Which vaginal discharge is normal
The vagina constantly releases a small amount of fluid that cleans it and keeps its environment healthy. Normal discharge is clear or white, can be thick and sticky or slippery and wet, and has no strong smell. How much there is and how it looks changes over the cycle, in pregnancy, with sexual activity and with hormonal medicines. There is usually more before a period and in the middle of the cycle. The question arises when there is clearly more than usual, the color, smell or texture changes, or itching, burning, pain or blood appears.
White, curd-like discharge with itching
Thick white discharge like cottage cheese, with itching and redness around the vagina, is most often thrush (candidiasis). It is a fungal infection that often appears after antibiotics or when immunity is low. But the same itching has other causes, such as irritation. For more on itching, see Itching. To avoid treating the wrong thing, see a gynecologist first, especially if it is the first time.
Discharge with an unpleasant smell
Thin gray-white discharge with a fishy smell, especially stronger after sex, is typical of bacterial vaginosis. It is an imbalance of the vaginal bacteria, not necessarily a sexually transmitted infection, but it needs treatment, and a doctor should confirm it.
Yellow or green, foamy discharge
Yellow-green, foamy or pus-like discharge, especially with a smell, itching, or pain when urinating or during sex, can be a sign of a sexually transmitted infection such as trichomoniasis, chlamydia or gonorrhea. For similar complaints when urinating, see Painful urination. Many of these infections cause few signs, so with a new partner or any suspicion, it is better to be tested. Some viral infections, such as human papillomavirus, usually cause no discharge but are found on examination and tests.
Bloody and brown discharge
Brown or bloody spotting between periods, after sex or after menopause is always a reason to see a gynecologist. If it comes with a missed period and lower abdominal pain, do not put off a visit: it may be related to pregnancy, including an ectopic one. For pain, see Abdominal pain, and for a missed period, Irregular periods.
Discharge in pregnancy and in girls
In pregnancy there is usually more discharge, and it stays light and odorless. If itching, a smell or a color change appears, and especially blood or a watery fluid, see the doctor who is following your pregnancy. Girls before their first periods usually have no discharge, and any discharge, especially with a smell or blood, should be shown to a pediatrician or gynecologist.
What you can do before the visit
- Wash with warm water, with a mild unscented soap if you like, and only on the outside.
- Do not douche or use scented gels, deodorants or wipes for the intimate area: they irritate the lining.
- Do not treat yourself with thrush products if the complaint is new: similar symptoms come from other causes.
- Wear underwear made of breathable fabric and change daily liners.
- Avoid sex until an exam if there is pain, burning or a suspected infection.
- Note when the discharge began, how it looks, whether there is a smell, itching or pain, and the date of your last period.
How a doctor looks for the cause
The doctor asks about the cycle, partners and pregnancy, examines the cervix with a speculum and takes a swab for the vaginal flora. If needed, tests for sexually transmitted infections and a pelvic ultrasound are ordered. Treatment depends on the cause: for an infection, suitable medicine is prescribed, and sometimes a partner needs treatment too.