- Vaginal discharge often varies at different times in your menstrual cycle
- If you see pink or brown discharge, not associated with a period of post-childbirth, then it’s best to speak to a doctor
- Using perfumed soap can disrupt the balance of beneficial bacteria which naturally cleanse and protect the vagina
Having some vaginal discharge is normal, and healthy. This mucus is secreted to keep your vagina clean and moist, and it supports an eco-system of healthy bacteria which protect against infections, infertility and premature delivery in pregnancy.
The amount and texture of your vaginal discharge can vary depending on your age, whether or not you are sexually active or pregnant, and what birth control you use.
‘It’s also entirely normal for a woman’s discharge to change throughout the menstrual cycle,’ says Livi Lead GP Dr Rhianna McClymont. ‘It can go from being thick and sticky just after your period, to slippery, wet and clear, and then to creamy in colour towards the end of the cycle.
‘Along with this, a woman will have a natural odour from her vagina,’ she adds. ‘But if this vaginal discharge changes from your “normal”, or develops a new unpleasant smell, it could be a sign of an underlying problem.’
If you’re worried about your discharge, it’s important to talk to a GP or attend a sexual health clinic to rule out an infection. But Dr McClymont explains some of the most common changes, and what might cause them.
A thick white discharge
This is a classic sign of vaginal thrush, especially if it looks like cottage cheese. ‘Thrush is usually very itchy, but generally the discharge from it does not smell,’ says Dr McClymont.
Thrush is caused by a fungus called candida that many women carry without experiencing any problems. But if something disrupts the natural balance of bacteria in your vagina, it can cause an overgrowth of candida, and this can lead to the symptoms of thrush. Common triggers may include:
• Having sex • Skin damage or irritation • Hormone replacement therapy (HRT) • Pregnancy • Poorly controlled diabetes • A weakened immune system
If you’ve had thrush before, and know the symptoms, it’s straightforward to treat with anti-fungal cream or pessaries, which are available from a pharmacy. But it’s important to see a doctor if:
• It’s the first time you have had symptoms • Symptoms do not clear completely with treatment • You are under 16 or over 60 • You are pregnant or breastfeeding • You have weakened immunity due to something else, like diabetes, HIV or chemotherapy • You experience symptoms more than twice in 6 months
Green or yellow discharge with a fishy smell
An infection called trichomonas, or trichomoniasis as it is also known, may be the cause. ‘This yellow discharge may also be frothy in appearance and have an unpleasant, sometimes fishy, smell,’ Dr McClymont points out.
Other symptoms include pain when urinating or having sex; and soreness, itching or swelling around the vagina, which sometimes extends to itchiness on the inner thighs.
Trichomonas is caused by a minute parasite called trichomonas vaginalis, which can be spread by having sex without a condom and sharing sex toys that have not been washed or covered with a new condom before each use.
Symptoms develop within a month, but up to half of the people carrying the microscopic parasite have no signs of infection, so they do not realise they are spreading it.
Trichomonas is relatively rare — in the UK, for example, it affects 6,000 people a year compared to chlamydia, which affects 200,000. But it does require treatment with antibiotics, so it’s important to talk to a doctor or a sexual health clinic. Your current and recent sexual partners should also be told.
Trichomonas during pregnancy increases the risk of having a low birth-weight or premature baby, another reason to see a doctor if you have symptoms.
Thick greeny-yellow discharge
Green-yellow discharge could be a symptom of gonorrhoea — the second most common STI in the UK after chlamydia. Other symptoms include pain when urinating and bleeding between periods, although half of women and 1 in 10 men with gonorrhoea have no symptoms.
A single antibiotic injection and single antibiotic tablet usually resolves symptoms within a few days. But most doctors and sexual health clinics recommend a follow-up test a week or two later to make sure the infection has cleared.
Treatment, and contacting recent sexual partners, is essential as untreated gonorrhoea can cause permanent blindness in newborn babies.
A very smelly discharge
A particularly smelly discharge is often a sign of bacterial vaginosis (BV), particularly if it’s ‘fishy’ and more prominent after sex. ‘The vaginal discharge can be thin and watery, or have a greyish-white tinge,’ Dr McClymont says. It’s not usually associated with soreness or itching.
BV is caused by an imbalance of bacteria in the vagina. It’s the most common vaginal condition in women between the ages of 15 and 44 — although half experience no symptoms.
It’s usually easy to treat with antibiotics — in the form of tablets, gels or creams — but it can recur and might require treatment for up to 6 months. Having BV also increases your risk of getting chlamydia and other sexually transmitted infections (STIs).
A pink or brown discharge
This can be a sign of bleeding, which is normal at the beginning and end of your period and after childbirth, when it is known as lochia.
But Dr McClymont says, ‘This should be discussed with a doctor if it occurs at other points in your cycle. Infections, particularly sexual infections such as chlamydia or gonorrhoea, can cause this, as well as conditions that affect the cervix or lining of the womb such as polyps or, in some cases, cancers.’
Any unusual discharge
If it’s accompanied by pelvic pain or bleeding, any discharge that isn’t usual for you could be a sign of an STI such as chlamydia or gonorrhoea.
As chlamydia is quite common, and not everyone develops symptoms, some countries recommend that anyone under 25 who is sexually active should be tested once a year. Left untreated, chlamydia can lead to pelvic inflammatory disease (PID), infertility and reactive arthritis.
How to prevent problems with vaginal discharge
If you’re sexually active and not in an exclusive relationship, using a condom will help prevent many problems.
It’s also a good idea to avoid products that supposedly promote vaginal hygiene or ‘freshness’, as they are not necessary and often do more harm than good.
‘Use water and an emollient instead of soap to wash and avoid vaginal douching — which involves cleaning the inside of the vagina with water,’ Dr McClymont advises. If you’re using lubricants, make sure they’re unperfumed.
When to see a doctor
Dr McClymont suggests speaking to a doctor or sexual health clinic if you’re worried about any abnormal discharge, or any change from what you usually experience during the course of your cycle. And she stresses, ‘Any new bleeding or bloody discharge should be discussed with a doctor — particularly if it occurs after sex, after the menopause or in between your periods.’