Vaginal Discharge is fluid that comes out of the vagina. It contains a mix of vaginal secretions and cervical mucus. Vaginal discharge usually starts after the commencement of the menstrual cycle in a woman and it is quite normal for changes in colour, texture and amount of vaginal discharge at different points of the monthly menstrual cycle.

Vaginal discharge occurs in most women with variation from woman to woman in the amount, type or time that it is produced and are often normal and healthy. It naturally keeps the vagina clean, provides lubrication during sexual intercourse and it is also understood that it may help prevent infection. If a woman has more than her usual amount of vaginal discharge or there is change in consistency or colour of discharge, there may be a problem and she may need to reach out to a Gynaecologist.

Types of vaginal discharge :

Vaginal discharge can be categorized in to different types based on their colour and consistency. While most types of discharge are normal, some may indicate an underlying condition with necessary treatment.

White discharge in nominal amounts, especially at the beginning or end of the menstrual cycle is considered normal.

Clear and watery:

Discharge is perfectly normal at any time of the month. It may be observed to be profound after exercise.

Clear and stretchy:

Discharge is not watery but mucous-like and is commonly normal around the time of ovulation.

Brown or bloody:

Discharge during or right after menstrual cycle happens to be normal. In certain rare cases of endometrial or cervical cancer, fibroids or any other abnormal tissue growth, brown or bloody discharge can be a preceding symptom. Bloody discharge in a woman during in her early stages of pregnancy is called spotting and can be an indication of miscarriage that needs to be discussed with a Gynaecologist. In women who have had recent unprotected sexual intercourse, spotting in place of the regular period could be a sign of pregnancy.

Yellow or green:

Discharge, which is also thick, chunky or with a foul odour is not normal. It may be commonly a sign of a sexually transmitted infection.

cottage cheese-like :

Discharge thick in consistency causing itching  is not normal and needs medical attention. This type of discharge could mean that there is yeast infection.

Signs of abnormal Vaginal Discharge :

A problem that may exist with need for medical care can be indicated by one or more of the following signs:

• an abnormal odour
• a change in colour like green, grey or anything looking like pus
• appearing changed in texture such as foamy or like cottage cheese
• accompanied by vaginal itching, burning, swelling or redness
• spotting or bleeding that is not a regular menstrual period

Causes of abnormal discharge:

Vaginal health is maintained by the pH balance of the vagina. A pH below 7 is acidic and a pH above 7 is basic. A normal vaginal pH is usually less than 4.5. A high pH of the vagina may cause infections as it can allow unhealthy bacteria and yeast to live and multiply. Vagina’s imbalance of normal bacteria can affect the smell, colour or texture of the discharge. Following are a few of the things that can upset the balance:

• Use of certain antibiotics or steroids
• Multiple sexual partners
• Parasitic infection due to unprotected sex
• Sexually transmitted diseases
• Pregnancy
• Birth control pills
• Cervical cancer
• Diabetes
• Post- surgical pelvic infection
• Pelvic inflammatory disease
• Vaginal atrophy – wastage of vaginal wall musculature mostly after menopause
• Vaginitis – irritation in and around the vagina
• Yeast infections
• Chemical irritants as part of douches, soaps, detergents, perfumes etc…

Unusual discharge along with certain other symptoms may rise an alarm for required treatment.  The symptoms to look out for are:

Prevention:

Normal vaginal discharge does not need to be prevented or treated. Precautions that can prevent abnormal discharge are :

• To bathe every day and pat the vaginal area dry.

• Douching frequently to remove vaginal discharge washes away healthy bacteria in the vagina, causing problems. The healthy bacteria is needed to help prevent infection causing bacteria. Hence, using a douche is not a good preventive measure.

• After using the toilet, always wipe from front to back. To help prevent getting bacteria from rectal area into the vagina, always wipe/wash from front to back after using the toilet.

• To use cotton innerwear which absorbs moisture well and avoid yeast infection.

• To avoid wearing tight pants, pantyhose, swimming suits or biking shorts for long periods.

• To avoid hot tubs and bubble baths.

• Changing laundry detergent or fabric softener that may cause irritation to the genital area

• To practise safe sex using contraceptive condoms, limiting the number of sexual partners and timely screening for STIs.

• Latex in birth control condoms or diaphragms can cause vaginal irritation. A Gynaecologist can suggest alternate birth control methods.

• To use natural unscented soaps, tampons and sanitary napkins. Strong scented products tend to disrupt the natural balance of bacteria in the vagina, increasing the risk of infection.

Treatment:

Abnormal vaginal discharge is completely treatable. Treatment of abnormal discharge depends on what is causing the problem. Women require quick access to a women’s health center. Any woman with abnormal vaginal discharge experiences interruption of day-to-day activities and concentration at work or home can be difficult. If a patient complains of vaginal symptoms, appropriate testing such as cultures, microscopy etc are utmost essential. Treatment with most appropriate prescribed medication, taking into consideration the patient’s status of compliance provides prompt relief. However, re-occurrence with regularity may be troublesome. Some women may suffer from frequent yeast infections resulting in repeated vaginosis. In such cases, there may be need for a longer treatment period.

Dr Manu Lakshmi ( Best Gynecologist in chennai )

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