Blood, Sweat, Tears…Discharge?

Bodily fluids make many folks uncomfortable, but many bodily fluids have positive metaphors: blood is associated with life and vitality; sweat with strength; tears with joy or sorrow, but, how about vaginal discharge? Where is its positive metaphor, and why do so many women find fault or negative associations with it, and even fear it? The female body has a unique super power that is rarely celebrated but manifests visibly every day- vaginal discharge. It is time to shed the shame and share what we know about what makes it as essential as blood, sweat, and tears.

Way too often for the last 14 years, I have heard my patients say there is something wrong down there.“I have too much.” “I have too little.” “It is too thick.” “It is too thin.” These observations lead women to believe that they are different, dirty or abnormal. They are alarmed when I tell them that actually their discharge is in the range of normal and is absolutely fine. It is then that that they learn that discharge is always in state of flux. Of course at rare moments in our lifetime our vaginal ecosystem can be tilted, harboring an improper balance of vaginal flora that changes the color, odor, or by undesired bacteria that can cause infection, inflammation, or life threatening changes. However, usually not. It is usually doing exactly what it is supposed to do.

Our discharge is a critical component of our immune system, pushing out unwelcome bacteria. It is essential to reproduce, can be a measurement for fluid and electrolyte balance, demonstrate whether we are aroused, and can serve as a fertility indicator. It is a critical part of our microbiome that populates our entire digestive tract as well as our vagina. It appears that one of the main mechanisms for how we inherit our gut bacteria early in life is by encountering vaginal discharge at birth as we move through the vaginal canal. It can easily be altered by how much water we consume, our period, our hormone levels, our sexual desire, our age, the products we use, the amount we exercise, the medications we take, diet, caffeine intake and so on and so on. Yes, it can be annoying leaking and staining underwear and even seem like it is out of our control, but it is actually most often an indicator of wellness and good health.

We live only in one body and vaginal discharge is deemed so private that it falls into the special category of subjective experience yet it is also universal, for at least 51% of the world population have it, not dissimilar to pregnancy, birth and miscarriage. Although many women experiences these changes, each experience this marker of well-being as hers and hers alone. After thousands of pelvic exams, women’s health providers are in a unique position to illuminate and extol this special substance. As providers, we should be here to reassure and confirm that indeed you are a normal human being.

Never has any patient said “my discharge is just perfect”, and yet for most of our lives it is just that.

The metaphor for it would be “essential” — for life itself.