Different types of vaginal discharge and what they mean
Vaginal discharge is a fact of life. Every woman of menstrual age experiences it. It can be said that vaginal discharge reflects a woman’s health. The colour and quality of the secretions indicate where she is in her menstrual cycle and can be sensitive to even slight changes in diet and routine, hormone imbalance, vaginal pH, and infection.
Vaginal discharge consists of fluid/mucus secreted from glands in the cervix and the vagina combined with cells the body naturally sheds. These secretions clean, lubricate, and protect the vagina, and also help sperm cells reach and fertilise an egg. In this article, we explore different types of healthy and unhealthy discharge—what they look like and what they mean—and how to keep your vagina healthy.
The vaginal microbiome
A healthy vagina maintains a subtle balance of microbial flora, usually lactobacilli and other fermentative bacteria that produce lactic acid and create a moderately acidic environment. Normal vaginal pH is 3,8–4,5. The vagina’s acidity protects both the vagina and the reproductive organs against harmful bacteria, parasites, and fungi. As we age the acidity decreases slightly and be closer to a pH of 5,0.
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The vagina is self-cleaning. The secretions play an essential role in keeping the vagina clean and healthy. You might see this mucus/fluid on toilet paper when you wipe, or in your underwear. If it feels uncomfortable, try using thin ‘panty liners’ that can be changed as necessary.
Healthy discharge is clear or white in colour and has no strong odour. Its colour and consistency change throughout the menstrual cycle. Some women track these changes to help them know when they are fertile, either because they want to give themselves the best possible chance of getting pregnant or because they wish to avoid getting pregnant.
Vaginal secretions change throughout the menstrual cycle
Beginning of the cycle—menstruation. During these days, the cervix isn’t producing much fluid, and even if it were, you wouldn’t notice because you are bleeding. Menstrual blood can vary in colour from bright red to dark brown. Usually, it gets darker at the end of the period. It’s normal to notice some clots in the blood because the uterine lining is shedding together with an unfertilised egg. Signs of abnormal bleeding are bleeding for more days than you usually do, heavy bleeding, or the period stops very shortly after it starts.
Just after your period—dry, absence of discharge. The production of cervical fluid is related to oestrogen levels. After your period, oestrogen levels slowly begin to rise as it is produced by the next follicle in the ovary that is preparing to release an egg. There won’t be much discharge until oestrogen levels are higher.
The week before ovulation—sticky then creamy, white to yellow discharge. As the egg matures, oestrogen levels rise, and the cervix begins to secrete fluid again. It may feel sticky or tacky when it first appears and then become creamier, more like lotion. The colour is usually white but can also be yellow, especially when it dries.
Around ovulation—slippery, clear, stretchy, wet discharge. Cervical mucus is most abundant at the time of ovulation. Your vagina will feel much wetter as the water content in the secretions also rises. The discharge at this time looks much like egg white—slippery, stretchy, and clear. The mucus helps to protect and transport sperm cells to increase the likelihood of fertilisation. Please remember, ‘ovulation discharge’ by itself isn’t enough to confirm ovulation.
The luteal phase—sticky, dry discharge. Once the egg has been released, the remnant of the follicle becomes the corpus luteum. If pregnancy has occurred, the corpus luteum produces progesterone to support pregnancy in various ways. If the egg was not fertilised, the corpus luteum degrades and circulating hormones diminish. The cervix and vaginal walls produce less mucus, and what discharge there is becomes drier and stickier. This lasts for the remainder of the cycle, or about two weeks until the uterine lining sheds in menstruation again.
Changes to normal vaginal secretions
Vaginal secretions vary throughout the menstrual cycle, but can also change because of hormonal fluctuations, dietary adjustments, new medicine, birth control. This generally is no cause for concern.
However, a change can sometimes be a sign that something is wrong. The colour of the discharge can be very helpful for diagnosis. Keep track of these changes and other symptoms irritation of the vagina and vulva, painful urination, itchiness, and foul odour as this can help your doctor determine the best treatment.
Greenish-yellow discharge
While light yellow discharge is probably nothing to be concerned about, especially if it coincides with a change in diet or a starting a new dietary supplement, dark yellow, yellowish-green, or green discharge is usually a sign of bacterial or sexually transmitted infection, especially if the discharge is clumpy and foul-smelling. Other symptoms can vary, but if an infection is present, the vaginal canal and vulva feel irritated and swollen, and you might also experience painful urination. See your doctor ASAP.
White discharge that is frothy or clumpy
Thick, white, clumpy discharge is typical of a vaginal yeast infection. Other symptoms include irritation and swelling of the vulva, moderate to intense itchiness, painful intercourse. If you experience any of these symptoms and your vaginal mucus has the consistency of cottage cheese, but the discharge doesn’t have a strong, unpleasant smell, you likely have a yeast infection.
Yeast infections are caused by an overgrowth of the Candida albicans yeast fungus, or other species of Candida—a common yeast that lives on and inside the human body. It is normally harmless, but under certain conditions it can multiply out of control and turn into candidiasis. Although not a sexually transmitted infection (STI), candidiasis can sometimes spread between partners practising vaginal sex.
Gray discharge
Gray is not a healthy colour for vaginal discharge and is often accompanied by other symptoms such as a strong, unpleasant odour (often described as fishy) and itchiness or irritation of the vulva. The most likely culprit is bacterial vaginosis—a bacterial infection that can occur when the vaginal microbiome is disrupted and the naturally-occurring healthy bacteria are displaced by an overgrowth of harmful bacteria.
It can happen to anyone, but certain behaviours increase the risk; these include douching or washing the vagina with scented or medicated soaps, washing your underwear in strong detergents, sex with a new partner or sex with multiple partners, using perfumed bubble bath, and smoking. Bacterial vaginosis is often treated successfully with antibiotics. It sometimes clears up on its own, but untreated BV can also sometimes lead to complications, especially in pregnant women. Male partners do not need to be treated but they can spread the condition to their female partners.
Pink discharge
Pink discharge at the start or end of menstrual bleeding is common as the presence of even a little blood will colour the vaginal secretions. If you see pink that isn’t associated with menstruation and you are sexually active, it might be spotting—postcoital bleeding caused by small tears in the skin that can result from vigorous sexual activity or vaginal dryness; this should only last for an hour or two.
Implantation bleeding caused by the fertilisation of an egg can last for a few hours or a few days. Sometimes switching to a new contraceptive can cause pink discharge for up to several months, especially if you use an implant, an IUD, or have started using a new type of pill.
However, abnormal bleeding can also signify something more serious, such as pelvic inflammatory disease, cervical cancer, or an STI. Keep track of any symptoms you experience and consult with your doctor to find the cause.
Read next: It’s not my period—why am I bleeding?
If you notice a strong odour, or if your vulva and/or vagina feels irritated, swollen, itchy, or painful, see your gynaecologist as soon as possible. Most of the conditions described here can be treated with over-the-counter medicines or antibiotics. If a problem is caught in the early stages and treated, you will likely feel better within a few days or weeks. Untreated conditions are more likely to result in lasting problems.
How to avoid unhealthy discharge
No matter how well you take care of yourself, sometimes vaginal infections happen. Yeast infections and bacterial vaginosis are the most common. Although they can’t always be avoided, there are some preventative steps you can take.
Less is more. As we said before, the vagina cleans itself. Rinsing the groin and vulva with lukewarm water is enough to freshen up. If you must use soap, then choose a gentle product designed for intimate hygiene. Scented products and harsh soaps can cause bacterial imbalance that opens the door for infection and bacterial overgrowth. Do not douche; washing the inside of your vagina washes away the good bacteria that protect you.
Keep it simple. Wear natural fabric underwear. Your underwear should be comfortable, not tight, and made from natural fabrics such as cotton. Cotton allows the skin to breathe and doesn’t disrupt the natural pH balance of your skin.
Practice safe sex and get tested regularly. If you have multiple sexual partners, it is wise to get tested for sexually transmitted infections at least once or twice a year. An undiagnosed STI can be the reason behind abnormal discharge and bad smells. However, there are a number of conditions that can cause changes to vaginal discharge. For a proper diagnosis, your gynaecologist can do a PAP smear, a blood analysis, and check the general health of your reproductive organs.
Vaginal discharge is normal and plays a significant role in keeping your vagina and reproductive organs healthy and safe. Noticing changes in your vaginal mucus can help you monitor your health. If you do get an infection, it is nothing to be ashamed of. It happens to most women at one time or another. Regular testing, proper intimate hygiene, and safe sex will keep you healthy and infections at bay.
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