Top things to know:
Vaginal discharge is normal, and will vary throughout your menstrual cycle
Vaginal discharge is one way of telling what phase of your menstrual cycle you’re in
Abnormal vaginal discharge differs in color, consistency, smell or quantity compared to your usual discharge
Abnormal vaginal discharge may be a symptom of a bacterial imbalance, an infection or an STI, or in rare cases, cervical cancer
To keep your vagina healthy, avoid douching and use protection during sexual activity
Your vagina has a dynamic and finely tuned ecosystem. It includes a specific balance of bacteria, pH, and moisture. This balance is sensitive to changes, from within and outside your body, and it doesn’t always take much to throw it “off.”
Vaginal fluid also changes when you’re aroused, and during and after pregnancy. But significant or sudden changes in the smell, color or consistency of your fluid might mean something else is going on, like an infection that needs treatment.
Tracking “atypical” or “abnormal” vaginal fluid in Clue provides a record of symptoms to give to your healthcare provider, including when the changes began, and which other factors may be related (like unprotected sex or starting a new birth control method).
It’s important to familiarize yourself with your own, unique “normal” vaginal discharge—in terms of smell, color, and changes throughout the cycle.
What’s considered “normal” vaginal discharge:
Vaginal discharge color and consistency
Your discharge will change along with your body’s production of cervical fluid. At the beginning of the cycle, it tends to be more dry/sticky, or you may notice no discharge at all. It becomes creamy and whitish in the mid-to-late follicular phase (the first phase of your cycle). Just before and around ovulation, it’s likely to become similar to stretchy, wet, transparent egg white. Shortly after ovulation it usually changes back to dry/sticky. Read more about these changes here. Fluid can look white or slightly yellowish and paste-like on your underwear when it dries.
Vaginal discharge volume
Most people will notice their discharge increases throughout the first phase of their cycle, with the most discharge being produced in the days before and including ovulation. Fluid volume then decreases in the day or two after ovulation, which normally lasts until the end of the cycle. You’ll probably also notice your vagina produces more fluid when you’re aroused.
Vaginal discharge smell
Normal discharge can be odorless or have a smell, but it’s usually mild and not unpleasant. It might mix with some urine, or blood around the time of menstruation, which can influence how it smells on your underwear. Getting to know your typical smell is most important for identifying when something changes.
If you use hormonal birth control, these typical patterns of vaginal discharge will stop, as the hormonal cycling is stopped.
Signs of “atypical" or "abnormal" vaginal discharge
Watch for changes in:
Consistency: Fluid becomes unusually thinner, or thicker and more textured
Color: Discharge that is gray, green, yellow, or brown
Volume: Significant and unexpected in volume
Smell: Fishy, metallic, or just different
What causes abnormal vaginal discharge?
Abnormal discharge can happen when the vagina’s microbial community gets out of balance. This means there is a decrease in the amount of “good” microbes and an increase in “bad” microbes (or an overgrowth of something that’s usually only present in small numbers). Such imbalances can lead to conditions like bacterial vaginosis (aka BV — the most common cause of abnormal discharge) (1) and yeast infections (vulvovaginal candidiasis) (2).
Factors that may disrupt the vaginal ecosystem include:
Douching and cleansing practices
Sexual activity, having a new sexual partner
Hormonal birth control or IUDs
Use of antibiotics or steroids
Menarche, menopause, or pregnancy
Hormonal changes through the menstrual cycle
Generally having less vaginal Lactobacillus bacteria
Possibly smoking and diet (but more research is needed) (2–8)
Abnormal discharge can also be caused by sexually transmitted infections (STIs). The most common curable STI is trichomonas vaginalis, a parasite. Other common ones include chlamydia and gonorrhea. Keep in mind these STIs are often asymptomatic (have no apparent symptoms), which is why regular STI testing is so important.
Rarely, abnormal discharge can be a sign of something more serious, like cervical cancer. Be sure to get your Pap tests at the recommended intervals. The CDC recommends testing every 3 years from ages 21–65 if your results are regular, or up to every 5 years if you are tested for HPV (human papillomavirus) along with the Pap.
What should I do if I have abnormal vaginal discharge?
If you are experiencing thick, white vaginal discharge with burning or itching and suspect you have a yeast infection:
You might try an over-the-counter treatment first. These usually come in the form of a vaginal pill/suppository or cream. If symptoms don’t go away after about a week, or if you have recurrent infections, see your healthcare provider. Yeast infections are usually not harmful, but you’ll want to be sure you don’t have something else if your symptoms don’t resolve. The application of a cold press can help to relieve itching. Note that treatments for yeast infections can weaken latex condoms and diaphragms (9).
If you are experiencing other symptoms:
Visit your healthcare provider for a test. They will look at your vulva and vagina and take a sample (swab) to be checked under a microscope, or sent for a lab test. They may also test the pH of your vagina with a simple pH-strip test.
Bacterial vaginosis (BV) may go away on its own, but will often recur, so it’s a good idea to talk to your healthcare provider about treatment. BV can create uncomfortable symptoms, and can increase the risk of contracting an STI, but it doesn’t usually lead to health complications. In some cases, though, untreated BV can lead to infection after gynecologic surgery and pregnancy complications including miscarriage and preterm birth (8-11). BV may contribute to developing pelvic inflammatory disease (PID), but more research is needed (12).
The treatment of BV or an STI like trichomonas, chlamydia or gonorrhea is usually quite simple, and may involve putting an antibiotic gel or cream into your vagina for several days, or taking just one dose of an antibiotic by mouth or injection (depending on the type of infection) (9).
More intervention may be needed in the case of infections that have been left untreated and have become more complicated. Note that many STIs do not cause symptoms, or they remain asymptomatic for a long time. This doesn’t mean they don’t need to be treated as soon as possible. If you are sexually active, regular STI testing is crucial.
Can yogurt, garlic, or tea tree oil cure vaginal infections?
There is mixed evidence on the use of certain foods and supplements for restoring and/or maintaining the balance of healthy vaginal bacteria. There isn’t enough evidence to include the use of yogurt or Lactobacillus probiotics in formal treatment recommendations (9), although there may be some benefit for certain people and it’s unlikely to be harmful (13-14).
Garlic and tea tree oil both have antifungal and antibacterial properties, and are touted as natural cures when used in the vagina. But there is not enough research to say how effective they are at treating vaginal infections, and some people may find that these methods irritate the vagina (15). More research is needed.
If you have symptoms like itching and/or odor, you might be tempted to douche for relief. Resist the urge! Douching and cleansing will not help—and may make things worse (16,17).
Keeping your vagina healthy
Keep foaming and scented soap away from your vulva (or avoid soap on your vulva and in your vagina altogether)
Be extremely diligent about using protection with new and untested sexual partners
Use a fresh barrier tool (like a condom) if switching from anal to vaginal activity during sex
A healthy vaginal environment will make you less likely to contract an STI, and help you avoid uncomfortable symptoms and potential health complications.
Did you know?
You may be more prone to getting an STI during your luteal phase (the second part of your cycle, after ovulation), when your immune system may not be as strong (18). This happens as your body creates an environment that makes getting pregnant most possible, in which an egg can be fertilized and implant in your uterus, without your immune system getting in the way.
Article was originally published on Aug. 7, 2017.