Vaginal discharge: when to get worried

Vaginal discharge can be a normal and regular occurrence. However, there are certain types of discharge that can indicate an infection. Abnormal discharge may be yellow or green, chunky in consistency or have a foul smell. It is usually caused by fungal or bacterial infection.

Other symptoms are pelvic pain and burning on passing urine. There are several different types of vaginal discharge, categorised based on colour and consistency. A bit of white discharge, especially at the beginning or end of your menstrual cycle, is normal. Accompanied by itching and with a thick, cottage cheese-like consistency or appearance, it needs treatment as it may be a sign of a yeast infection. A clear, watery discharge is perfectly normal and can occur at any time of the month.

Ovulation can be accompanied by a clear but stretchy, mucous-like discharge. This is normal. Brown or bloody discharge is usually normal during or right after your menstrual cycle. You may also experience a small amount of bloody discharge in between periods, which is called spotting. If spotting occurs during the normal time of your period and you have recently had sex without protection, this could be a sign of pregnancy.

Spotting during an early phase of pregnancy can be a sign of miscarriage, so it should be discussed with your gynaecologist. In rare cases, brown or bloody discharge can be a sign of advanced cervical cancer. This is why it’s important to get an annual pelvic exam and Pap smear.

A yellow or green discharge, especially when it’s thick, chunky or accompanied by a bad smell, may be a sign of the infection, trichomoniasis, commonly a sexually transmitted infection. If you have unusual discharge with other symptoms, such as a fever, pain in the abdomen, unexplained weight loss, fatigue, or increased urination, see your doctor as soon as possible.

If you have any concerns about the normality of a discharge, make an appointment to see your doctor.

Causes

Normal vaginal discharge is your body’s way of cleaning and protecting the vagina. It’s normal for discharge to increase with exercise, sexual arousal, ovulation, birth control pill use and emotional stress.

Bacterial vaginosis

Quite common. It causes increased vaginal discharge that has a strong, foul, and sometimes fishy odour, although it produces no symptoms in some cases. Women who receive oral sex or who have multiple sexual partners are at increased risk.

Trichomoniasis

A protozoan (a single-celled organism) causes this infection. It is usually spread by sexual contact, but can also be contracted by sharing towels or bathing suits. It’s yellow or green discharge has a foul odour. Pain, inflammation, and itching are common, although some people don’t experience any symptoms.

Yeast infection

A fungal infection that produces white, cottage cheese-like discharge in addition to burning and itching sensations. The presence of yeast in the vagina is normal, but its growth can multiply out of control in certain situations.

The following may increase your likelihood of yeast infections: stress, diabetes, oral contraceptives, pregnancy, overuse of antibiotics (especially prolonged use over 10 days).

Vaginal yeast infections, also known as candidiasis, are a common female condition. A healthy vagina has bacteria and some yeast cells. But when the balance changes, the yeast cells can multiply. This causes intense itching, swelling and irritation. Treating a vaginal yeast infection can relieve symptoms within a few days. In more severe cases, it may take up to two weeks.

Vaginal yeast infections aren’t considered a sexually transmitted infection. Sexual contact can spread it, but women who aren’t sexually active can also get them. Once you get a yeast infection, you’re more likely to get another one.

Vaginal yeast infections have a common set of symptoms: vaginal itching, swelling around the vagina, burning during urination or sex, pain during sex, soreness, redness and rash.

Gonorrhoea and chlamydia

Gonorrhoea and chlamydia are sexually transmitted infections (STIs) and can produce an abnormal discharge, which is often yellow, greenish, or cloudy. Chlamydia is a common sexually transmitted infection caused by bacteria. People who have chlamydia often do not have outward symptoms in the early stages. That might make you think you shouldn’t worry.

However, chlamydia can cause health problems in the later stages, including preventing women from getting pregnant or even endangering their pregnancies. If you have unprotected sex with someone whose STI status you’re not certain of, get tested for chlamydia and other STIs. You should get tested every time you might have been exposed.

Gonorrhoea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk. Symptoms usually occur within two to 14 days after exposure. However, some people infected with gonorrhoea never develop noticeable symptoms.

It’s important to remember a person with gonorrhoea who doesn’t have symptoms, also called a nonsymptomatic carrier, is still contagious. A person is more likely to spread the infection when they don’t have noticeable symptoms.

Pelvic inflammatory disease

Is often spread by sexual contact. It occurs when bacteria spreads up the vagina and into other reproductive organs. It may produce a heavy, foul-smelling discharge.

Human papillomavirus or cervical cancer

The human papillomavirus infection (HPV), which is spread by sexual contact, can lead to cervical cancer. While there may be no symptoms, this type of cancer can produce a bloody, brown and/or watery discharge with a bad odour. Cervical cancer can be prevented with yearly Pap smears and HPV testing.

Home care

To prevent infections, practice good hygiene and wear breathable cotton underwear. Don’t use douches because they remove useful bacteria. Practice safe sex and use protection to avoid sexually transmitted diseases. To decrease the likelihood of yeast infections when taking antibiotics, eat yogurt that contains live and active cultures. If you know you have a yeast infection, treat it with an over-the-counter yeast infection cream.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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