Vaginal discharge is one of the most common reasons women book a visit to their gynaecologist. Depending on the appearance and characteristics of the discharge, it can be an indication of a bacterial or viral infection, but it might also just be a symptom of the normal workings of your body and nothing to be concerned about. So, when should you worry?

What is a normal discharge?

A normal vaginal discharge is white in colour and has a thick, sticky consistency. It is important to note that a normal discharge does not have a foul smell and is not accompanied by any irritation, itching or burning sensations. Scientifically speaking, normal discharge is made up of vaginal epithelial cells mixed with material from sebaceous, sweat and Bartholin’s glands, as well as secretions from the cervix. Normal vaginal pH levels usually fall between 3.8 and 4.2 and the amount of discharge varies from woman to woman, increasing during ovulation, pre-menstruation and pregnancy.

Where does the discharge come from?

Let’s begin with a quick lesson in female physiology. The vagina itself does not have glands to produce any fluid – its moist state is maintained by secretions from the cervical glands and fluid coming from the blood vessels in the connective tissue layer of the mucous membrane.

The cervix, which forms the neck of the uterus, is about 2cm in length and lies at the top of the vaginal canal. Oestrogen and progesterone stimulates the secretion of mucus in the lining of the cervix canal. Additional fluid is produced by what doctors refer to as Skene’s ducts – these ducts are situated on each side of the urethral opening and they produce additional secretions during moments of sexual arousal. Then there are the Bartholin’s glands that lie posteriorly on each side of the vagina, which further secrete mucus during sexual stimulation to serve as a lubricant for the vagina, especially during intercourse.

Why do we have discharge and what is the function of cervical mucus?

Apart from anything else, vaginal discharge is the body’s way of keeping the vagina healthy and clean. Cervical mucus changes throughout the menstrual cycle in response to oestrogen and progesterone levels in your body. These changes determine the fertile period prior to ovulation and stimulates the growth of the ovarian follicles. During this time the cervical mucus changes from dry and sticky to a slippery, clear and stretchy mucus, and helps the sperm move from the vagina into the uterus. By tracking these changes, a woman can determine when intercourse is most likely to result in conception. Alternatively, women who wish to prevent pregnancy with natural methods can monitor these changes to determine which days of the menstrual cycle she should abstain from sex.

When to worry

Now that we understand what a normal vaginal discharge is and why we have it, let’s consider some deviations from the norm to determine whether we should be making that doctor’s appointment.

When discharge becomes foul-smelling or is accompanied by symptoms like itching or burning, it might be indicative of an infection. The most common infections associated with a discharge are thrush (yeast infection or candidiasis) and bacterial vaginosis.

Thrush can be diagnosed with a quick physical examination and sample testing by your doctor. These infections can usually be eliminated with a short course of antifungal medication such as topical antifungal creams and suppositories administered directly into the vagina.

Bacterial vaginosis occurs when the pH levels and healthy bacteria in the vagina are disturbed, leading to an infection. Using antibiotics, harsh soaps and even having sex can produce a state that encourages bacterial growth. Bacterial vaginosis usually presents as a thin, white or greyish discharge with an unpleasant ‘fishy’ smell. It can be treated with over the counter topical medication or oral antibiotics. If you suspect you have bacterial vaginosis, a visit to your doctor is the way to go.

Abnormal symptoms may also point to sexually transmitted infections, which definitely warrant a doctor’s visit. If you’re experiencing any burning, itching, painful urination or painful sex, soreness, redness or inflammation, or an odd-smelling, greenish-yellow and sometimes frothy discharge, you should get yourself checked out.

If you feel concerned or have noticed any symptoms that do not look or feel normal to you, you can book an appointment with one of our friendly doctors and get the treatment you need.