Updated: Sep 20, 2019
If you have a vagina, you have discharge. But it isn’t always the same, is it? It changes. And that makes us wonder… is that normal? Should I be worried?
Let’s take a look at what normal vaginal discharge is - and by the way, the medical term is “physiological discharge”. That means it’s created by normal physiological processes in the body.
Normal vaginal discharge
Is white or clear
Does not smell bad
Varies based on hormone levels
Gosh, how informative. What the heck IS THE STUFF?
Well, up to 90% of it is just water. The rest is a mixture. There are amino acids, sugar, enzymes and electrolytes in the mix. Some of these are produced and released by our own tissues as they go about their business of living and responding to instructions from hormones. Other contributions come from cells that are not exactly ours, but come from the bacteria and other microbes that form our vaginal microbiome.
Another significant contributor (if being just one part of just ten percent of something can be called sgnificant) is exfoliated epithelial cells - that's our dead skin. Skin cells are constantly being replaced by a fresh layer underneath, as is promised by every jar of body scrub. 'Outside' skin cells can drift away in the air or wash down the drain when we shower, so we never really see how much they add up. The cells inside our vagina all have to exit by the one pathway, and that makes the total amount more noticeable.
The last and possibly most important ingredients in vaginal discharge are mucins. It's not that there's a huge amount of them, but that they make a very big difference to what our discharge looks and feels like. The healthy epithelial cells and certain other cells in our cervix and vagina produce mucins. I'll skip to the end of the chemistry lesson: mucins absorb water, form gels, and turn all the previously mentioned ingredients into MUCUS.
Eeewwwww. Even ‘discharge’ sounds better than that. But mucus is really important, and not just in the vagina. It coats the surfaces of our respiratory system and digestive tract, providing important lubrication and acting as a physical protective barrier. It also plays an active role in our immune system, with mucins binding pathogens to put them out of action.
So vaginal discharge is mucus, and mucus is a damn fine thing.
Some of our vaginal mucus is formed and descends from inside the cervix, and that flow provides added protection against unwelcome bacteria (or sperm!) climbing up into the uterus. The rest is produced within the vagina. It is both a lubricant and a wonderful barrier that protects our vaginal walls against damage and discourages invading bacteria.
As we continually produce this cervicovaginal mucus, and with the help of gravity, it makes its way down the vaginal passage and out of our body. This adds another layer of protection, as the gel-like nature of mucus means is carries along anything that isn't nailed down. It helps get rid of things that shouldn’t be hanging around inside - like blood and semen. Our mucus is our own personal housework fairy.
Vaginal Discharge Changes
The quantity and type of cervical mucus varies during the menstrual cycle, and at other times, because of hormonal fluctuations.
In the lead-up to a menstrual period, our estrogen levels are falling and our progesterone levels are rising. This is when cervical mucus becomes thick and sticky, giving us the most protective barrier.
After a menstrual period finishes, we cycle back towards ovulation - and mother nature wants sperm gaining entry during ovulation. Our estrogen levels rise, and our mucus becomes clearer, wetter, slippery and kind of stretchy/stringy. There might be more of it, or it might just seem that way because it’s wetter and spreads more. When we ovulate, our mucus is at its slipperiest.
During pregnancy we have loads of estrogen circulating, so women often produce more discharge while pregnant. (High estrogen also makes women more likely to get Thrush, but by a different process.) Immediately after birth our estrogen plummets downward, and so does mucus production. Since we may bleed for weeks after birth, this change might not be obvious at first. But as time goes on, and particularly if breastfeeding, new Mums can get quite uncomfortable and need to do something about their vaginal dryness.
As menopause approaches and estrogen levels reduce, discharge tends to settle to a lower normal level. The new level might still be healthy and comfortable, but if it isn't there are various options available to help. Do ask your health professional about it. Some women put up with symptoms because they don't want hormone therapy, but that's not the only option. And hormone possibilities have changed for the better as well. Change your vagina to suit your life, not the other way around!
Does Vaginal Discharge Need Treatment?
This article is about normal vaginal discharge, but for clarity I'll add a quick summary of what is not considered normal - what we perhaps should pay attention to.
There are many conditions that can cause abnormal discharge. We shouldn’t ignore it because some of those conditions can be quite serious - and pretty much all of them are downright unpleasant to put up with.
The most common cause of abnormal discharge is Bacterial Vaginosis (BV), and the second most common is Thrush (yeast infection). Other possibilities include sexually transmitted infections, foreign bodies (usually a forgotten tampon), dermatitis, allergic reactions and other inflammatory conditions.
Discharge colours we don’t want to see include grey, green and yellow. We don’t want it clumpy like cottage cheese, nor do we want there to be pus or blood (except for menstruation). It shouldn’t smell bad, and it shouldn’t be associated with itching, burning, a rash or soreness.
It’s a really good idea to get a proper test to diagnose the cause of unusual discharge, because then the right treatment is likely to be effective. Vaginal problems are pretty sneaky, and antibiotics might be the answer - but they might not, too.
If you’d like more info about specific symptoms, check out ‘possible causes’, ‘clinical presentation’ and more at http://www.sti.guidelines.org.au/syndromes/vaginal-discharge