Updated: Mar 24, 2021
Vaginal discharge is a normal process which keeps the mucosal lining of the vagina moist. The consistency and quantity of the discharge varies throughout the menstrual cycle as well. There is a healthy balance of good bacteria and pH that is necessary to maintain an optimal environment in the vagina.
When this changes in response to certain medical conditions, that’s when women start to notice their vagina discharge appears different from what it usually it.
The common ways to detect a difference in the discharge would be through simple observations in colour, quantity or even smell.
Types of Vaginal Discharge
This type of discharge is what women tend to experience from time to time. It may be related to the beginning or the end of the menstrual cycle. Around the mid-cycle between menses, it can appear clear and stretchy and transiently increase in quantity during ovulation.
Another common type of discharge women face would be a whitish discharge which can appear thick and cheesy. This is most commonly caused by a yeast infection or candidiasis. Some women may have no symptoms or for some, it may become apparent when the discharge changes in consistency or causes considerable itch and discomfort.
Treatment involves using an anti-fungal pessary or in severe or recurrent cases, a course of oral anti-fungal medications.
Having a greyish discharge can often occur concurrently with an yeast infection and can sometimes be difficult to differentiate. This is caused by bacterial vaginosis and the discharge is often described as more of a greyish watery consistency with a characteristic ‘fishy smell’.
Bacterial vaginosis is due to a disturbance of normal bacterial equilibrium in the vagina and can be caused by recent use of antibiotics or frequent vaginal douching. Treatment involves antibiotic topical gel or a course of an antibiotic called metronidazole.
4) Yellowish to greenish
If the appearance of the discharge appears yellowish green, almost pus-like and is also associated with local vaginal pain, there is a high likelihood a sexually transmitted infection is involved. It can range from trichomoniasis, to gonorrhoea or chlamydia. Apart from the colour, the discharge may appear clumpy and be malodorous.
Treatment involves diagnosing the correct STD before deciding on an appropriate course of antibiotics which may need to be given via an injection or orally. Consideration of sexual partner involved and concurrent treatment is also essential to prevent back and forth transmission.
5) Reddish or brownish
A reddish vaginal discharge would suggest there is the possibility of some blood mixed with the discharge. Apart from ruling out blood coming from just the regular menstrual cycle, pregnancy needs to be considered and checked.
Local bleeding from the cervix could be from cervical infection secondary to STDs, or local cervical masses, which could be benign or cancerous. Hence, it is important for women to go for their regular Pap smears to pick up pre or early cervical cancer.
When to see a doctor?
1) Vaginal discharge changes from the usual
The more sinister colours wound be grey, green or reddish discharges.
If it changes from usual clear and stretchy texture to thick, watery or pus-like consistency.
Foul-smelling odour could be a sign of bacterial vaginosis or a STD.
Look out for significant larger amount of discharge compared to previously or if it starts to cause local vaginal skin irritation.
2) Vaginal skin discomfort
3) Abnormal vaginal bleeding
After sexual intercourse
4) Urinary symptoms suggesting concurrent urinary tract infection
Burning sensation during urination
Blood in urine
What can I do to protect myself?
1) Regular Pap smear screening
Cervical cancer is cause by a virus called Human Papilloma Virus (HPV) which is sexually acquired. Women may remain asymptomatic for long periods of time before they start to develop vaginal symptoms, hence the importance of regular Pap smear screening.
2) Cervical cancer vaccination
Cervarix, gardasil-4 and gardasil-9 are examples of vaccinations that can protect against acquiring HPV virus, which in turn translates to protecting against cervical cancer.
3) STD screening
This is advisable especially when changing new sexual partners and should be done even when there is no abnormal vaginal discharge present. Other latent sexually transmitted conditions like syphilis, HIV, herpes and hepatitis B may not manifest symptoms until months to years later.
4) Condom contraception
Apart from preventing pregnancy, condoms are the only form of contraception that can prevent transmission of STDs. Other forms of contraception merely work towards the general goal of preventing pregnancy.
If you have any specific questions related to Women’s Health, do drop by Paddington Medical Clinic to visit our lady doctor, Dr Zhang Huipei for a consultation. Remember to protect yourself with regular health screening and relevant vaccinations where appropriate. Do excuse the use of food imagery, they are useful in conveying relevant colours and textures.
Dr Zhang Huipei (Mdm)
MBBS (Singapore), GDFM (Singapore)