This blog concludes our series on vaginal discharge and sexually transmitted diseases.
Is vaginal discharge normal?
It is quite normal and healthy to have a clear or white discharge from your vagina.
This mucus is produced naturally from the neck of the womb, known as the cervix.
The amount of vaginal discharge varies throughout your menstrual cycle (brown discharge is usual towards the end of your period) and most pregnant women will get a ‘pregnancy discharge’.
Healthy discharge does not have a strong smell or colour. You may feel an uncomfortable wetness, but you should not have any itching or soreness around your vagina.
How do I know if my discharge is unhealthy?
Any sudden change to your discharge may indicate a vaginal infection. There will be a recurring pattern of how your discharge varies throughout your cycle – if you are concerned by any possible changes contact your GP or GUM clinic. Obvious warning signs of infection are:
• A change in colour or consistency
• A sudden bad smell
• An unusually large amount of discharge
• Another symptom alongside the discharge, such as itching on the outside of your vagina or pain in your pelvis or tummy
• Unexpected bleeding from the vagina
Common causes of abnormal discharge
There are many possible causes of abnormal vaginal discharge, but it is usually a sign of infection. The infection is often caused by something that upsets the natural balance of bacteria or yeast in your vagina, such as washing inside the vagina, or it may be sexually transmitted.
The most common causes are:
• Thrush – a fungal infection that commonly affects the vagina
• Bacterial vaginosis – a bacterial infection of the vagina
• Trichomoniasis – a sexually transmitted infection (STI) caused by bacteria
• Genital herpes – an STI caused by the herpes simplex virus
The guide below may help you identify the cause of your discharge:
Watery or white vaginal discharge with intense itchiness
If your discharge is thin and watery, or thick and white (like cottage cheese), you may have thrush. This common fungal infection causes a high level of itching and soreness around your vagina. The discharge may smell slightly yeasty, but doesn’t have a strong smell.
Almost all women get thrush from time to time and it is NOT sexually transmitted. It is easily treated with antifungal medicine, which can be bought over the counter from your pharmacy or via White Pharmacy.
White or grey, fishy-smelling discharge
If your vaginal discharge is grey or develops a strong fishy smell, particularly after sexual intercourse, you could have bacterial vaginosis (BV). BV is an imbalance in the normal bacteria found in your vagina. It doesn’t usually cause itching or irritation.
Like thrush, BV is very common and isn’t sexually transmitted. It is easily treated with antibiotics prescribed by your GP or from White Pharmacy.
Green, yellow or frothy discharge
Trichomoniasis is a common STI caused by a tiny parasite. It can make your vaginal discharge frothy, yellow or green. You may have a lot of discharge, which may also have an unpleasant fishy smell. Other possible symptoms are soreness, swelling and itching around the vagina and pain when passing urine.
Trichomoniasis is effectively treated with an antibiotic called metronidazole, which your GP or the White Pharmacy doctors can prescribe. If you have Trichomoniasis you should also consider visiting a local GUM or sexual health clinic, as it can exist alongside other STIs.
Abnormal discharge with pain or bleeding
See your GP or go to a genitourinary medicine (GUM) clinic as soon as possible if your vaginal discharge is abnormal and you have:
• Pain in your pelvis
• Pain when you urinate
• Bleeding between periods or after sex
You may have chlamydia or gonorrhoea (both STIs). Gonorrhoea can make your discharge turn green, although often the pain or bleeding is more noticeable. Both conditions are treated with antibiotics.
Untreated gonorrhoea or chlamydia may spread upwards and lead to pelvic inflammatory disease: a serious infection of the womb, fallopian tubes or ovaries. This, in turn, can cause infertility.
Abnormal discharge with blisters around the genitals
Genital herpes can cause painful, red blisters or sores to appear around your genitals, as well as an abnormal vaginal discharge. See your GP or go to a genitourinary medicine (GUM) clinic as soon as possible. You may be offered a course of antiviral tables, which stop the herpes virus multiplying, but the symptoms have a tendency to return.
Young girls and post-menopausal women
It is unusual for young girls to have abnormal vaginal discharge before they have gone through puberty. If this happens, they should see a GP. A common cause is a type of vulvitis (inflammation of the vulval area), caused by a streptococcal infection.
Abnormal discharge is also unusual in older women. If you have gone through the menopause and suddenly notice an abnormal vaginal discharge, see your doctor as soon as possible. Possible causes include:
• A sexually transmitted infection (STI)
• Cervical polyps – non-cancerous growths in the womb or lining of the cervix (neck of the womb).
• An intrauterine device (IUD)
It is also important for the doctor to be able to rule out cervical cancer or endometrial cancer.
Should I wash my vagina?
The vagina is self-cleansing, so there is no need to wash inside it (called douching). Douching can upset the natural balance of bacteria and fungi in your vagina and lead to thrush or bacterial vaginosis.
Overusing perfumed soaps, bubble baths and shower gels can also cause vaginal soreness and abnormal vaginal discharge. Never clean your vagina with anything strongly perfumed. Use a mild soap and warm water to gently wash around the outside of your genitals.
If your symptoms are not on this list but you are concerned about your sexual health, visit a doctor or GUM clinic as soon as possible. Remember, the longer symptoms persist the more chance there is of lasting damage.