Similar to the gut, lungs and uterus, the vagina is home to an ecosystem of microorganisms that keep our tissues healthy and prevent infection. Bacteria themselves can make and release gases, mucus and other substances, and leave evidence for us through sensations, smells and discharge. Some of these are normal and healthy, while others may prompt a visit to your doctor for further investigation. Here’s everything you need to know about vaginal discharge, including what different types mean.
What is vaginal discharge?
The vagina is lined with a mucus membrane, much like our respiratory and digestive tracts. It’s what keeps those delicate tissues healthy and provides that ideal moist environment for beneficial bacteria to flourish, keeping the vagina healthy and infection-free. Discharge also prevents the soft vaginal tissues from drying out (crucial for comfort during intercourse, but also when the vaginal canal is vacant).
Vaginal discharge—the fluid, secretions or mucus that we often notice upon wiping (or that ends up on your underwear)—is completely normal and healthy. But different types of discharge may indicate issues like inflammation, an overabundance of yeast growth or a bacterial or viral infection.
An imbalance in the vaginal micro-ecosystem itself can cause changes to our discharge. A healthy vaginal (and uterine) environment should be made up of at least 90 percent Lactobacillus bacteria and healthy discharge provides an excellent environment for Lactobacilli bacteria to live. These bacteria are critical for vaginal health as they produce lactic acid which maintains the perfect vaginal pH. They also produce other compounds that protect against invaders like pathogenic bacteria, fungi and viruses. Further up the reproductive tract, they can even influence immune function and assist in the implantation of an embryo. Anything that disrupts this ecosystem (having a lower percentage of Lactobacillus or having other microbes there instead) will affect vaginal health and sometimes we are alerted to that change via our discharge.
Since our reproductive hormones cycle up and down over the course of a month (give or take a few days), this can influence the vaginal environment, and it’s common to notice changes in discharge over the course of a cycle.
What is normal vaginal discharge?
From the end of the menstrual period to ovulation (approximately cycle days five to 14), rising estrogen levels cause certain pockets—called cervical crypts—to open, releasing a cervical mucus. You might notice more discharge than usual at this time, and it’s often more lubricating, slippery and stretchy, compared to discharge at other times of your cycle. It should also be clear, which is why it’s often described as looking like raw egg whites. You’ll notice this discharge disappear after a few days, as estrogen levels decline around ovulation.
Outside of your period and this fertile pre-ovulation mucus, normal discharge is often white or milky. It can be thick or thin in consistency, but not chunky or curd-like. It also should not have any odor.
How much discharge is normal?
Fun fact: women of reproductive age produce about 1.6 to 4.8 grams of vaginal discharge each day.
What is abnormal discharge?
Discharge that indicates there might be something not normal going on will either be completely different than the types mentioned above, or it could appear normal, but be accompanied by symptoms like itching, redness, swelling or odor (like a fishy smell).
See your doctor immediately:
- If discharge is green, grey, yellow, clumpy or frothy
- If you notice any fishy or foul smells
- If you notice redness, swelling, or experience itching or burning sensations
- If you experience pain with urination or intercourse
- If you experience vaginal bleeding outside of normal menstruation
Vaginal discharge colours and what they could mean:
Red or pink: If you are not menstruating and your discharge is bright red, this indicates fresh blood. Blood can also mix with regular discharge and appear pink. Spotting or bleeding outside of normal menstruation could be a sign of abnormally low estrogen or progesterone. Other causes of spotting can include vaginal irritation, embryo implantation and cervical cancer—though this last one is unlikely if you have regular screening for the earliest signs of abnormal cervical cells, a.k.a., a pap test.
Yellow or Green: Discharge that leans yellow or green-ish tends to indicate infection, often of the sexually transmitted variety.
Grey: Grey discharge can indicate bacterial vaginosis or other infection
Brown: Brown discharge typically indicates old blood, which could be a sign of inflammation or low estrogen levels.
What does cottage-cheese-like discharge mean?
This is an abnormal type of discharge, especially if you also notice itching. Most people associate cottage-cheese discharge with yeast infections—which it can be—but it can also be cytolytic vaginosis. This is where the vaginal environment is overabundant in Lactobacillus bacteria and becomes too acidic. The acidity can cause the cells lining the vagina to die off, resulting in itching and the change in discharge texture. If you’ve tried over-the-counter yeast infection treatments and your symptoms are still there, it’s time to see your doctor and have a swab and culture done. They can also check your vaginal pH to find out the level of acidity.
What if you get symptoms only after having sex with your partner (or a new partner)?
If you’re noticing symptoms only after intercourse—or if you tend to get yeast or other vaginal infections every time you have sex with a particular partner, that partner is likely causing your infection (or you’re passing it back and forth). First, the pH of semen is closer to or just above seven, while the vagina is happiest when the pH is around 3.8 to 4.5. Semen itself can disrupt the vagina’s pH balance, but it also can contain bacteria. There’s a good chance if you’re noticing symptoms after intercourse, both you and that partner may need to be treated, otherwise you’re going to keep getting reinfected every time you have unprotected sex.
How can I ensure healthy vaginal discharge?
In general, avoid mucking around with your vaginal environment. Its ecosystem, when in a healthy balance, can manage itself just fine. Avoid douching (the vagina is self-cleaning!), and make sure to always clean any sex toys properly before and after use.
Should I avoid tampons?
Another reason for abnormal discharge could be the presence of a foreign body, like a tampon. This is also the reason there’s a warning on how long to leave a tampon in. Tampons soak up your vagina’s natural healthy discharge, drying out the tissues and leaving them more susceptible to irritation and infection. Meanwhile the cotton tampon itself when left for too long can breed pathogenic bacteria causing an infection (this is how toxic shock syndrome happens). Common symptoms of a foreign body infection include foul smelling and abundantly watery discharge.
How do I know if something is seriously wrong?
Any abnormal composition of bacterial species (meaning, not 90 percent Lactobacillus, and instead having the environment populated with other species of bacteria) can cause abnormal discharge. Although there are some clues as to what the cause might be, we really can’t tell for sure without doing a swab and culture test. In some cases, it might be Bacterial Vaginosis (BV) which just means the balance of healthy bacteria isn’t present and the vagina becomes less acidic (and more susceptible to infections), whereas in other cases it could be an actual infection with a pathogenic (disease-causing) bacteria or virus. When in doubt, or with persistent symptoms, it’s best to get a swab done to learn more. And remember, these types of infections can be passed between sexual partners so if you notice symptoms, avoid sexual intercourse—or use a condom—to prevent transmission. The same applies while you’re being treated for any infections.