Infections

VAGINAL DISCHARGE

Vaginal discharge is the term for fluid or mucus that comes from the vagina. Vaginal discharge is a common concern among women, and leads many women to see their doctors. Some amount of vaginal discharge is normal, unless it occurs with itching, burning, or other bothersome symptoms. Vaginal discharge is made by the skin cells of the vagina and cervix under the influence of the female hormone, oestrogen. Women who are menopausal normally have minimal vaginal discharge as a result of lower levels of oestrogen. In women who are premenopausal, it is normal to have about one-half to one teaspoon of white or clear, thick, mucus-like, and mostly odorless vaginal discharge every day. However, the amount and consistency of the discharge varies from one woman to another. The amount can also vary at different times during the menstrual cycle. It may become more noticeable at certain times, such as during pregnancy, with use of birth control pills/patch/vaginal ring, near ovulation, and in the week before the menstrual period.

Normally, discharge contains vaginal skin cells, bacteria, and mucus and fluid produced by the vagina and cervix. A normal discharge often has a slight odor and may cause mild irritation of the vulva. This discharge helps to protect the vaginal and urinary tract against infections and provides lubrication to the vaginal tissues.

ABNORMAL VAGINAL DISCHARGE

Vaginal discharge is common and normal. However, vaginal discharge with the following signs and symptoms is not normal and should be assessed by a doctor or nurse:

  • Itching of the vulva, vaginal opening, or labia
  • Redness, burning, soreness, or swelling of the vulvar skin
  • Foamy or greenish-yellow discharge
  • Bad odor
  • Blood-tinged vaginal discharge
  • Pain with intercourse or urination
  • Abdominal or pelvic pain

CAUSES OF ABNORMAL VAGINAL DISCHARGE

The most common causes of vaginal discharge include:

  • A vaginal infection (yeast or bacterial infection, trichomonas)
  • The body's reaction to a foreign body (such as a forgotten tampon or condom) or substance (such as spermicide, soap).
  • Changes that occur after menopause can cause vaginal dryness, especially during sex, as well as a watery vaginal discharge or other symptoms.

Treatment — In some cases, it is possible to make a diagnosis and begin treatment immediately, based upon the examination. In other cases, the provider may recommend delaying treatment until test results are available. Sexual partners of women with a sexually transmitted infection, such as chlamydia, gonorrhea, or trichomonas, need evaluation and treatment. For other infections, such as yeast or bacterial vaginosis, the sexual partner does not need treatment. If treatment is needed, you should avoid having intercourse until the treatment is completed.

Can I treat myself? — Many women would prefer to avoid seeing their healthcare provider. However, self-treatment can delay getting the correct diagnosis, be costly, or even cause worsened symptoms. In most cases, a physical examination should be performed before any treatment is used. In particular, you should not douche to get rid of the discharge because douching can make the discharge worse if it is due to an infection.

SELF-HELP HYGEINE

Abnormal vaginal discharge may be more likely to develop in women who practice certain habits, such as those who use:

  • Douches
  • Pantyliners every day
  • "Feminine hygiene" sprays, powders, or rinses
  • Bubble baths or other scented bath products
  • Tight or restrictive synthetic clothing (eg, thongs, synthetic underwear)

Healthier practices include the following:

  • Use water or unscented non-soap cleanser to wash genitalia, use warm (not hot) water and the hand (not a washcloth)
  • Do not douche or use feminine hygiene products; if odor or discharge is bothersome, see your doctor
  • Avoid hot baths with scented products; plain warm water is preferred
  • Wear cotton underwear; avoid thongs and lycra underwear
  • Rinse genitals with water and/or pat dry after toileting;
  • avoid use of baby wipes or scented toilet paper