Vaginal Discharge is one of the common reasons women visit a gynaecologist. Sometimes, this can be annoying and an indication of some underlying health issue. Thus, it is important to identify whether the discharge is normal or abnormal. To know more about it, we spoke to Dr Sowmya Raghavan, Obstetrician and Gynaecologist, Apollo Cradle & Children’s Hospital, Chennai.
Vaginal Discharge Causes
According to Dr Raghavan, "Normal discharge should be clear, white or off-white. The consistency of the discharge changes with the time of the menstrual cycle." She highlighted that it is thin and watery around the time of ovulation and becomes thicker for a few days before menstruation.
"This is due to changes in hormone levels at different stages of the menstrual cycle. The discharge is considered abnormal only when the discharge is profuse and there is a change in colour, consistency, or odour," she added.
"Non-infectious causes of discharge include a foreign object inside the vagina, such as a forgotten tampon, intrauterine devices, or sex toys," said Dr Raghavan. She added that the use of detergent, soaps, lubricants, and vaginal cleansers, could cause an allergic reaction and cause discharge. The use of antibiotics also weakens the protective bacteria and leads to infection and discharge.
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"In pre-pubertal girls and menopausal women, low oestrogen levels cause the protective vaginal bacteria to be low which leads to the growth of other harmful bacteria which might cause discharge and irritation," said the doctor.
When Does Vaginal Discharge Become Concerning?
"Dark yellow, brown, green or grey discharge may indicate vaginal infection or Sexually Transmitted Infection (STI)," said Dr Raghavan. She said that while normal discharge may have a mild odour, any fishy or foul-smelling discharge could indicate a vaginal infection.
STIs, such as trichomoniasis, Bacterial Vaginosis (BV), gonorrhoea, chlamydia, and genital herpes may cause Pelvic Inflammatory Disease (PID), symptoms of which include severe abdominal pain, fever, and painful intercourse.
A study published in the journal Singapore Medical Journal stated that among all cases, 70% are linked to BV, vulvovaginal candidiasis, or trichomoniasis. Among these three mentioned causes, BV stands out as the most prevalent, contributing to as much as 50% of all infections.
"PID should be immediately treated because of long-term implications, such as infertility, ectopic pregnancy, pelvic adhesions and chronic pelvic pain,” said Dr Raghavan.
She highlighted that some people produce more discharge than others due to certain conditions like pregnancy or taking birth control pills. "Brown or red discharge can mean irregular menstruation, endometrial polyp, fibroids, pregnancy-related bleeding and in pre or post-menopausal stages," she added.
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Dr Raghavan said that the discharge could sometimes indicate a precancerous or cancerous discharge from the vagina, cervix, and uterus. "Thick, chunky discharge and itchiness around the genitals denote yeast infection," she added.
"During pregnancy, BV is associated with late miscarriages, preterm birth, premature rupture of membranes, and uterine infection after delivery," said Dr Raghavan.
"In women with altered or less immunity, the infection has a possibility to spread into the bloodstream and cause septicemia (sepsis), which requires aggressive treatment," she added.
Dr Raghavan concluded that not all vaginal discharges are abnormal and identifying the cause would help to effectively treat them.
[Disclaimer: This article is for informational purposes only. Consult your healthcare provider to get a thorough diagnosis and treatment as per your health needs.]
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