What’s Vaginal Discharge? Causes & When It’s a Problem

Key takeaways:

• The vagina has glands secreting both watery and mucus-like substances, creating a normal vaginal discharge.
• Since the vagina is exposed to the outside, its normal discharge can be altered by infections, changing its consistency and appearance.
• Your vaginal discharge can be a sign that all is well or, alternatively, a sign that there’s a medical problem.

The vagina is a chamber whose walls are normally collapsed together. The front of the vagina, incompletely covered with your labia minora, exposes delicate vaginal tissues to the outside world. Secretions, however, complete a protective liquid seal, both adjacent to the labia and along the collapsed walls. The rear of the vagina holds the cervix, the lowermost part of the uterus. The cervix’s secretions are primarily mucus to alter how sperm and infectious organisms pass. Mucus produced by cervical glands changes over the course of the menstrual cycle and contributes to the total amount of vaginal discharge. During pregnancy, this mucus acts as a barrier to prevent infection.

Definition of vaginal discharge

Both watery vaginal gland secretions and cervical mucus gland secretions contribute to and result in your normal vaginal discharge, called leukorrhea. Mucus from the cervix combines with secretions from vaginal glands:

• Skene’s glands: a pair of glands on either side of where your urine exits (urethra).
• Bartholin glands: paired glands on either side of the lowermost part of your vaginal opening.

Besides these, there is also water that passively filters through the layers of cells of your vaginal walls from deeper layers. Thus, your normal vaginal discharge is made up of secretions from vaginal and cervical glands and the normal moisture exchanged with deeper tissues. Some may confuse vaginal discharge with a mucus plug, you can read about the difference between vaginal discharge and mucus plug here.

What vaginal discharge says about your health

While a thin, filmy, clear, or milky discharge is completely normal, when you notice a change, it may indicate an abnormal process, such as:

• A fungal infection, such as yeast.
• A bacterial imbalance, such as bacterial vaginosis.
• A bacterial infection, such as Escherichia coli (E. coli), from your rectum.
• A sexually transmitted infection (STI), such as bacterial gonorrhea or Chlamydia, or the protozoan Trichomonas.

Abnormal vs. normal vaginal discharge

A thin, filmy, clear, or milky discharge is part of the normal moisturizing of your vaginal tissues, including the lubrication that occurs with sexual arousal and intercourse. You may even pass a more organized mucus collection as a mucous “plug” if dislodged from your cervix with sex, exercise, or normal gland secretions.

When you notice a change in your vaginal discharge, however, it may indicate an abnormal process, such as:

• An infection, possibly yeast or bacteria, such as E. coli from your rectum or a foreign body.
• A bacterial imbalance, such as bacterial vaginosis.
• An STI, such as bacterial gonorrhea or Chlamydia, or the protozoan Trichomonas.

The discharge you see, when abnormal, may be accompanied by certain individual or mixed symptoms:

• Burning
• Itching
• Pain
• Discoloration (pink, yellow, green, dark, red)

This means you can use the nature of your vaginal discharge as an indicator of whether all is normal or if you require a diagnosis and treatment from your medical provider. This is especially true if you have sexual contact with a new partner or you suspect infidelity.

Common causes of vaginal discharge

Even infections and conditions that cause an abnormal discharge may not look abnormal to you. Without burning, itching, pain, discoloration, a foul odor, or bleeding (aside from your period), an infection can be present. This is why keeping routine gynecology appointments is important. Below are common causes of both normal and abnormal vaginal discharges.

Leukorrhea

Leukorrhea is the normal vaginal discharge. It can become thicker around ovulation or even become pink-tinged right before your period. It should not be accompanied by unpleasant symptoms or odor. (Your vagina has a normal odor which shouldn’t be unpleasant.)

Irregular menstrual cycles

When your normal menstrual cycle doesn’t repeat normally every month, your hormones can become stuck in one part of the cycle. This can result in a change in your vaginal discharge. It can also result in a bloody discharge due to irregular shedding of menstrual tissue.

Yeast vaginitis

Yeast is a common cause of a burning or itchy discharge with a characteristic white, cream-cheese-like discharge. It can happen spontaneously while taking antibiotics, a change in diet, or douching.

Cervicitis

Cervicitis is a general term for inflammation of your cervix. However, it is too vague to serve as a diagnosis. Usually, cervicitis is associated with infections that cause inflammation, such as bacterial or fungal infections, or a shift away from the normal bacterial balance of the vagina.

Bacterial vaginosis

The acidic nature of the vagina is important for discouraging infections and assisting in reproduction. The dominant bacteria are the lactobacilli, which make the lactic acid that keeps the vagina mildly acidic. If these helpful bacteria are replaced with other bacteria, this system breaks down and causes inflammation (vaginitis and cervicitis) and a gray discharge that burns or itches. Bacterial vaginosis can, but may not be, sexually acquired.

Infections

While bacterial vaginosis may not be an actual infection, other infections are always sexually acquired and exchanged:

• Gonorrhea.
• Chlamydia.
• Trichomonas.
• Other infections, such as those acquired in other parts of the world.

Another bacterial infection that can be acquired sexually or may even come from bacteria in your rectum, despite the most scrupulous hygiene is E. coli

Bleeding

Blood mixing with either a normal or abnormal discharge can make it pink, red, or even brown or black. While vaginitis and cervicitis can cause some bleeding to discolor your discharge, bleeding in and of itself may be the problem:

• Irregular cycles.
• Pregnancy (implantation bleeding, ectopic pregnancy, threatened miscarriage, preterm or early labor, or placental problems.
• Trauma (sexual or blunt). Blunt trauma can occur from “straddle” injuries, usually occurring in childhood.

Common vaginal discharge colors and consistencies

There are various types of vaginal discharge. The following incidences of colored discharge can indicate specific underlying conditions:

• Clear, filmy, milky discharge: This could be normal leukorrhea, varying in volume and thickness during your menstrual cycle.
• Pink leukorrhea-like discharge before a period: This could be normal leukorrhea mixed with menstrual blood.
• Bloody discharge: This could be vaginitis from yeast infection, or atrophy from menopause or cervicitis due to one of many causes (infection, bacterial vaginosis, chemical irritation).
• Bloody discharge of early pregnancy: This could be implantation bleeding, which is normal, or warning signals of a threatened miscarriage, ectopic pregnancy, or infection.
• Bloody discharge after menopause: This may represent atrophic vaginitis (common but very irritating) or perhaps a sign of cancer.
• Clear or grayish mucusy discharge: This can occur with a loss of normal mucus from the cervix.
• White, thick, itchy, or burning discharge: This may be a yeast infection.
• Greenish, often frothy or bubbly discharge, with burning or itching and possibly a “fishy” odor: These are classic symptoms of a Trichomonas infection.
• Gray, yellow, or green-yellow discharge with a “fishy” odor: This could be bacterial vaginosis.
• Brown or black discharge: This could be a normal vaginal discharge mixing with old blood from a delayed period or hormone imbalance.
• Greenish, foul-smelling discharge: This could be an infection due to an STI, e.g., gonorrhea or chlamydia, or a foreign body, such as a lost tampon or condom.
• Discharge of any color with a foul odor: This could be an infection due to an STI or foreign body. Read more about vaginal discharge with odor.
• Pus: Pus occurs with STIs or something stuck inside, like a forgotten tampon.
• Clear, yellow discharge that smells like urine: Urine can collect in the vagina due to incontinence or bladder infection. Your discharge can also be red-tinged if you have a bladder infection.

How to maintain healthy vaginal discharge

The vagina has its own system for staying healthy via its secretions, mucus, and acidity. The vagina does a remarkable job of caring for itself. Many hygienic products and home remedies for vaginal discharge are pushed with misleading marketing messages, such as that the vagina should not have an odor or that douching is necessary. However, often the best advice is not to use unnecessary cleaning mechanisms on an otherwise healthy vagina.

Strangely enough, the vaginal environment seems to get along well with the normal organisms of your partner (skin) and even saliva, unless there is an alteration from their normal bacterial balance, such as via skin infections or dental disease.

Keep your regular gynecology exam appointments

Even if you notice nothing unusual, it is best to be proactive and visit your gynecologist at regular intervals.

Don’t ever douche, unless it’s medication from your doctor

You don’t have to douche, even after intercourse or your period. Douching is an invasion of your vagina with bacteria and yeast and may wash out your normal helpful bacteria (lactobacilli). Let your body’s physiology do what it does best.

Do not use feminine products

Many have harsh chemicals for fragrance or have cleansers. All you need to do is wash your external vaginal area with simple soap and water.

See your doctor with any changes after a new partner

New or multiple sexual partners may mean exposure to unwanted pathogens. Pay attention to how your body reacts to each of your partners.

When you should see a doctor about vaginal discharge

You should see a doctor for any abnormal discharge, which always warrants evaluation.

You should see a doctor if:

• You have any bleeding not associated with your expected period.
• A discharge smells foul.
• A discharge burns, itches, or causes pain.
• You have painful sex, urination, or bowel movements.
• A discharge is discolored.
• You have a discharge with irregular cycles.
• You have any blood in a discharge in menopause.

You should go to the emergency room if:

You experience any of the above and

• You have a fever.
• You are pregnant or might be.
• You are menopausal.
• You have pelvic, back pain, or intercourse-related pain.
• You have nausea.
• You have painful urination or bowel movements.
• There is pus present.

Questions to ask your doctor about vaginal discharge

Important questions include the following:

• Is this normal, hormonal, or an infection?
• How will you diagnose and, if indicated, treat it?
• Should my partner be included?
• What if I’m pregnant or plan to be?

How a doctor may help treat abnormal vaginal discharge

This depends on a proper diagnosis.

Anti-fungal medication

Suppositories, creams, or pills may be prescribed.

Antibiotics

These have been proven useful in bacterial vaginosis and are necessary for infections, especially STIs (gonorrhea, Chlamydia) and non-bacterial Trichomonas.

Re-establish the microbiome

With bacterial vaginosis, non-medical additional remedies include lactobacilli cultures via suppository or even yogurt in the vagina.

Frequently asked questions: vaginal discharge

Due to sexual and reproductive concerns, the following questions may arise:

Is it normal to have vaginal discharge every day?

Yes, if it’s unsuspicious leukorrhea (see above) and has no odor or discomfort.

How do you know if you have excessive vaginal discharge?

Excessive discharge is not abnormal. If you have concerns, the best way to be sure is with a proper exam.

Does your vaginal discharge change when you’re sick?

If you’re sick because of the infection causing the discharge, your discharge can change as the illness becomes more severe. The normal leukorrhea, however, can get thicker due to the dehydration that often goes along with being sick.

Vaginal discharge–in summary

A vaginal discharge is normal unless it burns, itches, hurts, smells foul, or is accompanied by other symptoms like back pain, fever, or other discomfort. When your vaginal discharge is clear, filmy, and/or milky without any discomfort, it’s a good indication that all is well. Any exceptions, however, require a proper evaluation.

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.

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