Vaginal Discharge & Cervical Cancer: A Guide

Key takeaways:

• Cervical cancer, like all cancer, grows at the expense of normal tissues, causing them to die and decay as a discharge or bleeding.
• Cervical cancer can cause unusual vaginal discharge that is watery, bloody, foul-smelling, or discolored.
• Other possible causes of unusual discharge are less severe but may still warrant medical attention.

Your cervix is part of your uterus at the back of your vagina. Its mucus glands provide lubrication and help moisturize vaginal tissue. However, like other organs, your cervix is susceptible to different cancers. The most common type of cervical cancer is due to the sexually transmitted human papillomavirus, called HPV. But regardless of its manifestation, cervical cancer causes the death of normal tissues, which can decay, shed, and cause bleeding.

All of these changes can affect vaginal discharge, giving it an unusual look, feel, or smell. Early detection of cervical cancer is key for adequate treatment and a positive outlook, which means you should always check with your doctor if you notice changes in discharge.

Does cervical cancer change vaginal discharge?

Yes, cervical cancer can cause changes in vaginal discharge, but it typically takes some time to do so. Cancer begins microscopically, so it may not initially cause noticeable symptoms. That’s why regular checkups and Pap smears are so important. The further cervical cancer progresses, the harder the treatment and the lower the chances of survival.

When a vaginal discharge changes due to cervical cancer, it may present as bloody (pink, red, brown, or black), have tissue flecks in it, or be foul smelling. Since cancer cells affect blood vessels, bleeding may be your first warning signal in your vaginal discharge.

The reality is that by the time cervical cancer has caused necrosis (death of tissue) and a foul discharge or irritates cells enough to cause bleeding, it may already have progressed significantly. This not only creates additional risk but also makes treatment challenging.

Normal vs. abnormal vaginal discharge colors

Your normal vaginal discharge is a result of secretions from vaginal glands, moisture, and cervical mucus. It can change throughout your menstrual cycle and in pregnancy, but it typically is:

• Clear or white,
• Stretchy, slimy, or mucousy at midcycle near ovulation, or even
• Pink-tinged (or darker) right before your period.

Changes in vaginal discharge can be a warning signal that something isn’t right. You might notice that your discharge takes on a yellow, green, or gray color when something is amiss.

Unusual-looking or -smelling discharge could be a sign of an infection, like a yeast infection, or a sexually transmitted infection (STI) like chlamydia or gonorrhea. Changes in discharge could also be a result of shifts in your vagina’s bacterial balance (or microbiome).

While the above infections can cause bleeding, blood-tinged discharge can rarely be a sign of cancer. The bottom line is any vaginal discharge changing from what you usually see requires evaluation.

Read our guides on types of vaginal discharge and vaginal discharge colors for more.

How cervical cancer can change vaginal discharge

Early on in the progression of cervical cancer, changes to discharge are typically due to bleeding. Cancer cells bleed easily – due to trauma from the mechanical act of intercourse, for example – and cause blood vessels to grow, adding to their blood supply. That means more blood and easier bleeding. Both of these factors contribute to how cervical cancer changes vaginal discharge.

Once cell necrosis (death) begins, decaying tissue or flecks may appear in vaginal discharge, causing a foul odor. The volume varies by the amount of blood supply, cell mass involved, and amount of tissue death.

Let’s take a closer look at how, specifically, cervical cancer can change the look and feel of vaginal discharge:

Color

Blood mixes easily with vaginal secretions and mucus. As a result, much of the changes in appearance that cervical cancer causes in discharge are related to varying amounts of bleeding:

• Pink
• Red
• Brown
• Dark brown or black – as blood ages, it loses its iron content, making its color darker.

Other changes in color associated with cervical cancer include the following:

• Gray, brown, or black: These colors are common with necrosis (dead, rotting tissue).
• White, yellow, or gray: These colors indicate that pus is present in the discharge.

Texture

Necrotic tissue can be strewn in a discharge as tissue or tissue flecks, which can thicken the discharge itself. The texture of discharge affected by cervical cancer can vary in consistency from watery to thick with tissue fragments.

Odor

Necrotic tissue is usually quickly invaded by bacteria and associated with pus, causing a bad odor.

Amount

The amount of discharge a person experiences with cervical cancer varies. As cancer grows, what it produces in the way of discharge and shed tissue can vary, but that isn’t something upon which you can judge its severity. In other words, the discharge is not as meaningful as having cervical cancer at all, regardless of what you see and smell.

Other symptoms or red flags of cervical cancer

Cancer – no matter where it strikes – affects the whole body. Your entire metabolism is affected, including energy, appetite, sleep patterns, weight, temperature (fever), and even the way blood vessels grow. That means that other bodily symptoms may be warning signs of cervical or other cancers.

Bleeding

Besides vaginal bleeding creating a discharge, your ability to clot may be affected, making bleeding more likely anywhere, e.g., nose bleeds, rectal bleeding, bloody urine, etc.

Anemia

Anemia means low amounts of red blood cells (RBCs) in your circulation beyond what is explained by any bleeding you have. RBCs carry oxygen to all of your tissues. Inadequately oxygenated tissues can cause problems with cell health, growth, and turnover. A lack of oxygen also affects the very function of tissues and organs.

Weight loss

Besides affecting your appetite, cervical (or any) cancer can cause weight loss beyond that explained by decreased consumption.

Vitamin deficiencies

Not only does appetite decline, but the way food is digested is altered. Dysfunction that affects digestion can lead to nutritional deficiencies that may cause symptoms of their own.

Fatigue

When you have cancer, your metabolism works to support your body and another living entity (cancer), which takes what it needs and leaves what’s left (if anything) for you. This often comes up short, causing a decrease in energy.

Other common causes of a change in vaginal discharge

Many causes of unusual vaginal discharge are far less severe than cervical cancer. Some of the most common culprits include the following:

Bacterial vaginosis (BV)

BV is an imbalance of your vagina’s normal bacteria, specifically the helpful lactobacilli. It can cause a discharge that is gray or white, frothy, and can be associated with itching, a fish-like smell, and burning urination.

Yeast infection

A yeast infection-related discharge usually causes burning or itchiness and can be thick and white, like cream cheese.

Bacterial infections

Other bacterial infections, especially STIs like gonorrhea and chlamydia, can create a green or dark discharge with a foul smell.

Trichomoniasis

The STI trichomoniasis causes a green discharge that is frothy and can have a fish-like odor.

Foreign body

A forgotten tampon or lost condom offers a site for bacteria to grow, causing a green, dark, or pus-like discharge with a foul smell.

How to tell if a change in vaginal discharge is caused by cervical cancer

There’s only one way to tell if changes in discharge are the result of cervical cancer or something else: an official diagnosis. Only a medical professional can identify cervical cancer; the diagnosis process requires identifying cancerous cells via biopsy.

While other conditions may cause unusual discharge more frequently, they’re also worth paying attention to. Untreated infections can affect your long-term health and fertility, even if they’re not related to cancer.

When you should see a doctor about a change in vaginal discharge

It’s important to seek medical attention for unusual discharge, regardless of whether you believe it may be a sign of cervical cancer. However, some symptoms may indicate that you need care more urgently than others.

You should see a doctor if:

You experience one or more of the following:

• Vaginal bleeding outside your menstrual period, particularly during menopause.
• Unusual vaginal discharge that is discolored, smells foul, burns, itches, or causes pain.
• Painful sex, urination, or bowel movements.
• Fatigue.

You should go to the emergency room if:

Seek immediate medical attention if, in addition to the symptoms above, you:

• Have a fever.
• Are pregnant or might be.
• Have pelvic, back, or intercourse-related pain.
• Have nausea.
• Have painful urination or bowel movements.
• Notice pus or tissue present in vaginal discharge.

Questions to ask your doctor about a change in vaginal discharge

• How will you diagnose and, if applicable, treat the cause of my unusual vaginal discharge?
• What if it’s cancer?
• Should my partner be included in my evaluation?

How a doctor may diagnose cervical cancer after a change in vaginal discharge

After hearing reports of unusual vaginal discharge that could indicate cervical cancer, your doctor will likely conduct a full evaluation. The steps of this evaluation could include, but aren’t limited to, the following:

• Pap smear and HPV genetic identification.
• Colposcopy and directed biopsy.
• Microscopic evaluation of your vaginal discharge.
• Blood work to rule out anemia and check other biomarkers.

Following these diagnostic procedures, your doctor will help you determine the cause of your symptoms and discuss the best treatment options for your needs.

Frequently asked questions: cervical cancer and vaginal discharge

Below are some answers to other common questions that may help you better understand your symptoms:

Is thick, white vaginal discharge a common symptom of cervical cancer?

No, a thick white discharge is not usually associated with cervical cancer, though cervical cancer can cause any type of change in your discharge.

Are there any other visible signs of cervical cancer?

Other than the consistency and smell of a vaginal discharge, other visible signs of cervical cancer include pain, weight loss, fatigue, and easy bleeding. Later stages include swelling and bowel or urinary problems.

Final thoughts on cervical cancer-related vaginal discharge

While you shouldn’t consider cervical cancer first with any change in your vaginal discharge, it still should be on that list, especially if you’re menopausal. Just like with STIs and other infections, any change in your vaginal discharge requires proper evaluation. Talk to your doctor about any changes in vaginal discharge, regardless of whether you believe you may be at risk for cervical cancer.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

World Health Organization (WHO). “Cervical cancer.” 5 Mar. 2024, https://www.who.int/news-room/fact-sheets/detail/cervical-cancer.

Centers for Disease Control and Prevention (CDC). “About HPV.” 3 Jul. 2024, https://www.cdc.gov/hpv/about/index.html.

Centers for Disease Control and Prevention (CDC). “About Bacterial Vaginosis (BV).” https://www.cdc.gov/bacterial-vaginosis/about/index.html.

Miller, EA, Beasley, DE, Dunn, RR, Archie, EA. "Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?" Front Microbiol, December 2016, doi: 10.3389/fmicb.2016.01936, PMID: 28008325, PMCID: PMC5143676, https://pmc.ncbi.nlm.nih.gov/articles/PMC5143676/.

MedlinePlus. “Vulvovaginitis.” National Library of Medicine, National Institutes of Health, 16 Apr. 2024, https://medlineplus.gov/ency/article/000897.htm.

MedlinePlus. “Gonorrhea.” National Library of Medicine, National Institutes of Health, 5 Jun. 2024, https://medlineplus.gov/gonorrhea.html.

MedlinePlus. “Chlamydia Infections.” National Library of Medicine, National Institutes of Health, 31 May 2024, https://medlineplus.gov/chlamydiainfections.html.

MedlinePlus. “Trichomoniasis.” National Library of Medicine, National Institutes of Health, 4 Dec. 2022, https://medlineplus.gov/ency/article/001331.htm.