Definition

Vaginal discharge is a clear, white or off-white fluid that comes out of the vagina. Discharge from the vagina is a natural and normal process. The uterus, the mouth of the uterus (cervix), and the vagina produce vaginal discharge, which is mainly made up of cells and bacteria. It helps clean and lubricate the vagina and helps fight off bad bacteria and infections. 

Women experience varying amounts of vaginal discharge. Some women produce more vaginal fluid while others produce very little. Changes in the color, texture, smell, or amount of usual vaginal discharge may mean there is an infection or disease present. Most causes of abnormal vaginal discharge are treatable with feminine hygiene medication.

Cause

Infection

Some infections cause vaginal discharge to change or become unpleasant smelling. Many of these infections can be caused by having sex with someone who has the infection.

• Yeast infections. Vaginal yeast infections happen when a specific fungus (candida) grows out of control in the vagina. It produces a thick, white, clumpy, cheese-like vaginal discharge. The vagina may swell and itchy, and be painful during sex.
• Trichomoniasis.  Sexually transmitted infection (STI) can be transmitted by having sex with an infected person. A parasite causes trichomoniasis. It makes vaginal discharge green, yellow, or gray and bubbly or frothy.
• Gonorrhea and chlamydia. These are two common STIs and are transmitted when you have sex with an infected person. Some people with these infections have cloudy, yellow, or green vaginal discharge.
• Bacterial vaginosis (BV). BV occurs when there is too much of a certain bacteria in the vagina. It can be transmitted through sexual contact. Women with BV have white or gray discharge that’s foul-smelling and fishy.

You can have two or more types of infection at the same time.

Read more about Bacteria Vaginosis: Bacteria Vaginosis - Definition, Cause, Symptom, And Treatment

Non Infection

An infection does not always cause vaginal discharge. Changes in the normal balance of healthy bacteria in your vagina and sexual excitement can also cause vaginal discharge.

Other things that can cause discharge include:

• The presence of a foreign object in the vagina, such as a tampon or menstrual cup
• An irritation or rash from an object or chemical that causes an allergic reaction. This could be from detergents, soaps, sexual lubricants, or materials used in condoms or sex toys
• Atrophic vaginitis. This condition can happen after menopause when there is a decrease in estrogen. Low estrogen levels cause the walls of the vagina to become dry and thinner than normal.
• Pregnancy. During pregnancy, your body produces more discharge to protect you from infection so that germs do not reach the uterus. Increased levels of the hormone progesterone can also lead to increased production of vaginal fluid.
• Ovulation period. Vaginal discharge may become extra slippery and wet during ovulation (when the ovaries release an egg). This is to help sperm swim up to reach an egg for fertilization.

Risk factor

Experts don't know exactly why women get infections. However, some types have been known to be transmitted as a result of having sex with an infected person. You may have a higher risk of developing an infection if you:

• Have unprotected sex or with multiple partners
• Have uncontrolled diabetes
• Take birth control pills
• Taking antibiotics
• Have HIV infection or reduced immunity
• Using certain soaps, sprays or detergents
• Douching, which is cleaning the vagina with a liquid consisting of a mixture of various chemicals

Symptoms

Normal vaginal discharge is clear or white and odorless. Throughout the menstrual cycle, the discharge's viscosity may vary. Other characteristics of vaginal discharge include the following:

• Texture. Normal vaginal discharge can range in texture from sticky and watery to thick and paste-like. The hormones in the body bring on these variations, but other elements, like an infection, can also alter the discharge's consistency. Clumpsy, frothy, or accompanied by discoloration and itchy vaginal discharge could indicate an infection.
• Color. Vaginal discharge which appears dark yellow, brown, green, or gray may be a sign of an infection or another disease.
• Odor. Although vaginal discharge may smell somewhat, it shouldn't be overbearing or disagreeable. If you notice a fishy or unpleasant odor in your discharge, along with a change in texture or color, you may have a vaginal infection.
• Amount. Some women produce vaginal discharge in greater quantities than others. The quantity of vaginal discharge you produce might vary depending on some factors, including ovulation, birth control pill use, and pregnancy. A sudden increase in the amount of vaginal discharge you generate may indicate a problem.

Color of Vaginal Discharge

The color of the vaginal discharge can indicate a problem:

• Yellow, gray, or green: may indicate a bacterial infection or sexually transmitted infection (STI)
• Brown or red: usually associated with irregular periods or pregnancy (implantation bleeding). If you have brown vaginal discharge or red spotting and you are not menstruating, then this may indicate a disorder
• Clear or white: normal vaginal discharge is clear, white, or milky white. If your discharge is white but looks thicker than usual or causes itching, this could indicate a yeast infection.

Discolored, more frequent, or smelling differently discharge is indicative of abnormal vaginal discharge. Along with pelvic pain or painful micturition, you could also experience irritation around the vaginal opening.

Diagnosis

To diagnose an abnormal vaginal discharge, your doctor will conduct a series of tests, including a medical interview, physical examination, and supporting tests if needed.

Medical interview

In the medical interview, the doctor will ask about:

• Your current symptoms
• Whether you have experienced similar complaints before
• Are you sexually active, if your answer is yes, the next question is whether you change partners and use safety during sex

Physical examination

After a medical interview, the doctor will conduct a physical examination, which will include measuring blood pressure, breathing rate, pulse, and body temperature.

Supporting examination

If needed, supporting examinations will be carried out to confirm the diagnosis, including:

• Laboratory examination

Blood sampling is used to calculate the number of white blood cells. White blood cells range=\

from 5-10 thousand per microliter. If the number found is excessive, it indicates an infection.

• Pap Smear

The doctor will take a sample of vaginal fluid or perform a Pap smear test to take a sample of cells from the mouth of the uterus for laboratory examination.

Management

The treatment and management of vaginal discharge depend on the cause:

• Yeast infections are treated with antifungal medications. These come as pills, as well as creams or gels that can be inserted directly into the vagina
• Bacterial vaginosis can be treated with antibiotic pills or creams
• Trichomoniasis is treated with oral medicine such as metronidazole or tinidazole

Complications

Some untreated vaginal infections can spread and cause pelvic inflammatory disease characterized by pelvic pain.

If you want to know more about pelvic inflammation, you can read it here: Panggul - Definition, Cause, Symptoms, And Treatment Diseases

Prevention

Having a certain amount of vaginal discharge every day is normal. You cannot prevent it, as it is the body's way of keeping the vagina clean and healthy. You should not do douching to treat vaginal discharge. Douching can disrupt the normal balance of organisms in the body. Douching can also cause infection.

To help keep your vagina clean, you can use mild soap and water to gently clean the external genital area once daily. The vagina naturally keeps itself clean with the help of certain healthy bacteria. These bacteria keep the vagina acidic, which prevents microorganisms and fungi from growing out of control.

Other tips for keeping the vagina clean include:

• Avoid using perfumed soaps, gels, wipes, or other feminine products
• Don’t douche or wash inside of the vagina
• Avoid wearing tight underwear, bathing suits or sweaty clothes for long periods
• Wipe the vagina from front to back. This prevents bacteria from rectum from getting to the vagina

When to see a doctor?

Contact your doctor if you notice:

• An increase in the amount of vaginal discharge
• A change in the color of the discharge
• A foul-smelling odor
• A change in texture or consistency of the discharge
• Irritation, itching, swelling, or pain in or around the vagina
• Pelvic pain

You should undergo an examination to check for infection.

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