Vaginal discharge: what’s abnormal

Vaginal discharge causes undue concern in many women and their partners. It is important to appreciate that the vagina is a dynamic organ that responds to changing hormones in the female reproductive cycle. Secretions arise from the vagina and cervix, and vary depending on circulating female hormones. The secretions serve an important housekeeping function that carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection.

Thus most of the time, vaginal discharge is perfectly normal. The amount, odour and colour can vary depending on the time in your menstrual cycle. There will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene. However if the colour, smell, or consistency seems significantly unusual, especially if accompanied by itching or burning, you could be having an infection or other condition.

Abnormal discharge is caused by an imbalance of normal vaginal bacteria. This may be caused by antibiotic use; birth control pills; sexually transmitted infections (for example Chlamydia or gonorrhea); Pelvic inflammatory disease (PID); fungal (yeast infections) and general disease conditions like diabetes. Vaginal douching, scented soaps and bubble baths can also affect the normal vaginal bacterial balance. A forgotten tampon and rarely cervical or vaginal cancer can cause excessive discharge.

Abnormal discharge is characterized by excessive secretions, changes in colour and smell of the discharge; and sometimes itching and burning sensations. Bloody or brown discharge may be due to irregular menstrual cycles, while a thick and cheesy white discharge implies a fungal infection. Greyish and yellow discharge, often with a fishy smell may imply a condition called Bacterial Vaginosis. Usually, a sample of the discharge is sent to the laboratory for further tests.

There are several things you can do to reduce risks of abnormal vaginal discharge. Keep the vagina clean by washing regularly with a gentle, mild soap and warm water. Do not douche. While many women feel cleaner if they douche after menstruation or intercourse, it may actually worsen vaginal discharge because it removes healthy bacteria lining the vagina. Limit use of scented soaps, and bubble baths. And always wipe from front to back to prevent bacteria from getting into the vagina. Wear loose cotton underpants; avoid underwear made of silk or nylon, these materials are not very absorbent and restrict air flow. Use condoms to avoid catching or spreading sexual infections. Avoid using feminine hygiene sprays, fragrances, or powders in the genital area.

Treatment for an abnormal discharge depends on the specific cause. This may range from anti-fungal to antibiotics, either inserted into the vagina or occasionally taken by mouth. If the cause is a sexual infection, your sexual partner may also need treatment.