Vitamin D Deficiency: Causes, Symptoms, and Prevention

Vaginal discharge can occur normally or result from inflammation of the vagina (vaginitis), often caused by an infection. The genital area (vulva), the area surrounding the vaginal opening, may be inflamed.

Vaginal Discharge

Depending on the cause of the vaginal discharge, other symptoms are often experienced. These include itching, a burning sensation, irritation, redness, and sometimes pain during sexual intercourse.

What are vaginal discharges?  

Vaginal discharges (leukorrhea) are natural secretions originating from a woman's vagina. The term vaginal secretions encompasses several physiological phenomena. These may include white discharge, cervical mucus, or menstrual flow. They begin at puberty and cease at menopause. The amount can vary from one woman to another, and this is completely normal.

First, before going into the subject, we must distinguish between normal and abnormal vaginal discharge.

Normal Vaginal Discharges:

Vaginal discharges can result from the normal fluctuations in estrogen levels. When levels are elevated, estrogens stimulate the cervix to produce secretions (mucus), and a small amount of mucus may be expelled from the vagina. Estrogen levels are high in the following situations:

• During menstrual cycles, a few days prior to ovulation.
• A few months before the first menstruation in young girls.
• During pregnancy.
• In women taking medications containing estrogens or those that increase estrogen production (such as fertility-stimulating medications)
• In newborns, for one to two weeks due to the absorption of maternal estrogens before birth.

Generally, normal discharges are odorless. They are typically milky or clear and liquid. In women of reproductive age, their volume and appearance vary according to the menstrual cycle. For instance, mid-cycle, when the egg is released (ovulation), the cervix secretes mucus in greater quantities, and it is more fluid.

Pregnancy, oral contraceptives, and sexual stimulation also influence the quantity and appearance of discharges. After menopause, estrogen levels decrease, often resulting in a corresponding reduction in normal vaginal secretions.

Abnormal vaginal discharge:  

Abnormal vaginal discharge

A vaginal discharge is considered abnormal when it is:

• Denser than normal.
• Thicker than normal.
• Similar to pus.
• White and curd-like (like fresh cheese).
• Grayish, greenish, yellowish, or streaked with blood.
• Foul-smelling or having a fishy odor.
• Accompanied by itching, a burning sensation, a rash, or pain.

Understanding Vaginal Discharge Better

Being a woman brings its share of problems. Vaginal discharge could be one of them. In the following lines, we will tell you the important things to know about it.

Normal Discharge and Cervical Mucus

Normal vaginal discharge is also referred to as "cervical mucus." It is a substance secreted by glands in the cervix. This mucus plays a role in fertility. During fertile days, the mucus facilitates the movement of sperm and ensures an adequate pH for their survival. During infertile periods, the mucus forms a plug to obstruct the cervix.

Discharge Throughout the Menstrual Cycle 

The appearance and texture of the mucus vary according to levels of female hormones. Therefore, it is normal for the discharge to fluctuate throughout the menstrual cycle.  

• At the beginning of the cycle: the mucus is minimal, white, and thick.  
• Near ovulation: the mucus is more abundant, fluid, and stretchy.  
• On the day of ovulation: the mucus resembles egg white.  
• After ovulation: the mucus becomes less abundant and drier.

What do the colors and textures of discharge mean?

White  

Normal discharge is often clear to whitish. If the discharge becomes white and very thick, resembling cottage cheese, this may be a sign of a yeast infection. Antifungal treatment will be necessary; although over-the-counter treatments are available, consulting a healthcare professional is recommended, as they can advise on the appropriate treatment.

Yellow 

Yellowish discharge can be normal. In fact, normal discharge may take on a yellow hue when exposed to air. A small amount of blood mixed with normal discharge can also darken the discharge, which is not concerning at all.

Green  

If the discharge is rather greenish, a consultation is necessary. Green discharge, especially when accompanied by a foul odor, may be a sign of a bacterial infection.

Brown or pink

Around the time of menstruation, it is not uncommon to have brown or pink discharge due to the presence of blood. This is completely normal. However, if brown or pink discharge occurs frequently at other times in the cycle or after menopause, a consultation with a healthcare professional is necessary.

Transparent Discharge

Ovulation is approaching. This completely normal appearance, resembling raw egg white, serves to prepare for the arrival of sperm.

Vaginal Discharge in Pregnant Women

Vaginal Discharge in Pregnant Women

Pregnancy brings its share of discomforts, and increased vaginal discharge is one of them. The discharge is odorless. If a foul odor is present, it is a sign of a bacterial infection, and consultation is necessary. In cases of yeast vaginitis during pregnancy (abundant and chunky white discharge), antifungal treatment is required. A consultation with a healthcare professional is preferable to choose the appropriate treatment.

It is also possible for urine leakage to occur, particularly after physical exertion, sneezing, or laughing.

However, special attention should be given if the fluid loss is continuous, translucent, and odorless, as it may indicate amniotic fluid. This could suggest that the amniotic sac has ruptured, and this situation can pose a risk to the baby if they are not full-term (37 weeks).

Vaginal Discharge After Menopause

As menopause is a period of hormonal upheaval, it is not uncommon for women to report abnormal vaginal discharge, dryness, and discomfort during sexual intercourse. These issues are frequent and normal, but treatments are available. It is important to discuss these concerns with your healthcare professional.

After menopause, defined as one year without menstruation, if any blood-stained discharge occurs, it is crucial to investigate further.

When to Consult?

In summary, here are the situations in which a consultation with a healthcare professional is necessary:

• Sudden and marked change in texture
• Itching of the vulva
• Green, gray, yellow, or brown discharge (outside of menstruation)
• Blood-stained discharge outside of menstruation or after menopause
• Foul odor (such as a fishy smell)
• Pelvic pain accompanied by fever
• Significant pain during sexual intercourse.

If there are concerns regarding vaginal discharge during pregnancy, it is important to discuss them during your prenatal follow-up visits. An untreated infection can have consequences for the fetus.

What can be done to prevent vaginal infections?  

• Several measures can help prevent vaginal infections:
• Avoid vaginal douching.  
• Maintain proper hygiene of the genital area, avoiding scented or irritating products.  
• Wear underwear made from natural fibers to promote ventilation.  
• When using the toilet, wipe from front to back.  
• Use a condom during sexual intercourse.  
• Ensure to change tampons regularly.

Causes of Vaginal Discharge

Abnormal vaginal discharge is typically caused by vaginitis, which most often results from irritation due to a chemical substance or an infection.

Common Causes

The likely causes of vaginal discharge vary depending on age.

In childhood, common causes include:

1. - Infection related to bacteria in the digestive tract.
2. - Chemicals present in bubble baths or soaps.
3. - Foreign body (such as a piece of toilet paper or sometimes a toy) in the vagina.

An infection may arise from a lack of hygiene. For example, young girls, particularly between the ages of 2 and 6, may transfer bacteria from the digestive tract to the genital area when they wipe from back to front or if they do not wash their hands after using the toilet.

If a foreign body is the cause, the discharge may contain small amounts of blood.

In women of childbearing age, vaginal discharge typically arises from a vaginal infection. The most common causes include:

1. Bacterial vaginosis
2. Candidiasis (yeast infection)
3. Trichomoniasis (vaginal trichomoniasis), which is sexually transmitted

Sometimes, the discharge is caused by another infection, including sexually transmitted infections (such as gonorrhea or chlamydia).

The protective bacteria that normally reside in the vagina (lactobacilli) help prevent vaginal infections. These bacteria maintain the normal acidity of the vagina. When this acidity decreases, the number of protective bacteria also diminishes, leading to an increase in harmful bacteria.

The following situations promote the proliferation of harmful bacteria (and consequently increase the risk of vaginal infections):

• Use of antibiotics (as they can reduce the number of protective bacteria)
• Menstrual blood or semen in the vagina (as they reduce the acidity of the vagina)
• Vaginal douching (as it can reduce the acidity of the vagina)
• Pregnancy
• Diabetes mellitus
• Foreign bodies, such as a forgotten tampon (because tampons provide a warm and moist environment where bacteria can thrive)

After menopause, many women experience abnormal discharge. This occurs due to the decrease in estrogen levels, which makes the vagina thinner and drier. A thin and dry vagina is more susceptible to irritations and inflammations, leading to discharge. 

The symptoms affecting the vagina and urinary tract after menopause are referred to as the genitourinary syndrome of menopause. These symptoms include vaginal dryness, pain during intercourse, urinary urgency, and urinary tract infections.

Less Common Causes

During childhood, sexual abuse may lead to vaginal infections. Such experiences can cause injuries or transmit sexually transmitted infections.

In women of childbearing age, the cause is sometimes the presence of a foreign body (such as a forgotten tampon). However, in women of this age, discharge is rarely caused solely by inflammation (without infection).

In older women, urine or feces can irritate the genital and anal areas, resulting in vaginal discharge. These irritations occur in women who suffer from incontinence (who cannot control their urge to urinate or defecate) or who are bedridden.

After menopause, many women experience abnormal discharge. This occurs due to the decrease in estrogen levels, which makes the vagina thinner and drier. A thin and dry vagina is more susceptible to irritations and inflammations, leading to discharge. The symptoms affecting the vagina and urinary tract after menopause are referred to as the genitourinary syndrome of menopause. These symptoms include vaginal dryness, pain during intercourse, urinary urgency, and urinary tract infections.

In rare cases, a woman may present with an abnormal opening (fistula) between the intestine and the genital tract, resulting in vaginal discharge. This discharge sometimes contains feces. The fistulas may have the following causes:

1. - Vaginal injuries during childbirth (primarily in developing countries)
2. - Infection occurring at the site of a surgical incision or a tear in the vaginal opening during childbirth
3. - Chronic inflammatory bowel disease
4. - Pelvic radiotherapy
5. - Injuries during pelvic surgery
6. - Tumors in the pelvis

How to Avoid Genital Irritations and Infections During Pregnancy?

Sometimes, the abundance of vaginal discharge leads pregnant women to adopt overly irritating hygiene measures (vaginal douches, antiseptic soap, deodorants, etc.). This chronic irritation of the vulva and vagina can promote the development of local infections.

To avoid these inconveniences:

1. Use a mild, alkaline soap (for example, glycerin-based), and avoid vaginal douches, deodorants, antiseptic liquids and soaps, or scented bubble baths;
2. Avoid wearing panty liners, especially those that are scented;
3. Use hypoallergenic detergent for your underwear and feel free to run an additional rinse cycle;
4. Preferably wear cotton underwear and change them as often as necessary.

Be aware that smoking, in addition to its dangers for pregnancy and the fetus, seems to contribute to the occurrence of genital and urinary infections in pregnant women.