Discharge

Vaginal discharge is a kind of liquid that is formed inside the vagina and it is a part of the body’s defence towards infections. Vaginal discharge is normal when the protective liquid is secreted through the vagina. The frequency and abundance of the discharge varies a lot between women.

What is vaginal discharge?
Vaginal discharge is a liquid that is formed in glands inside the cervix, and its role is to protect the vagina from bacteria and fungi. The liquid has an acidity that is around 3.8-4.0 pH. A low pH value provides an excellent protection against bacteria and fungi, since the acidity makes it difficult for other bacteria than lactic acid bacteria to survive. As a result, the vaginal flora almost exclusively consists of benign lactobacilli. Without this protection the vagina and the cervix could easily get infected with bacteria and fungi. So called normal vaginal discharge usually refers to the protective liquid that regularly leaves the body by being secreted through the vagina in small amounts. Vaginal discharge is absolutely normal and is something that all women experience. It generally does not indicate that there is something wrong, and what is normal depends on the individual.

The liquid is normally odourless and transparent, but the consistency may vary a little. It is usually either fluid or has a somewhat stringy consistency. The frequency and abundance of the discharge may vary greatly between women, which is why the definition of “normal” largely depends on the individual. There is usually increased vaginal discharge when you are ovulating or having your period.

What is normal?
Even in normal cases the consistency, colour and abundance of the discharge may vary. Women usually have more discharge during a period or ovulation. Many women experience more frequent and abundant vaginal discharge during pregnancy. The discharge may be thicker and somewhat pus-like during menopause. A change in the consistency or colour of the discharge may be an indication that something is wrong, and the most reliable signs of that are when the discharge suddenly becomes more abundant than usual or when there is a change in colour, consistency or smell.

Discharge2
An illustration of vaginal discharge on underwear

Take special care if the discharge starts smelling bad or changes colour. These might be indications of an infection, bacterial imbalance or disease. A typical sign of infection is a discharge that changes colour, smells bad or suddenly becomes much more abundant. Changes in the discharge may be accompanied by swelling, itching and a burning sensation. These are sure signs of an issue in your body that needs to be treated. Some infections, diseases or circumstances that may affect the discharge:

  • Vaginal discharge that is white and grainy is often a symptom of a fungal infection. The smell generally does not change, but it may be a little sour. Apart from changes in the discharge, swelling and itching in the vagina are also common symptoms.
  • If the colour of the discharge changes into green or grey, it may be a sign of bacterial vaginosis. Apart from changes in colour, the discharge may also be foamy and smelly.

Changes in your body may affect discharges
Changes in the body or medications may also affect the discharge, without necessarily being a sign of a disease or infection:

Women may experience increased discharge during pregnancy. The secreted liquid may have a lower pH value, i.e. becoming more “acidic”.

Breast-feeding women may experience lower levels of oestrogen. This results in thin and watery discharge among other things. Also, the pH level increases and the mucous membranes become thinner and more delicate.

Contraceptives such as birth control pills, coils, (copper IUD), Nexplanon/Implanon (etonogestrel contraceptive implants) and mini pills (progestogen-only pills) may affect the vaginal discharge. Contraceptive pills containing higher levels of oestrogen often cause heavier discharge, while preparations containing more progesterone cause a thinner discharge. Contraceptives with high levels of progesterone such as contraceptive implants, coils or mini pills seldom affect the discharge, but a small percentage of users get thinner and watery discharge.

A fever may reduce the amount of lactobacilli, which in turn causes thinner discharge. The effect is temporary, and once the fever is over everything will be go back to normal.

The appearance of the vaginal opening may under some circumstances change in women who have given birth. If the change leads to mucous membranes bulging out through the vagina, it may increase vaginal discharge, i.e. there will be more abundant discharge.

Women who are taking antibiotics for something else than infections in the genital area may experience watery discharge. This is because the antibiotics may have a restraining influence on lactobacilli in the vagina, which leads to thinner discharge. The effect is temporary, and when the course is completed everything will soon go back to normal. There are some antibiotics that do not influence the vagina, e.g. erythromycin and tetracycline.

Sexual intercourse may influence the smell of the discharge because of a temporary increase in pH.