When Could Vaginal Discharge Be a Sign of Something Else?

Vaginal discharge is a normal and physiological function of the body to help keep the vagina healthy. It can also have certain odors, textures, and colors, which help in the identification of infections and other physiological changes in the female body. 

What is a normal vaginal discharge?

Vaginal discharge normally varies when it comes to its appearance, amount, color, and odor. It also depends on a female's monthly cycle. A normal vaginal discharge ranges from clear to milky-white in color. An increase in vaginal discharge is also expected when a female is sexually aroused, ovulating, or breastfeeding. A different odor may also be observed in pregnant women and in women with poor hygiene. 

These changes are often not a cause for concern. However, infection or other conditions may be present if the discharge is accompanied by a burning sensation, vaginal itching, and foul odor. 

What causes an abnormal vaginal discharge?

One major cause of an abnormal discharge is an infection. Another is the disruption in the balance of the vagina's normal flora. Such imbalance can cause changes in the color, smell, and texture of vaginal discharge. The following conditions are few of the things that can cause an abnormal discharge. 

1. Yeast Infection

A genital yeast infection occurs when the normal balance of organisms in the vagina is disrupted, causing more yeast to grow. Individuals with diabetes, a weakened immune system, and those who are pregnant are more susceptible to developing yeast infections. Some of its symptoms include:

• Extreme vaginal itching
• A thick or white vaginal discharge with a cottage cheese appearance
• A painful or burning sensation when urinating
• Swelling and redness of the vulva and vagina
• Discomfort during sex

Yeast infections are also often observed in people with any of the following conditions:

• Stress
• Taking birth control pills
• Prolonged use of antibiotics (more than 10 days)

2. Bacterial Vaginosis

Bacterial vaginosis is a common bacterial infection in women. This type of bacterial infection causes an increase in the amount of vaginal discharge along with a strong fishy odor. Women who regularly receive oral sex and those who have multiple sex partners are more prone to acquiring bacterial vaginosis. 

3. Trichomoniasis

Trichomoniasis is a sexually transmitted disease caused by a single-celled parasite called Trichomonas vaginalis. Some people may develop symptoms, while others do not. However, those who do not have symptoms can still transmit the infection to other people. The infection can last for several months to years if it is left untreated. 

Women with trichomoniasis may notice changes in their vaginal discharge, such as increased volume and a yellowish or greenish color with a fishy odor. Other common symptoms include vaginal itching, pain, and inflammation. 

4. Sexually Transmitted Infections (STIs)

When women are infected with sexually transmitted infections (STIs), such as chlamydia and gonorrhea, an abnormal vaginal discharge can occur. These infections can cause cloudy, greenish, or yellowish discharge. 

5. Pelvic Inflammatory Disease

Pelvic inflammatory disease is an infection that is also transmitted through sexual contact. This infection occurs when bacteria are spread from the vagina to other pelvic organs (uterus, cervix, ovaries, and fallopian tube). It also causes a green or yellow vaginal discharge with an unusual odor.  

6. Human Papillomavirus (HPV) or Cervical Cancer

Human papillomavirus (HPV) infection is spread through direct sexual contact. It can also cause cervical cancer, which produces an abnormal vaginal discharge. It can range from a watery, brown, or bloody discharge with a foul odor. However, cervical cancer can be prevented through HPV testing, annual Pap smears, and vaccination. 

7. Other Causes

• Low estrogen levels and menopause 
• Forgotten tampon
• Other foreign objects in the vagina
• The use of feminine sprays, douches, contraceptives, creams, or ointments
• Allergic reaction or irritation from chemicals

When to See a Doctor

Abnormal vaginal discharge can be diagnosed and treated by primary care physicians, which include family practitioners, internists, and gynecologists. 

Seek immediate medical attention if you have an unusual vaginal discharge along with the following symptoms:

• Fever
• Abdominal pain
• Fatigue
• Frequent urination
• Painful urination
• Unexplained weight loss

Diagnosis

The doctor will first take the patient's medical history and symptoms. Some of the doctor's questions may include the following:

• When did you notice the unusual discharge?
• Do you experience pain, itching, or burning in the vaginal area?
• What is the color of the discharge?
• What does it smell like? 
• Do you douche?
• Are you sexually active?

After taking your medical history, a physical examination will be performed along with a pelvic examination. The doctor may also:

• Perform a Pap smear
• Collect a sample for cervical culture
• Examine the vaginal discharge under a microscope
• Perform a cervical biopsy

Treatment

Treatment usually depends on the main problem:

• Yeast Infections - Antifungal medications in the form of vaginal suppositories, creams, or gels

• Bacterial Vaginosis - Oral antibiotics or creams

• Trichomoniasis - Antibiotics such as metronidazole or tinidazole 

It is important to take the full antibiotic course or antifungal medication prescribed by your doctor even if the symptoms get better. Consult your healthcare provider if the symptoms persist or recur after treatment. 

Both antifungals and antibiotics are effective in getting rid of bacterial and fungal infections that cause an abnormal vaginal discharge. However, when sexually transmitted infections are left untreated, such as chlamydia and gonorrhea, severe infections may progress into pelvic inflammatory disease (PID), which seriously affects other genital organs. Pelvic inflammatory disease can damage the ovaries, fallopian tubes, and other related structures of the female reproductive system. PID can also lead to infertility, ectopic pregnancy, chronic pelvic pain, and other serious conditions. 

Prevention

Vaginal irritation and infections that can cause an abnormal discharge can be prevented with the following preventive measures:

• Avoid wearing extremely tight clothing or undergarments. Wear cotton made underwear instead. 
• Avoid using scented feminine products, sprays, soaps, or douche. 
• Clean the vagina and its surrounding area using mild soap and warm water. 
• Avoid bubble baths.
• Prevent urinary tract infections, bladder infections, and vaginal irritation by always wiping from front to back. This will prevent intestinal bacteria and other types of bacteria from getting into the vagina and urinary system and cause an infection.