Let's Talk About Vaginal Discharge
Written by: Dr Danielle Robinson
Sexual Health Specialty Doctor
You’ve looked in your pants and something is there. What is it, and is it normal? You may be unsure because, like most things having to do with women’s specific bodily functions, we don’t talk about vaginal discharge and what is normal and what you should see your doctor about.
Luckily, we’re covering everything you need to know about vaginal discharge here. It’s important to say, this is guide to vaginal discharge before menopause hits. We will be creating a follow up piece of content around vaginal discharge during and after menopause.
What is normal vaginal discharge?
First things first: we’re going to talk about discharge that is completely normal. Normal vaginal discharge is a white, cream or clear odourless fluid that comes from the vagina. You might see this on the toilet paper when you wipe or in your underwear.
The colour, texture and consistency of the discharge is likely to change throughout the month because the levels of hormones in your body change during your menstrual cycle. The hormones’ primary purpose is to make your ovaries release an egg (called ovulation) in the middle of the menstrual cycle, but a by-product of that is changes to the residue that discolours your pants. When women reach the menopause and no longer have menstrual cycles, the vaginal discharge often dries up due to a reduction in production of reproductive hormones.
Let's talk about this in more detail…
Normal vaginal discharge is creamy or white and sticky for most of your cycle. Around the time of ovulation, it becomes clearer, wetter, and stretchy for a short period. This usually happens around 14 days before your period is due and is related to changes in the level of oestrogen in your body.
If the egg is not fertilised by a sperm to form a pregnancy, your hormone levels will fall towards the end of your menstrual cycle. This causes the lining of your womb to shed, which is your period. So you may notice that shortly before and after your period you will have less discharge than at other times of the month, as your reproductive hormones are at their lowest at this point. See table below which demonstrates this (note: this is based on the average 28 day menstrual cycle – if your cycles are shorter or longer the duration of each phase will be slightly different).
It is important to recognise what your normal vaginal discharge looks like throughout the month, so that you can recognise any abnormal changes. It can also be helpful when trying to become pregnant – you are most fertile just before you ovulate so recognising the changes that happen to your discharge just before this time can help with conception.
My normal discharge has changed. What does that mean?
If your normal discharge changes in colour, consistency or smell, there could be a number of reasons for this. These can include contraception/hormonal treatment, infection, dietary and medication changes or the menopause. The colour change can be a useful indicator of the potential underlying cause and help to guide you regarding the likely diagnosis and health service you may need to contact. See the below table which helps to summarise this. If you notice an abnormal change in your vaginal discharge it is best not to ignore it as often the cause can be easily identified and treated.
Vaginal discharge in pregnancy – what changes?
Taking all of the above information into account, it makes sense that your discharge may increase when you are pregnant, as your reproductive hormones remain high throughout pregnancy. You also have more blood flow to your reproductive system and this also helps to produce more discharge. This is a good thing however, as it helps to stop bacteria travelling up into your womb through the vagina, therefore protecting your baby. Some women need to wear light sanitary towels whilst pregnant if they produce a large amount of discharge – this is not uncommon.
What does vaginal discharge in pregnancy look and smell like?
The discharge should be clear or milky white / cream, just like your normal discharge. If you ever notice a new and sudden gush of fluid, especially towards the end of your pregnancy, this could be your waters breaking rather than vaginal discharge - it is always best to get checked out if this has possibly occurred. For any such concerns you should ring your local maternity unit and speak to a midwife.
Vaginal discharge in pregnancy should be odourless and should not cause excessive irritation. If you notice an unpleasant odour, itching, a change in consistency or colour or something else unusual it is always best to talk to a Doctor, Nurse or Midwife about this.
All of the infections, discussed previously in this article, are possible in pregnancy and it is important that treatment is given quickly and effectively to prevent any harm to the developing baby. Therefore, please contact a healthcare professional as soon as possible if you notice any unusual changes. Thrush is very common in pregnancy and there is no evidence that this can lead to any harm, but the treatment is slightly different so it is best not to self-medicate. If you do prefer to purchase treatment over the counter, at your local pharmacy, it is very important that you inform the pharmacist that you are pregnant. If pharmacy treatment does not work very quickly, or you get a recurrence you should contact your local GP, midwife or sexual health clinic to check that all is well.