Vaginal discharge

Vaginal discharge is secretions from the vagina. All women have some vaginal discharge which is the body’s way of keeping the vagina healthy and clean.

Definition

Vaginal discharge is secretions from the vagina. All women have some vaginal discharge which is the body’s way of keeping the vagina healthy and clean. A normal discharge is clear or cloudy white and might appear yellowish when dry on clothing. The discharge may differ in consistency, colour and smell.

Other names

Discharge from the vagina.

Possible causes

Vaginal infections are very common. Symptoms of vaginal infection include a sudden profuse discharge, which becomes discoloured and thicker, and has an unusual smell. Treatment depends on the cause. Possible causes include the following:

• Vaginal yeast infection – also called thrush or candidiasis, is the most common type of infection: three out of four women will experience this before they reach menopause. It is caused by an excess growth of yeast-like fungi in the vagina. The main symptom is an intense burning and itching of the vagina. Thrush causes a clumped, white discharge that looks like cottage cheese and is odourless. The vulva (vaginal lips) may be red, slightly swollen and feel raw. There might be a burning sensation during urination, and sexual intercourse may become painful. The most common time to get thrush is before a period. You are more susceptible if you are taking antibiotics, birth control pills or steroids; if you are pregnant; if you are diabetic; or if you have had a recent illness. It is not sexually transmitted.
• Bacterial vaginosis causes a thin, gray discharge with an unusual fishy smell, which becomes worse after sex or washing with soap. The causes of this infection are not always clear. It is associated with having a new or multiple sexual partners, the use of an IUD or diaphragm, pregnancy, and with frequent douching. It may also occur in women who are not sexually active or have none of these risk factors.
• Trichomoniasis causes a more frothy, foamy, greenish-yellow discharge with an unpleasant smell. The discharge is often worse after a period. Itching could be severe. It is caused by a tiny parasite, which is spread by sexual contact. You, or your sex partner, can be infected but have no symptoms for a long time.
• Other causes include herpes infections, scabies and lice.

Homecare/self treatment

To treat vaginal discharge:

• If you are certain that you have a yeast infection, you can usually treat this yourself. Use a non-prescription antifungal vaginal cream, pessary or tablet, such as miconazole or econazole. Ask your pharmacist. Or call your doctor about a one-dose pill, taken per mouth.
• For mild thrush, use yoghurt with live cultures (such as Bulgarian yoghurt) to douche the vagina. Put some into the top of a tampon applicator, and remove an hour later. Also apply to the vulva.
• To relieve itchiness, add 2 tablespoons of sodium bicarbonate to a lukewarm, shallow bath and sit with your knees open for 15 minutes.
• Do not scratch. Apply a cold compress to the genital area. Caladryl cream on the vulva may also help.
• Do not use tampons until the infection has cleared up. Make sure that the discharge is not caused by a forgotten tampon.
• Abstain from sex or have your partner use a condom for a week after starting treatment.
• Limit sugar in your diet if you have a yeast infection, or are prone to them.

Prevention

To prevent vaginal discharge:

• Wipe from front to back after a bowel movement. Pat yourself dry after passing urine. Use unscented, uncoloured, double-layered toilet paper.
• Wash your genital area once a day with plain water or use a mild, unperfumed soap to wash the genital area. Rinse well with a hand-held shower head and dry the area thoroughly with a soft towel or a cool air hairdryer before getting dressed. Don’t use bubble baths, vaginal deodorants or talc, or douches.
• Use sanitary towels, rather than tampons, or change tampons every 4 hours. Do not forget to remove tampons.
• Eat a well-balanced diet, which includes live yoghurt. Follow a healthy lifestyle, since a healthy person fights infection more effectively.
• When taking antibiotics, take probiotics, such as Inteflora, or increase your intake of live yoghurt.
• If you are overweight, get into shape, as being overweight might cause repeated yeast infections.
• Wear cotton underwear or clothes with a cotton crotch. Cotton absorbs moisture. Yeast thrives in a warm, damp atmosphere. Let your body breathe. Avoid tight-fitting jeans, Lycra shorts and tights. Wear loose clothing and sleep without any undergarments at night. After a swim, do not keep your wet swimsuit on, but promptly change into dry clothes.
• Do not use any chemicals, such as douches, spermicides and “feminine deodorants”.
• Women who have recurrent yeast infections may become allergic to foods containing yeasts and moulds, such as bread, beer, wine, vinegar, pickles, cheese, fermented foods and juice.
• Yeast thrives on sugar. Diabetics should monitor sugar levels closely. Excessive lactose in dairy products and artificial sweeteners increase the likelihood of thrush.
• If you have multiple sex partners, practise safe sex.

When to see a doctor

• If you think you might have a sexually transmitted disease. Bacterial vaginosis and trichomoniasis require antibiotic treatment. Your partner has to be treated as well.
• If self-medication for a yeast infection is not effective. You might actually have another type of infection.
• If the vaginal infection is recurring more than twice a year.
• If abdominal pain or fever accompany the discharge.
• If the discharge lasts more than two weeks.
• If you have pain during intercourse that a lubricant doesn’t ease.

What to expect at the doctor

Your doctor will take a medical history, noting your own observation of symptoms, and perform a physical exam (including a pelvic exam). However, laboratory tests to allow for microscopic evaluation of vaginal fluid may be required for correct diagnosis. Your doctor may insert swabs into the vagina and cervix to take samples.

Treatment

Treatment will depend on the underlying condition, for instance antibiotics or antifungals, directed at the specific organism causing the infection. Yeast infections are treated with antifungal suppositories, creams and ointments.

Soothing vaginal creams or lotions may also be prescribed.