Team AckoJun 19, 2023
Most women experience one very common issue that not many discuss: the whitish discoloration of underwear after a few weeks/months. This bleaching phenomenon is due to Vaginal Discharge (VD) that is acidic and it is completely normal! However, if you have profuse discharge that has a weird smell or a different colour, there may be some other issue. Thus, it is important to understand the distinction between normal and abnormal VD and know when to seek medical intervention. Read ahead to get an overview of VD.
Vaginal Discharge is a normal process that occurs in all women in the premenopausal age group. It is produced by the lining of the female reproductive tract (vagina, cervix, uterus) in response to the female reproductive hormone, oestrogen. Oestrogen levels in the body decrease significantly following menopause, and hence normal Vaginal Discharge is minimal following menopause.
Normal Vaginal Discharge can be thin, watery, or slightly thicker, pastier in consistency. It is usually clear, pale white, or off-white in colour. Normal Vaginal Discharge does not usually have any strong smell. It does not irritate the skin or tissues of the genital region. Some people produce minimal amounts of discharge, whereas some have an increased volume on a regular basis. Women who are sexually active or on contraceptive pills may have more discharge.
This discharge primarily consists of vaginal lining cells, mucus, bacteria, and fluid produced by glands in the vagina and cervix. The primary functions of normal VD is to prevent vaginal and urinary tract infections and provide lubrication.
Pregnancy can also cause you to have VD. It is due to an increase in the hormone progesterone. This is a protective mechanism to prevent any ascending infections during pregnancy.
The following changes in VD should prompt you to question whether there is any abnormality causing the discharge.
Sudden increase in volume
Any unpleasant or fishy smell
Change in colour
Associated itching or burning sensation of the genitalia
Associated pain during urination/difficulty in passing urine
Lower abdominal pain
Nausea & vomiting
Altered bowel habits
Here’s a list of causes related to abnormal Vaginal Discharge.
Infections are among the commonest causes of abnormal Vaginal Discharge. A change in colour of the discharge may be one of the first noticeable signs.
Here are some of the commonly occurring infections.
Yeast Infection or Candidiasis: This is a commonly occurring fungal infection. It presents with curdy white, cottage cheese-like VD, associated with itching and burning, redness & swelling of the vulva, and painful urination.
Bacterial Vaginosis: This is a condition that occurs due to a change in the normal bacterial flora of the vagina, especially a decrease in the lactobacilli concentration. It is associated with grey or off-white, thin, foul-smelling (fishy odour) VD, burning, and itching. It may become more obvious following a period or sexual intercourse.
Trichomoniasis: This is a sexually transmitted, parasitic infection that presents with thin, greenish-yellow or off-white, frothy VD, vulvar redness & irritation, painful urination, and pain during intercourse.
Chlamydia: Chlamydia is a sexually transmitted infection. It is caused by a bacteria called Chlamydia trachomatis. Most patients may not have symptoms; however, they are still carriers and can transmit it to their sexual partners. It can cause symptoms like VD, abnormal vaginal bleeding, abdominal pain, pain during urination, pain during intercourse.
Gonorrhoea: Gonorrhoea is another sexually transmitted disease that resembles Chlamydia closely in clinical presentation. It can affect the oral cavity, reproductive tract, and anal canal. It can present with VD, itching, abnormal bleeding, abdominal pain, rectal pain, constipation, and pain during bowel movements.
Pelvic Inflammatory Disease (PID): This is a condition of ascending infection through the vagina upwards into the uterus, fallopian tubes, and ovaries. It is a serious infection that is caused by sexually transmitted bacteria. Symptoms include heavy abnormal foul-smelling VD, abnormal vaginal bleeding, abdominal pain, nausea & vomiting, fever, pain & difficulty in urination, etc.
Listed below are some prominent non-infectious causes of Vaginal Discharge
Use of hygiene products: The use of products for douching, scented vaginal cleansers, sprays, or soaps can be harmful as they can cause damage to the natural lining and flora. It can cause VD and other issues.
Retained products: A forgotten or retained tampon or any part of such objects can be left behind in the vagina which can cause Vaginal Discharge.
Atrophic Vaginitis: This is a condition primarily affecting women in the menopausal age group. Due to a decrease in oestrogen levels, there is thinning and drying of the vagina. It can cause vaginal dryness & burning, discharge, itching, urinary issues like pain, burning, & recurrent UTIs, and pain during intercourse.
Cancers: Rarely, vaginal and cervical cancers may present with VD. Often this discharge is reddish-brown and blood-stained. Human Papillomavirus (HPV) is an infection that can progress to cause cervical cancer. An HPV infection can cause reddish discharge with abnormal vaginal bleeding and pain.
To diagnose Vaginal Discharge (severe cases), your doctor will elicit a detailed history, including a history of sexual habits, and perform a genital examination. They may take a swab of your discharge and have it analysed by a lab so as to determine the cause of your discharge. They may also request an ultrasound scan and other imaging to aid their diagnosis if they suspect specific causes.
The treatment of abnormal VD depends on the cause. Infections primarily require a full course of antibiotics or antifungals. Sometimes the use of antimicrobial medicines in the form of creams & ointments may also be prescribed.
In general, the use of mild soap and water to wash the vulva is enough to keep it clean. The use of special intimate area cleansers is not recommended for vaginal hygiene as they alter the normal pH and bacterial flora of the vagina, making it more susceptible to infections.
Safe sexual practices and the use of condoms are very useful in preventing the transmission of STIs. Condoms not only prevent unwanted pregnancies but also the transmission of sexually transmitted diseases. They are a cheap, easy to use, and accessible way of practising safe sex.
Vaccines against HPV are available, and these are extremely effective in the prevention of an HPV infection and cervical cancer that may occur because of it. It is recommended for all girls and is usually given in 2 doses between the ages of 11-12 with a gap of 6-12 months between the doses. The vaccine can be given to adults up to 26 years too; over the age of 15 three doses of the vaccine are recommended. As HPV is a sexually transmitted disease, this vaccine can be administered to boys/men as well.
Normal VD varies throughout the menstrual cycle. In case of daily discharge, it is better to consult a gynaecologist to find the underlying cause.
Since VD is normal, especially around ovulation, it need not be prevented. It is enough to maintain hygiene to prevent infections. Avoid using strong products with added fragrance. Instead, use only warm water over the outer area (not in the vagina). Wear clean, cotton underwear and change out of sweaty or wet clothes at the earliest.
The vagina is self-cleaning and the naturally acidic pH of Vaginal Discharge helps in this process. Hence, scrubbing intimate areas or using chemical products to clean them should be avoided.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Vaginal Discharge is written as VD in this article.
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