One of the most common complaints I hear in my practice is about vaginal discharge. Usually the complaint is associated with a change of from their normal: either too little or too much, different odor or bad odor, and finally either a change in consistency or color. The complaints are generally right on and indicate a vaginal infection. However there are quite a few misconceptions about vaginal discharge, what’s normal and what’s abnormal. So here is what you should know about vaginal discharge:
1. A certain amount of vaginal discharge is produced daily. This is how the vagina cleans and regulates itself. These secretions allow the vagina to maintain its normal acidic pH and keep the proper ratio of “good” bacteria and “bad” bacteria. The “good” bacteria help keep the vagina acidic whereas the bad bacteria can cause infections.
2. Vaginal discharge changes in appearance regularly. It can be clear and stringy, cloudy, thick and yellow when it’s dry on your clothing. Sometimes it may even contain some specks of white. These changes are related to your menstrual cycles and your hormones. Environmental stressors, diet changes, exercise, medications (including birth control), pregnancy and sexual arousal can also cause changes in the appearance and amount of vaginal discharge being secreted.
3. Your menstrual cycle causes your vaginal pH to fluctuate, making it less acidic right before you menstruate, which can cause you to be more susceptible to a bacterial infection during that time.
4. Signs of an abnormal discharge include: discharge with itching and irritation; white, thick clumpy discharge; grey/ copious foul smelling discharge; persistent, copious and irritating discharge and discharge that causes painful irritation.
5. The three most common vaginal infections include: bacterial vaginitis, yeast vaginitis and trichomonas vaginitis. Each of these is treated differently and associated with a different type of discharge.
6. Bacterial vaginitis is very common and we are unclear about the cause. We do know it’s associated with an imbalance between the “good’ and the “bad” bacteria. It is commonly associated with a copious, grey/white, foul smelling discharge. The discharge smells worse after intercourse because semen changes the pH of the vagina. It is treated with Flagyl or Metronidazole. Metronidazole can cause darkening of the urine and nausea. You should also avoid alcohol consumption when taking Flagyl since it causes alcohol intolerance.
7. Yeast vaginitis is a fungal infection and is associated with a thick, white, clumpy, itchy discharge. The discharge can cause extreme irritation both inside the vagina and on the skin. It is treated with an anti fungal. Anti fungal medications are available in the cream or ovule form over the counter. I usually cautioned patients against the one-day treatment as it is very strong and cause even more irritation but both the 3 and 5 day course can work wonders.
8. Trichomonas is almost always sexually transmitted. You can not catch it from seating on the toilet bowl, swimming in the pool, etc. It is associated with a copious, foul smelling, frothing, yellow discharge. It is also treated with Flagyl or Metronidazole.
9. You should use any and all medications with the allotted prescribed time. If your symptoms persists after 48 hours of using the medication, go back to your provider for further evaluation. And please make sure not to use anything in the vagina for at least a day before going to see your provider otherwise we can’t do a proper exam and it may interfere with your culture results.
10. Practice good vaginal hygiene, yes you read right: good vaginal hygiene! Vaginal hygiene includes:
- Having new partners wear condoms
- Stay healthy with a balance diet, plenty of hydration & enough sleep (remember stress affects vaginal pH)
- Wear cotton underwear (Yep the Victoria Secret tiny lacy number does nothing for your vajay-jay!!)
- Wipe from front to back
- Keep the vagina clean and dry and avoid: pad & tampons with deodorants, no douche, no oil or petroleum jelly, no items in the vagina that don’t belong there (yes including any “50 Shades of Grey” toy you may or may not have does not belong in there for longer than the allotted time!!)
- Treat your vagina kindly!!
As usual if you are experiencing any symptoms mentioned above, it is important to discuss them with your provider.