Vaginal Discharge: The normal and the not so normal
Meet Akosua! She is a 21-year-old lady and even though she has had sex a couple of times before, she is currently not sexually active. Akosua has always had a discharge ‘problem’. Even before she had sex, she used to notice her panties stained with a clear – sometimes whitish – fluid. This discharge happens so randomly and needless to say, it is a cause of serious embarrassment to her. The discharge does have a smell to it, and though not fishy, nor a disgusting smell, it’s a smell. A smell she tries so hard for no one to notice. When she started birth control, the discharge reduced a bit but picked up again when her mum recently took her off the pills.
Perhaps, reader, you identify with Akosua. Or maybe you identify more with Yaa, who has noticed that during sexual intercourse with her partner, there is this foul-smelling fishy odour that emanates.
The questions to ask? What is normal vaginal discharge and what is not? And is every abnormal vaginal discharge really candidiasis as most of us think? Let’s find out!
What is Vaginal Discharge?
Vaginal discharge is fluid released by the glands in the vagina and cervix. This fluid plays a vital housekeeping role in the female reproductive system. It carries dead cells (pus) and bacteria out of the body. This keeps the vagina clean and helps prevent infection.
More often than not, vaginal discharge is perfectly normal (as seen in Akosua’s story). Normal vaginal discharge changes in response to the changing hormonal levels during the menstrual cycle. The discharge varies in amount and odour and ranges from clear to milky-white in colour. It may, however, turn slightly yellow on oxidation and hence tends to leave yellow stains in your underwear.
Just around ovulation, the normal vaginal discharge is white, very stretchy and abundant and is usually likened to ‘egg white’. Aside from ovulation, the quantity may also increase when you are breastfeeding or sexually aroused. It may also smell different when you are pregnant.
None of those changes is cause for alarm. However, if the colour, smell, or consistency seems quite different than what you are used to – especially if you also have vaginal itching or burning – you could be dealing with an infection or other condition.
Fun fact: The pH of the vagina is usually between 3.5 and 4.5, with lactobacilli being the most common organisms found in the vagina. This, however, differs in menopausal women, who can have a vaginal pH of up to about 7.0, due to the reduced influence of oestrogen. An imbalance in the pH may predispose one to infection.
Abnormal vaginal discharge1
Yeast infection is one of the most common genital infections. 3 out of 4 women get a yeast infection at some point in their lifetime. Symptoms of candidiasis include:
- Vulval itching and soreness
- Redness and swelling
- Thick, cheese-like discharge
- Burning during urination or sex
- Pain during sexual intercourse (Dyspareunia)
Candidiasis is more common in states where your body has reduced immunity (pregnancy, diabetes mellitus, people on steroids, and HIV infected women) and also people on a repeated course of broad-spectrum antibiotics.
Candidiasis can be uncomplicated, complicated or recurrent and treatment depends on which type you have. (See your gynaecologist for more information and also for treatment if you are experiencing any of these symptoms).
To prevent catching a yeast infection, try these tips:
- Don’t douche (avoid the use of soaps and perfumes in and around the vagina and vulva)
- Change your pads (and tampons) frequently
- Ditch synthetic underwear in favour of cotton underwear and wear loose clothes
- Wipe from front to back after visiting the washroom
- Change out of wet and damp clothes ASAP
- Skip the hot tubs and bubble baths
Trichomonas vaginalis is sexually transmitted. Hence, it goes without saying that it will recur if your partner is not treated simultaneously. Most men and many women with trichomoniasis don’t show any symptoms. But if you or one of your sex partners has it, it’s important for all of you to get treatment. Having trichomoniasis can make it feel unpleasant to have sex. Without treatment, the infection can last for months or even years. Trichomoniasis also raises the chances that you could catch or spread other STDs including HIV. Symptoms to look out for include:
- Foul-smelling vaginal discharge; yellowish-green in nature
- Painful urination
- Itching, burning, redness or soreness of the genitals
As with all sexually transmitted conditions, the best way to prevent trichomoniasis is to make sure your partner wears a condom or to wear one yourself.
Gonorrhoea is caused by the bacteria Neisseria gonorrhoea. It is also a sexually transmitted disease which is usually without any symptoms in women. If it does show symptoms, some things to expect are:
- Painful urination with pus-like discharge from the urethra (the tube that carries urine out of the body) or vaginal discharge
- Lower abdominal pain and
- Inter-menstrual bleeding (bleeding in-between your periods)
Just like gonorrhoea, chlamydia is also sexually transmitted and usually shows no symptoms. It may, however, show certain symptoms which include:
- Pus-like vaginal discharge
- Bleeding after sex and
- Painful urination
Bacterial vaginosis gives off a fishy, malodorous discharge which is more prominent during and following menstruation. The discharge is usually thin, grey, white or green. Most women with bacterial vaginosis have no signs or symptoms. You are at a higher risk of acquiring bacterial vaginosis if you:
- Have multiple sexual partners or a new sexual partner
Well, folks! This is a little summary of the different types of abnormal vaginal discharge. This list is by no means exhaustive and should you experience any of the symptoms described above, consult a physician. Below is an infographic on the types of vaginal discharge to help you know what that stain in your undies might be telling you.