Illustration by Emma Günther
Vaginal discharge: Why does it change and what does it mean?
What is “normal” vaginal discharge?
Top things to know about vaginal discharge:
Vaginal discharge is common and will vary throughout your menstrual cycle
Vaginal discharge is one way of telling what phase of your menstrual cycle you’re in
Unusual or atypical vaginal discharge differs in color, consistency, smell, or quantity compared to your usual discharge
Unusual 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 both within and outside of your body, and it doesn’t always take much to throw it “off”.
It’s common to notice different types of vaginal fluid throughout your menstrual cycle—it changes cyclically along with your hormones in appearance, consistency, and volume.
Vaginal fluid also changes when you’re aroused, and during and after pregnancy. However, 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” vaginal fluid in Clue provides a record of symptoms to share with 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 “typical” 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 (1). It becomes creamy and whitish in the mid-to-late follicular phase (the first phase of your cycle) (2). You will likely have clear discharge just before and around ovulation, similar to stretchy, wet egg white (3,4). Shortly after ovulation, it usually becomes thicker and stickier (4). Read more about these changes here. Fluid can look white or slightly yellowish and paste-like on your underwear when it dries (4).
One in four people who track vaginal discharge with Clue track "creamy" discharge
Amount of vaginal discharge
Most people will notice their discharge increases throughout the first phase of their cycle, with most discharge being produced in the days leading up to and including ovulation (5). The fluid volume then decreases in the day or two after ovulation due to the increase of progesterone until the end of the cycle (5). You’ll probably also notice your vagina produces more fluid when you’re aroused (6).
More than one in five people who track their discharge in Clue do so around ovulation
Vaginal discharge smell
Typical discharge can be odorless or have a smell, but it’s usually mild and not unpleasant (7). 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 can help you identify when something changes.
Users of hormonal birth control may have different experiences of vaginal discharge due to the influence of outside hormones (5).
Signs of “atypical" vaginal discharge
Atypical vaginal discharge is different from your usual discharge in consistency, color, volume, and smell. It may be a sign of an infection, including:
Bacterial Vaginosis (8)
Thin gray, green, or white discharge
A fishy, musty, or foul smell
Other symptoms include genital pain, vaginal itching, or burning
Yeast infection (9)
Thick, white, and chunky discharge, like cottage cheese
Discharge does not smell, or there is a slightly “off” smell
Other symptoms include genital itching, swelling, irritation, painful urination, or redness
Trichomoniasis (9,10)
The majority of people have no symptoms or only mild symptoms
A large amount of green discharge or yellow discharge
Foul or fishy-smelling discharge
Other symptoms include genital itching, burning, or soreness
What causes atypical vaginal discharge?
Atypical discharge can happen when the vagina’s microbial community gets out of balance (9). 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 mentioned above, like bacterial vaginosis (aka BV, a bacterial infection—the most common cause of atypical discharge) (8) and yeast infections (vulvovaginal candidiasis) (9).
Factors that may disrupt the vaginal ecosystem include:
Douching and cleansing practices (11,12)
Spermicide use (9)
Sexual intercourse, having a new sexual partner or multiple sexual partners (11)
Presence of an IUD (13,14)
Prolonged or irregular bleeding or spotting (14)
Use of antibiotics (9)
Menarche, menopause, or pregnancy (15,16)
Hormonal changes through the menstrual cycle (15)
Uncontrolled diabetes (17)
Generally having less vaginal Lactobacillus bacteria (14)
Cigarette smoking (11,18)
Diet (16) (but more research is needed)
Atypical discharge can also be caused by sexually transmitted infections (STIs). The most common non-viral STI is trichomonas vaginalis, a parasite (19). 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, atypical discharge can be a sign of something more serious, like cervical cancer (20). Be sure to get your Pap tests at the recommended intervals.
What should I do if I have atypical 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 (21).
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.
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 (11,12).
Bacterial vaginosis (BV) may go away on its own, but often requires treatment (22). Even with treatment, BV may frequently recur (22). BV can create uncomfortable symptoms and can increase the risk of contracting an STI (22), 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 (23,24). BV may contribute to developing pelvic inflammatory disease (PID), but more research is needed (25).
How do you treat conditions causing vaginal discharge?
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 an antibiotic by mouth or injection (depending on the type of infection) (26).
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 remain asymptomatic for a long time (27). 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.
App Store
Play Store
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 (28), although there may be some benefit for certain people and it’s unlikely to be harmful (28). More research is needed.
Some research has suggested that garlic and tea tree oil may have antimicrobial properties and that each may be effective against certain types of bacteria that cause vaginal infections (29,30). However, research on these alternative treatments is too limited to draw any conclusions
Keeping your vagina healthy
How to prevent disrupting the vaginal microbiome:
Don’t douche
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.
FAQs
Are you more prone to getting an STI during the luteal phase of your menstrual cycle?
You may be more prone to getting an STI during your luteal phase (the second part of your cycle, after ovulation) because your immune system may not be as strong (31). In your luteal phase, 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.
What does a yellowish discharge mean?
Discharge may appear yellow for several reasons. For some people, pale yellow discharge without any irritation or odor is typical throughout the cycle. Sometimes, dried discharge can appear yellow on your underwear.
However, if your discharge has recently changed color, or if the color is accompanied by other symptoms including itching, irritation, swelling, or odor, consider checking in with a healthcare provider to rule out infection.
Why do I have vaginal discharge?
After puberty, everyone with a vagina will have some kind of vaginal discharge! What is normal for each person may vary slightly in terms of amount, color, and consistency. However, discharge should always be mild and will usually not cause discomfort.
Vaginal discharge helps clean the vagina by removing old, dead cells. It contains bacteria called lactobacilli that help maintain the right pH and keep the vagina healthy (7).
What does thick white discharge mean?
You might notice thick white discharge during the second half of the menstrual cycle, the luteal phase. The increase in progesterone at this time causes cervical mucus to thicken and become more sticky (1). Discharge might also appear creamy and white between your period and ovulation (32).
If thick white discharge is accompanied by redness, itching, burning, or swelling, it might indicate a yeast infection. A sudden change in your discharge, especially alongside other symptoms, should be evaluated by a healthcare provider.
What does brown discharge mean after sex?
Brown colored discharge is usually caused by the presence of blood. Bleeding after sex may happen if there is friction from a lack of vaginal lubrication. Vaginal dryness may be hormonal (33).
Sometimes, changes to the cervix can make bleeding after sex more likely. These include benign changes like cervical polyps (non-cancerous growths) and cervical ectropion (hormonal change in the type of cells found on the outside of the cervix). Rarely, bleeding after sex can also be a sign of cervical or uterine cancer (33).
In some people, bleeding after sex can be a sign of infection. This is especially true if other symptoms, such as pain or odor, are present (33).
There are also several other health conditions, such as endometriosis, pelvic organ prolapse, or lichen sclerosus, that can cause bleeding after sex. These are usually accompanied by other symptoms (33).
Because of the many different causes of bleeding after sex, it’s important to pay attention to your body. Tracking your symptoms may help you notice trends. For brown discharge after sex that happens frequently or alongside other symptoms, it’s best to get checked by a healthcare provider.
Article was originally published on Aug. 7, 2017.
