Vaginal Discharge 101: What is “normal?”

This post was updated on August 7, 2017

Your vagina has a dynamic and finely tuned ecosystem. It includes a specific balance of bacteria, pH and moisture. This balance is sensitive to changes, from within and outside your body, and it doesn’t always take much to throw it “off.”

It’s normal to notice different types of fluid throughout your cycle — fluid changes cyclically along with your hormones, in appearance, consistency and volume. It also changes when you’re aroused and during and after pregnancy. But significant or sudden changes in the smell, color or consistency of your fluid might mean something else is going on, like an infection that needs treatment. Tracking “atypical” fluid in Clue provides a record of symptoms to give to your healthcare provider, including when the changes began, and which other factors may be related (like unprotected sex or starting a new birth control method).

It’s important to familiarize yourself with your own, unique discharge “norm” — in terms of smell, color, and changes throughout the cycle.

What’s considered “normal”*:

Color and consistency: At the beginning of the cycle, discharge tends to be more dry/sticky. It becomes creamy and whitish in the mid-to-late follicular phase (the first phase of your cycle). Just before and around ovulation, it’s likely to become similar to stretchy, wet, transparent egg white. Shortly after ovulation it usually changes back to dry/sticky. Read more about these changes here. Fluid can look white or slightly yellowish and paste-like on your underwear when it dries.

Volume: Most people will notice their discharge increases throughout the first phase of their cycle, with the most discharge being produced in the days before and including ovulation. Fluid volume then decreases in the day or two after ovulation, which normally lasts until the end of the cycle. You’ll probably also notice your vagina produces more fluid when you’re aroused.

Smell: Normal discharge can be odorless or have a smell, but it’s usually mild and not unpleasant. It might mix with some urine, or blood around the time of menstruation, which can influence how it smells or your underwear. Getting to know your typical smell is most important for identifying when something changes.

*The use of hormonal birth control will stop/change the typical cycling patterns of vaginal discharge.

What exactly is “atypical?”

Noticing changes in:

Consistency: Fluid becomes unusually thinner, or thicker and more textured

Color: Grayish, greenish, yellowish, brownish

Volume: Significant and unexpected in volume, often with other symptoms

Smell: Fishy, metallic or just different

What causes abnormal discharge?

Abnormal discharge can happen when the vagina’s microbial community gets out of balance. This means there is a decrease in the amount of “good” microbes and an increase in “bad” microbes (or an overgrowth of something that’s usually only present in small numbers). Such imbalances can lead to conditions like bacterial vaginosis (aka BV — the most common cause of abnormal discharge) and yeast infections (vulvovaginal candidiasis)(1).

Factors that may disrupt your vaginal ecosystem include: douching and cleansing practices, sexual activity, having a new sexual partner, hormonal birth control, prolonged or irregular bleeding/spotting, use of antibiotics or steroids, certain medications, life stages (menarche, menopause, pregnancy), hormonal changes, diabetes, generally having less vaginal Lactobacillus bacteria, and possibly smoking and diet (but more research is needed) (2–6).

Abnormal discharge can also be caused by sexually transmitted infections (STIs). The most common curable STI is trichomonas vaginalis, a parasite. Other common ones are include chlamydia and gonorrhea. Keep in mind these STIs are often asymptomatic (have no apparent symptoms), which is why testing is so important.

Rarely, abnormal discharge can be a sign of something more serious, like cervical cancer. Be sure to get your PAP tests at the recommended intervals (the CDC recommends testing every 3 years from ages 21–65 if your results are regular, or up to every 5 years if you are co-testing for HPV).

What should I do?

Yeast infections: If you suspect you have a yeast infection, you might try an over-the-counter treatment first. These usually come in the form of a vaginal pill/suppository or cream. If symptoms don’t go away after about a week, or if you have recurrent infections, see your healthcare provider. Yeast infections are usually not harmful, but you’ll want to be sure you don’t have something else if your symptoms don’t resolve. The application of a cold press can help to relieve itching. Note that treatments for yeast infections can weaken latex condoms and diaphragms (7).

For other symptoms, visit your healthcare provider for a test. They will look at your vulva and vagina and take a sample (swab) to be checked under a microscope, or sent for a lab test. They may also test the pH of your vagina with a simple pH-strip test.

BV may go away on its own, but will often recur, so it’s a good idea to talk to your healthcare provider about treatment. BV can create uncomfortable symptoms, and can increase the risk of contracting an STI, but it doesn’t usually lead to health complications. In some cases, though, untreated BV can lead to pelvic inflammatory disease, infection after gynecologic surgery, and pregnancy complications including miscarriage and preterm birth (8–10).

The treatment of BV or an STI like trichomonas, chlamydia and gonorrhea is usually quite simple, and may involve putting a pill or cream into your vagina for one or more days, and/or taking oral medications (ones you swallow) (7). For other causes of abnormal discharge, including other STIs, or STIs that have been left untreated and have become more complicated, more intervention may be needed. Note that many STIs do not cause symptoms, or they remain asymptomatic for a long time. This doesn’t mean they don’t need to be treated as soon as possible. Regular STI testing is crucial if you have new sexual partners.

There is mixed evidence on the use of certain foods and supplements (like yoghurt and Lactobacillus probiotics) for restoring and/or maintaining the balance of healthy vaginal bacteria. There isn’t enough evidence to include it in formal treatment recommendations, although there may be some benefit for certain people. More research is needed (7, 11). If you have symptoms like itching and/or odor, you might be tempted to douche for relief. Resist the urge! Douching and cleansing will not help — and are likely to make things worse (12).

Keeping your vagina healthy

For prevention, keep your vagina as healthy as possible: don’t douche, keep foaming and scented soap away from your vulva (or soap altogether), and be extremely diligent about using protection with new and untested sexual partners. Use a fresh barrier tool (like a condom) if switching from anal to vaginal activity during sex . A healthy vaginal environment will make you less likely to contract an STI, and help you avoid uncomfortable symptoms and potential health complications.

Did you know? You may be more prone to getting an STI during your luteal phase (the second part of your cycle, after ovulation), when your immune system may not be as strong (13). This happens as your body creates a environment that makes getting pregnant most possible, in which an egg can be fertilized and implant in your uterus, without your immune system getting in the way.

Download Clue today to start tracking changes in your discharge.

References

1. Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG: An International Journal of Obstetrics & Gynaecology. 2001 May 1;108(5):439–50.
2. Farage MA, Miller KW, Sobel JD. Dynamics of the vaginal ecosystem — hormonal influences. Infectious Diseases: Research and Treatment. 2010 Jan 1;3:1.
3. Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu KF, Goldenberg RL, Klebanoff MA. Dietary intake of selected nutrients affects bacterial vaginosis in women. The Journal of nutrition. 2007 Sep 1;137(9):2128–33.
4. Cherpes TL, Hillier SL, Meyn LA, Busch JL, Krohn MA. A delicate balance: risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology. Sexually transmitted diseases. 2008 Jan 1;35(1):78–83.
5. Madden T, Grentzer JM, Secura GM, Allsworth JE, Peipert JF. Risk of bacterial vaginosis in users of the intrauterine device: a longitudinal study. Sexually transmitted diseases. 2012 Mar;39(3):217.
6. Cherpes TL, Hillier SL, Meyn LA, Busch JL, Krohn MA. A delicate balance: risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology. Sexually transmitted diseases. 2008 Jan 1;35(1):78–83.
7. Workowski KA, Berman SM. Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Clinical infectious diseases. 2011 Dec 15;53(suppl 3):S59–63.
8. Donders GG, Van Bulck B, Caudron J, Londers L, Vereecken A, Spitz B. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. American journal of obstetrics and gynecology. 2000 Aug 31;183(2):431–7.
9. Fethers KA, Fairley CK, Hocking JS, Gurrin LC, Bradshaw CS. Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clinical Infectious Diseases. 2008 Dec 1;47(11):1426–35.
10. Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P. Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. American journal of obstetrics and gynecology. 2003 Jul 31;189(1):139–47.
11. Homayouni A, Bastani P, Ziyadi S, Mohammad-Alizadeh-Charandabi S, Ghalibaf M, Mortazavian AM, Mehrabany EV. Effects of probiotics on the recurrence of bacterial vaginosis: a review. Journal of lower genital tract disease. 2014 Jan 1;18(1):79–86.
12. Allsworth JE, Peipert JF. Prevalence of bacterial vaginosis: 2001–2004 national health and nutrition examination survey data. Obstetrics & Gynecology. 2007 Jan 1;109(1):114–20.
13. Wira CR, Rodriguez-Garcia M, Patel MV. The role of sex hormones in immune protection of the female reproductive tract. Nature reviews Immunology. 2015 Apr 1;15(4):217–30.