What is the Difference Between Normal and Abnormal Vaginal Discharge

What Is Vaginal Discharge and Why Is It Important?

Vaginal discharge is the fluids and cells that come out of your vagina. It is produced by your uterus, cervix and vagina to protect and lubricate your reproductive tract and keep it healthy. A clear and whitish discharge is natural and normal. However, any changes in its colour or smell are indicative of underlying health issues.   

Vaginal discharge varies from person to person. Some women may notice very little discharge, while others may produce slightly more. A recent study shows that globally, every one in ten women presents with vaginal discharge in a year. 

How do you know if the discharge is normal or abnormal? Let us find out.

How To Identify Normal Vaginal Discharge?

Normal vaginal discharge is a clear or white fluid, which may be thin and watery or sometimes thick and stretchy, depending on the normal hormonal changes happening in your body during your menstrual cycle. Normal vaginal discharge is odourless and does not smell bad.

• Colour: Clear or milky-white.
• Texture: Watery, thick, stretchy or creamy.
• Smell: It may have a mild odour but does not smell strong or unpleasant.
• Volume: Moderate, but increases during ovulation, pregnancy and sexual arousal.
• Sensation: Does not cause itching or discomfort. 

Did You Know?

Your fertile period can be identified based on your vaginal discharge.

• Around the time of ovulation, your vaginal discharge turns more stretchy and slippery, resembling the texture of egg white. This indicates that you are fertile, and there’s a high chance of getting pregnant.

Let us see how normal vaginal discharge changes during your menstrual cycle:

• Early Cycle (Day 1-5): Vaginal discharge is mixed with menstrual blood.
• Post-Period (Day 5-10): White, thick and sticky in consistency.
• Pre-Ovulation (Day 10-13): Discharge gets thinner and cloudier.
• Ovulation (Day 14): Thin, wet, stretchy egg-white-like discharge.
• Post-Ovulation (Day 15-28): Discharge starts to dry up and becomes thick, dry and glue-like.

Common Causes of Abnormal Discharge

What causes the normal vaginal discharge to change?

This can be brought about by a number of factors like infections, irritants or hormonal imbalances. Here are some common causes of abnormal vaginal discharge:

1. Infections

Bacterial Vaginosis (BV)

This is an infection caused by bacterial overgrowth in your vagina. This condition is most common in women of reproductive age group who are sexually active. Hormone changes happening during this time make it easier for certain bacteria to grow and proliferate. It causes off-white, grey or greenish vaginal discharge with a fishy smell, itching in the vagina and a burning sensation during urination.

Yeast Infections

This is a fungal infection of the vagina and is also known as vaginal candidiasis. It causes itching, redness and irritation of the vagina and vulva (female external genitalia), odourless cottage cheese-like vaginal discharge, along with vaginal pain and burning sensation during urination or sexual intercourse.

Sexually Transmitted Infection (STI)

These are infections you can develop after engaging in sexual activities. It is caused by either bacteria, viruses or parasites. STIs cause vaginal discharge with a bad odour, warts, bumps, irritation, pain and burning sensation in the vagina and vulva, vaginal bleeding and pain during sex. The most common types of STIs are:

• Chlamydia: This is a bacterial STI which causes white, yellow or grey vaginal discharge, painful sex, vaginal bleeding in between periods, and pain and burning sensation in the vagina.
• Trichomoniasis: This is a parasitic STI causing foul-smelling foamy, thin, white, yellow or greenish vaginal discharge, irritation and redness around the vaginal opening.
• Syphilis: This is a bacterial STI causing round, painless genital sores on the vaginal wall or vulva and greenish or yellow vaginal discharge with an unpleasant odour.
• Gonorrhoea: A sexually transmitted bacterial infection which causes painful urination, swollen vulva, vaginal bleeding in between periods, painful intercourse, and white, green or yellow vaginal discharge.
• Genital Herpes: This STI is caused by the herpes simplex virus. Symptoms include pain, itching around the genitals, bumps that rupture to cause painful ulcers, and thick vaginal discharge which looks clear, white or cloudy. 
• Human Papillomavirus (HPV): This STI is caused by viruses. Some HPV strains are harmless and just cause warts, while others are high-risk and can progress to cancer. It can cause unpleasant-smelling vaginal discharge that is watery, pale, pink, red, or brown.
• Human Immunodeficiency Virus (HIV): HIV increases the risk of bacterial and fungal infections of the vagina, like bacterial vaginosis and vaginal candidiasis.

Pelvic Inflammatory Disease (PID)

You may get Pelvic Inflammatory Disease when untreated vaginal infections and sexually transmitted infections spread upwards into your cervix, uterus and ovaries. It can cause pelvic and lower abdominal pain, abnormal vaginal discharge and sometimes fever.

2. Hormonal Imbalances and Other Medical Conditions

Apart from infections, other factors that can lead to vaginal discharge are:

Hormonal Imbalances

Factors like pregnancy, ovulation or using birth control pills can alter vaginal discharge. The amount of vaginal discharge is less in women who are menopausal compared to women in their reproductive age due to low oestrogen (female sex hormone) levels after menopause.

Click here to read more about vaginal odour in menopause.

Foreign Bodies in the Vagina

Forgotten or retained contraceptive devices, tampons, diaphragms and other foreign bodies in the vagina for longer than intended durations can lead to foul-smelling vaginal discharge, itching, discomfort and pain.

Irritants

If you have allergies to soaps, scented toilet paper, hygiene products or over-the-counter douches, it can cause local irritation and vaginal discharge.

Cervical and Vaginal Conditions

Apart from infections and hormonal changes, other health problems can cause vaginal discharge. A few common conditions are:

• Cervical Polyps (non-cancerous finger-like growth in the cervix)
• Cervical Cysts (mucus-filled bumps on the cervix)
• Cervical and Vaginal Cancer
• Vaginal Atrophy (thinning, drying and inflammation of the vaginal lining caused by low oestrogen)
• Vaginal Fistula (abnormal connection between the vagina and nearby organs like the rectum or urinary bladder)

Signs of Abnormal Vaginal Discharge

What makes vaginal discharge abnormal? Changes in the colour, texture or odour of your vaginal discharge can indicate health concerns and require close observation and treatment.

Here are some types of vaginal discharge and what they might indicate:

1. Unusual Colours and Textures of Abnormal Vaginal Discharge

Normal vaginal discharge is clear or milky white, odourless and not associated with itching or any discomfort. A variation from this means there’s a problem. Let us look at what these different colours of vaginal discharge mean:

• Off-white or white discharge with a foul smell, cottage cheese-like consistency and itching indicates a yeast infection.
• Red discharge, apart from menstrual bleeding, can be a sign of cancer.
• Yellow and green discharge signals a bacterial infection or STD.
• Pink discharge can be a sign of implantation bleeding (light bleeding that occurs after fertilisation) or small tears in the vaginal walls after sexual intercourse.
• Grey vaginal discharge indicates bacterial vaginosis.

2. Strong Odours and Associated Symptoms

If you experience vaginal discharge with a strong odour, it is because of an underlying health condition. Here are some common causes of strong odours and their associated symptoms:

• Bacterial vaginosis causes vaginal discharge with a fishy smell, along with itching and irritation in the vagina.
• Trichomoniasis causes a foul-smelling vaginal discharge associated with itching, redness, burning sensation while urinating and pain during sex.
• In yeast infections, the discharge smells unusual but not necessarily foul. It is associated with intense itching and swelling of the vulva. 
• Sexually transmitted infections result in a greenish or yellowish discharge with a mild odour, along with symptoms like pain during sex and urination, pelvic pain and bleeding in between your periods.
• Foreign bodies in the vagina, like a forgotten tampon or contraceptive devices, cause very foul and rotten-smelling vaginal discharge, along with intense irritation and sometimes fever.
• Pelvic inflammatory disease results in a strong, unpleasant-smelling vaginal discharge associated with pelvic pain, painful intercourse and bleeding in between the periods.
• Cervical cancer causes watery, bloody, foul-smelling discharge, along with pelvic pain, bleeding and weight loss.

When Should You Seek Medical Attention?

We have seen how to differentiate normal and abnormal vaginal discharge. If you observe these symptoms, make sure to visit your healthcare provider for medical support:

• Changes in colour, odour or texture of your vaginal discharge from its usual appearance.
• Pain in the pelvis or lower abdomen, pain during sexual intercourse or burning sensation while urinating.
• Itching, irritation, rashes or bumps in and around the vaginal opening or vulva.
• Unusual bleeding or spotting in between periods (not menstrual bleeding) or after sex.

Preventive Measures for Vaginal Health

"An ounce of prevention is worth a pound of cure” – Benjamin Franklin.

Even though all vaginal infections are treatable, it is best to keep your vagina healthy. Here are some best ways to prevent vaginal infections and abnormal discharge:

• Use a condom whenever you take part in sex.
• Keep your private parts clean and dry.
• Change tampons or pads regularly.
• Stay away from scented hygiene products.
• Do not overuse antibiotics.
• Wear loose-fitting clothes and use cotton underwear. 
• Change out of wet or sweaty clothing as soon as you can.
• Limit the use of harsh chemicals to wash your underwear.
• Use water-based natural lubricants during sexual intercourse, that too, only if your body does not produce sufficient lubrication.
• Use mild soap and water to clean your private parts and avoid frequent douching.
• Take oral probiotics in the form of food or supplements.
• Eat healthy and stay hydrated.
• Limit smoking and alcohol consumption.
• Limit the number of sexual partners.
• Regular pelvic exams and Pap tests should be done to identify any infection as soon as possible.

It is always easier and healthier to prevent vaginal infections by following simple, consistent steps that deal with it later on. Following these recommendations can save you from encountering vaginal infections.

How Can You Treat Abnormal Vaginal Discharge?

Treatment for vaginal infections is decided based on what causes it. Your doctor may prescribe medications like:

• Metronidazole or clindamycin for bacterial infections, along with probiotic supplements.
• Antifungal creams or suppositories for fungal infections.
• Antibiotics like ceftriaxone or azithromycin to treat sexually transmitted diseases.
• Oestrogen creams or tablets to treat severe vaginal dryness and irritation in atrophic vaginitis.

Here’s a tip for you – Both partners should get treated to prevent chances of re-infection. Always use protection during sexual intercourse and get regular check-ups done if you are sexually active.

You can manage abnormal vaginal discharge by appropriate medical treatment of infections and underlying health issues, practising hygiene, proper clothing choices and following steps to prevent infections. Including probiotic supplements and warm sitz baths can soothe mild vaginal infections.

Wrapping Up

Hope that by now, you feel more confident in identifying abnormal vaginal discharges. Pay close attention to any changes in its colour, consistency or odour. Always remember to seek medical advice if you experience persistent abnormal vaginal discharge accompanied by symptoms like itching, redness or pain.

For simple remedies and tips to manage vaginal infections naturally, get in touch with our team of medical experts at Nirva Health.