How to Decode Your Vaginal Discharge — and When to Worry

Find out what's normal and how to treat what's not
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Any type of vaginal discharge can cause discomfort and concern — but some types are normal, while others are signs of a problem. So, how can you tell the difference?

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“Vaginal discharge can be normal or abnormal,” says Ob/Gyn Oluwatosin Goje, MD. “Not every vaginal discharge means something.”

Discharge is sometimes clear and watery, yellow-green, milky white, or curd-like. Understanding what causes these discharges can help determine whether they mean trouble and how best to treat the problem if there is one.

White discharge: It isn’t always a problem

Your normal discharge may vary from clear to milky white, but a whitish discharge could signal one of two common things:

Ovulation: Vaginal discharge may sometimes change consistency and color during your menstrual cycle. During ovulation, the body can produce a thicker, white, stretchy discharge.

Tip: Keep an eye on your monthly discharge so you know what’s normal for you.

Yeast infection: Most often caused by Candida albicans fungus, a yeast infection often produces a thick, cottage cheese-like, white discharge. Vaginal itching and burning are common.

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Tip: You can treat it with over-the-counter drugs, such as Monistat®, or with a prescription pill called Diflucan®. If these don’t work, Dr. Goje says your doctor can test to see whether a fungus other than Candida albicans is present.

Off-white or grayish discharge: A common infection

Bacterial vaginosis: Nearly 30 percent of women who are of child-bearing age have this infection. Bacterial vaginosis (BV) is the most common cause of vaginal discharge  It often causes an increase in a vaginal discharge that is thin and grayish-white with a foul-smelling, unpleasant fish odor. The discharge and odor are most notable after sex or they may be related to menstrual cycle (before and after menses) Dr. Goje says.

Tip: Two vaginal ointments — metronidazole gel and clindamycin cream — can treat the infection. Oral forms of the drugs are also effective.

Greenish-yellow discharge: Two possible culprits

Desquamative inflammatory vaginitis (DIV): This shows up most often in post-menopausal women whose estrogen levels have dropped. The vagina atrophies when the vaginal skin or wall  thins out, becoming red and inflamed. A yellow to greenish-yellow discharge appears, and sex is sometimes painful.

Tip: Treatment of DIV can be with clindamycin ointment or steroid ointment in the vagina, but needs a doctor’s prescription. Also, treatment with estrogen cream can relieve itching, burning and pain from vaginal atrophy, Dr. Goje says.

Trichomoniasis: Seventy percent of those with this sexually transmitted infection don’t notice symptoms. But for women who do, an odd-smelling, greenish-yellow discharge that is sometimes frothy is often one of them. Women can also have itching, burning, soreness and redness, along with painful urination.

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Tip: As with bacterial vaginosis, a single dose of metronidazole or tinidazole  pill by mouth should cure this infection.

Know what’s normal — and get the rest checked

If you notice any of these types of discharge — or any that’s unusual for you — see your doctor or your gynecologist.

Be prepared to discuss the color, consistency and smell of the discharge, as well as any itching and whether it appears related to having sex or your menstrual cycle.

If the first round of treatment doesn’t relieve your symptoms, ask your doctor for more tests.

“There are many tests out there that labs can run to make a diagnosis of an infection,” Dr. Goje says. “I also often recommend that patients keep a diary of their vaginal discharge so they know what’s normal and abnormal for themselves.”

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