All You Need To Know About Vaginal Discharge
Vaginal discharge is a normal bodily function and part of the menstrual cycle. This article highlights what normal vaginal discharge is, how it changes throughout the menstrual cycle, and any abnormal discharge that you should look out for.
What is vaginal discharge?
Vaginal discharge is a fluid or mucus that is expelled from the vagina. It can be produced in the vagina, cervix, or uterus, and flows out through the vaginal canal. The fluid or mucus helps keep the vagina clean and moist, and protects it from infection as the acidic nature of the discharge can repel germs.
Vaginal discharge can result from an increase in estrogen level. Estrogen stimulates the cervix to produce secretions or mucus, which is discharged from the vagina. During the menstrual cycle, estrogen level increases gradually after menstruation and usually peaks before ovulation. It can also be high in women who take drugs that contain estrogen or that increase estrogen production (such as some fertility drugs).
What is normal vaginal discharge?
Vaginal discharge is a normal bodily function that indicates the vagina is doing its work and cleaning itself. Discharge does not mean that the vagina is dirty, or that it needs cleaning. In fact, using vaginal cleansers, douches, or washes can disrupt the vaginal microbiome, and lead to infections such as thrush.
Normal vaginal discharge can be white or clear, thick and sticky, slippery and wet, and almost odorless. It can vary with age, the menstrual cycle phase, pregnancy, breast-feeding, menopause, sexual activity, and birth control method.
Thus, the type of vaginal discharge can indicate the female’s health, fertility, menstrual cycle phase, and any existing infections.
How does vaginal discharge change during the menstrual cycle?
The menstrual cycle typically lasts for 28 days, although it can vary from person to person. The volume, color, odor, and texture/consistency of vaginal discharge changes throughout the menstrual cycle, typically in response to hormonal fluctuations. (Note that the days mentioned below are approximate and can vary from person to person):
- During periods or menstrual phase (day 1-5): At the beginning of the cycle, the female reproductive system sheds blood and the tissue lining the uterus. This evolves into dark red or brownish discharge towards the end.
- Follicular phase (days 6-14): Vaginal discharge during the days leading up to ovulation is scanty. The fluid or mucus during this time is thick in consistency and cloudy-white in appearance.
- Ovulatory phase (around day 14): Before ovulation or the release of an egg, up to 30 times more mucus is produced than after ovulation. This discharge is more slippery and clear, and may have a cream-like appearance.
- Luteal phase (days 14 - 25): After ovulation, the mucus goes back to being cloudy, white or yellow, and possibly sticky or tacky. It reduces in volume, and may have a thicker consistency.
- Days leading up to menstruation (days 26-28): Less mucus is discharged during these days, and it lightens in appearance and consistency.
What is abnormal vaginal discharge?
Abnormal vaginal discharge is characterized by an increase in volume and/or a change in color, odor, or texture. There may be symptoms such as irritation, itchiness, or burning in or around the vagina, amongst others.
Vaginal discharge is considered abnormal if it is:
- Heavier or thicker than usual
- Pus-like in appearance or texture
- White and clumpy (like cottage cheese)
- Greenish, grayish, yellowish, or blood-tinged (pink or brown)
- Offensive smelling (foul or fishy)
- Accompanied by itching, burning, soreness, rash, or pain during urination, sex, or in the area between the tummy and thighs (pelvic pain)
The volume, odor, color and consistency of normal vaginal discharge varies from person to person. Therefore, it’s important to observe one’s vaginal discharge during the menstrual cycle. If there’s a noticeable change, compared to the discharge that occurs normally, then it should be suspected as abnormal discharge.
Why does abnormal vaginal discharge occur?
A change in the vaginal microbiome, or the balance of normal bacteria in the vagina, can affect the volume, odor, color, or texture of vaginal discharge. Some of the causes are:
- Frequent douching and cleansing
- Frequent use of steroids or antibiotics
- Sexually transmitted infections (STIs) like chlamydia or gonorrhea
- Vaginal infections like bacterial vaginosis, candidiasis, and trichomoniasis
- Use of oral contraceptive pills (OCPs)
- Cervical or uterine cancer
Abnormal vaginal discharge can also be caused by:
- An outside object in or near the vagina
- An irritation from contact with something that causes an allergic reaction
- Atrophic vaginitis that happens after menopause when estrogen decreases, causing the walls of the vagina to become dry and thinner than normal
If abnormal vaginal discharge is observed or suspected, it is advisable to consult a doctor to receive proper diagnosis and treatment.
Unless the cause is obvious (such as a foreign object or an allergic reaction), a sample of the discharge from the vagina or cervix may be taken (by the doctor or self-taken at home) and examined in a lab to identify the cause of the discharge.
How to prevent vaginal discharge?
Normal vaginal discharge cannot be prevented. One can use panty liners to help absorb heavy or excessive discharge, or odor. But avoid using these all the time as they can cause irritation.
To practice good vaginal health:
- Gently wash the area around the vagina daily using plain water
- Wipe the area from front to back
- Wear cotton underwear
- Avoid tight-fitting or lycra pants and shorts
- Avoid perfumed soaps and gels
- Avoid colored toilet paper
- Avoid deodorants or scented hygiene wipes
- Avoid douching (washing inside the vagina)
To learn how to prevent sexually transmitted infections or vaginal infections that may cause abnormal vaginal discharge, check out our earlier articles.
Vaginal discharge is nothing to be ashamed or embarrassed about. It's important to observe normal vaginal discharge and seek medical care in case any abnormal discharge is observed or suspected.
Kasper, D. L., et al. Harrison's principles of internal medicine (20th edition.). New York: McGraw Hill Education., 2018. (pg. 2821-2823)