Vaginal Discharge: What Is Normal and What Is Not?

Discharge is a natural part of a woman's body. Most women notice discharge in their underwear from time to time and wonder, "Is this normal?" Most of the time, the answer is yes. But some changes can be a sign of an easily treated infection. Knowing the difference both puts your mind at ease and helps you get help in time when you need it.

What does normal discharge look like? According to the NHS, normal discharge is clear or white and does not have a strong or unpleasant smell. The amount varies from person to person. It can increase during pregnancy, with sexual activity and when using some birth control methods.

It changes through your cycle: The NHS notes that discharge becomes clearer and wetter around ovulation, in between periods. According to the NHS cycle page, around ovulation discharge becomes thinner and stretchy, a bit like raw egg white. Noting these changes in your calendar helps you get to know your own pattern.

Bacterial vaginosis (BV): According to the NHS, this is one of the common causes of unusual discharge. It happens when the balance of bacteria in the vagina is disrupted. Its most typical sign is a strong, fishy-smelling discharge that is especially noticeable after sex. The discharge may be gray-white, thin and watery. BV usually does not cause itching or soreness. The NHS says about half of women with BV have no symptoms at all. It is not considered a sexually transmitted infection, but sexual activity can trigger it. Using an IUD and scented vaginal products can increase the risk. It is treated with antibiotics recommended by your doctor. According to the NHS, if it comes back more than 4 times a year, longer treatment may be needed.

BV and pregnancy: According to the NHS, BV does not cause problems in most pregnancies, but it can slightly increase the chance of complications such as preterm birth or miscarriage. If you are pregnant and notice a change in your discharge, tell your doctor.

Vaginal yeast infection (candida): According to the NHS, it usually causes itching and irritation around the outside of the vagina, along with odorless, white discharge that looks like cottage cheese. There may be pain when peeing or during sex. Antibiotic use, poorly controlled diabetes, a weakened immune system, hormone treatment and pregnancy can increase the risk. If a doctor has diagnosed it before and you recognize the symptoms, the NHS notes that you can talk to a pharmacist. But you need to see a doctor if:

• It is your first time having it
• You are under 16 or over 60
• You are pregnant or breastfeeding
• It comes back more than 4 times a year
• Treatment has not worked
• Your immune system is weakened for a reason such as diabetes

Other infections: According to the NHS, green, yellow or frothy discharge can be a sign of an infection called trichomoniasis. If discharge comes with pelvic pain or bleeding, it may be chlamydia or gonorrhea; if there are blisters or sores, it may be genital herpes. These require an exam and testing. The NHS notes that sexual health clinics, as well as family doctors, can help with unusual discharge.

Do not douche, and stay away from scented products. The NHS recommends gently washing the outside of the vagina with warm water and a mild, unscented soap. Scented products, deodorants, scented wipes and washing inside the vagina (douching) can cause irritation. To help prevent BV, the NHS also recommends taking showers instead of baths and avoiding harsh detergents and smoking. For yeast infections, wearing cotton underwear and avoiding tight clothing can help.

Do not diagnose yourself. BV is treated with antibiotics, while a yeast infection is treated with antifungal medicine. Because the symptoms can look alike, if you are not sure, getting an exam is better than starting treatment on your own.

When to see a doctor? According to the NHS, contact your doctor if:

• The color, smell or texture of your discharge has changed
• You have more discharge than usual
• You feel itching or irritation
• You have bleeding between periods or after sex
• It hurts when you pee
• You have pain in your pelvic area

If you have a serious condition such as severe tummy pain with a high fever, call your local emergency number without waiting.

Dear woman, asking questions about your discharge is nothing to be embarrassed about; it is part of taking care of yourself. As you get to know your body, you will find it easier to tell what is normal for you and what needs attention.