Vaginal Discharge

The vagina normally discharges a small amount of fluid that is clear, cloudy, or whitish. There is usually more discharge around the time the egg is released from the woman's ovary (ovulation). Many factors can affect the delicate balance of normal organisms within the vagina.

Some of these may cause an increase in discharge and perhaps a change in odor or thickness of the discharge. These include:

• antibiotics
• changes in estrogen levels that occur throughout a menstrual cycle, with pregnancy and breastfeeding and after menopause
• douching
• sexual intercourse
• sexually transmitted diseases (STDs)

One third of all women have symptoms of abnormal vaginal discharge at some point during their lives.

Vaginitis, a swelling, redness, and irritation in the vagina, can occasionally be caused by:

• harsh detergents
• spermicides in foams, jellies, and creams
• condoms and diaphragms
• feminine hygiene products, such as perfumed sprays and powders
• nonabsorbent clothing, such as nylon pantyhose
• tampons

However, most vaginitis is caused by an infection.

Symptoms of vaginitis include:

• irritation or itching of the genital area, inside or outside the vagina
• swelling or redness of the lips of the vagina or the genital area
• vaginal discharge that is cottage cheese-like, frothy, yellowish-green or colorless
• foul smelling vaginal odor, especially after intercourse
• discomfort or burning with urination
• dryness, discomfort, or burning with sexual intercourse

The causes of vaginal discharge include:

• yeast infection, caused by the Candida fungus
• bacterial vaginosis, caused by a change in the normal bacteria in the vagina
• Trichomonas vaginitis, caused by a parasite that is spread through sex
• atrophic vaginitis, an irritation of the vagina that causes dryness or burning

Other possible causes of vaginitis include:

• a foreign body in the vagina, such as a forgotten tampon
• gonorrhea
• genital herpes
• Chlamydia
• cervicitis
• Human papillomavirus (HPV)

Prevention of vaginal discharge depends on the cause. Candida infections can be decreased by avoiding a humid environment around the genital area. This can be done by wearing loose-fitting and absorbent clothing. Women should practice good hygiene methods, such as bathing, showering, wiping front to back after urinating, and frequent handwashing.

Practicing safer sex with a condom, or preferably, limiting sex to one lifelong relationship with a faithful partner, should reduce the chances of getting STDs. Hormone replacement therapy can prevent atrophic vaginitis caused by low levels of estrogen.

Tests that may be done during a pelvic exam include:

• culture of the vaginal discharge or cervix
• a lab analysis of the vaginal discharge
• pH analysis of the vaginal discharge, to check the acidity

Normal vaginal discharge does not need treatment. Feminine hygiene products and douching should not be used. These products can mask the symptoms of a sexually transmitted disease as well as force the bacteria higher into the pelvic organs. They can also cause a contact dermatitis to the vulva and vaginal tissues.

With proper treatment, there are usually no long-term effects. However, certain causes may not be completely curable. Some of these include herpes, human papillomavirus (HPV), and HIV. If a severe STD has spread to the pelvic organs, pelvic may occur. This can lead to long-term pain and infertility.

Normal vaginal discharge poses no risk to others. If there is an underlying infection, such as a sexually transmitted disease, the infection may be highly contagious through sexual contact.

Treatment of vaginal discharge depends on the particular cause of the condition. Treatment may include the following, in the form of pills or as a cream:

• antibacterial medication
• antifungal medication
• antiviral medication
• antihistamines to relieve itching
• cortisone to relieve itching
• estrogen or hormone therapy

Side effects depend on the particular agent used. Antibiotic pills may cause stomach upset allergic reactions, or a yeast infection. Some creams may cause skin irritation.

Most antibiotic treatment is used for 3 to 7 days. Estrogen treatment is usually continued indefinitely. If a sexually transmitted disease has been found, the woman's sexual partner or partners will also need evaluation and possibly treatment.

Any new or worsening symptoms should be reported to the healthcare professional.