Vaginal Infections which is an at-home testing kit that can help diagnosis thrush, BV and trichomoniasis by analysing your pH levels.
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