Symptoms of Abnormal vaginal discharge

Abnormal vaginal discharge is marked by change in color, consistency, volume, and/or odor. Other symptoms that might accompany abnormal vaginal discharge are:

• Itching or irritation in vaginal area
• Pain or discomfort in pelvic area
• Redness around the vaginal opening
• Strong foul smell from discharge
• Burning sensation or pain while urinating
• Spotting after sexual intercourse 
• Pain during or after sexual intercourse
• Flu-like symptoms including headache and fever
• Fatigue or tiredness
• Unexplained weight loss
• Lower back pain
• Constipation

Types of Vaginal Discharge

Vaginal discharge is broadly divided into:

I. Normal (Physiological) vaginal discharge

Vaginal discharge is a natural and normal process that helps to keep your reproductive tract clean, lubricated and healthy, warding off any infection. 

The amount, color and consistency of normal vaginal discharge can vary from person to person and where you are in your menstrual cycle:

• Days 1–5: During your period or menstruation, the discharge is red and bloody.

• Days 6–14: Following a period, vaginal discharge is mostly white or slightly yellow, and sticky.

• Days 14–25: A few days before ovulation, the discharge becomes clear, thin, slippery and stretchy, similar to the consistency of egg whites. After ovulation, the discharge goes back to being white or light yellow, and sticky.

• Days 25–28: The amount of discharge reduces before the next period.

II. Inflammatory vaginal discharge

This type of leucorrhoea occurs when there is inflammation (redness and swelling) in the vagina caused by microbes.

Various types of vaginal discharge vary in color, amount, consistency, and smell. Some are normal, while others are an indication of an infection that warrants consultation with a doctor. Here you can get an idea of what different discharge can mean:

1. Clear to whitish

Watery, clear to whitish vaginal discharge is normal. It usually becomes more slippery and has the consistency of egg whites during ovulation. The amount and thickness of vaginal discharge can also increase during sexual arousal, pregnancy and the use of oral contraceptives.

2. White to cream or light yellow

White to cream or light yellow discharge is mostly a sign of healthy lubrication. However, if the white discharge has a frothy consistency like cottage cheese and is accompanied by a strong smell, it may indicate a yeast/fungal/candida infection, which can also cause severe itching or irritation.

3. Red 

Red discharge occurs during a period or menstruation. However, if bleeding occurs between menstrual periods or after menopause you should consult a doctor on priority.

4. Pinkish to light brown

Pink to light brown discharge mostly occurs as spotting before a period. It can also be a sign of implantation bleeding during early pregnancy. Some pink discharge can be seen after sex if intercourse has caused tears or irritation in the vagina or cervix.

6. Yellow to green

While light yellow discharge may not indicate any illness, darker yellow to green discharge could indicate sexually transmitted infections. Sometimes, the discharge may smell fishy accompanied by itching or burning in or around the vagina.

7. Gray

When you have a gray color discharge with symptoms like pain in the pelvic region or pain while peeing and discomfort or itching around the genital area, it could be a sign of infection called bacterial vaginosis.

Causes of Abnormal Vaginal Discharge

1. Bacterial vaginosis

It is a common bacterial infection that occurs when the balance of bacteria in the vagina is altered. It can cause a grayish discharge accompanied by an intense fishy odor. It may also cause itching, redness, and swelling of the entire vaginal area. 

Women who have several sex partners, or those who use a contraceptive intrauterine device, such as copper-T, are more likely to get bacterial vaginosis.

2. Candidiasis or yeast (fungal) infection

A vaginal infection that is caused by a yeast known as candida is called candidiasis. It is commonly seen in women who are taking contraceptive pills or certain antibiotics, or have conditions, such as diabetes and weakened immunity. The main symptoms are intense itching along with a thick white discharge that appears like cottage cheese. 

3. Trichomoniasis

This vaginal infection is caused by the protozoa trichomonas vaginalis. It can cause a greenish-yellow, sometimes frothy, discharge and pain during urination. This infection is usually transmitted through unprotected sex.

4. Gonorrhea and chlamydia

These are sexually transmitted infections that produce abnormal discharges by affecting the cervix. Women may experience greenish or cloudy discharge, bleeding during or after sex, and abdominal pain.

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Risk Factors of Vaginal Discharge

1. Non-infectious causes

• Puberty 
• Menstrual cycle 
• Ovulation
• Sexual arousal
• Pregnancy
• Menopause
• Contraceptive device or birth control pills

2. Infectious causes

• Poor feminine hygiene like not changing pads/tampons regularly
• Douching, use of chemical or perfumed soaps
• Weakened immune system
• Uncontrolled diabetes
• Certain medications, such as steroids or antibiotics
• Unprotected sex with an infected partner
• History of STDs like gonorrhea, trichomoniasis, and syphilis in the past
• Use of public or unclean toilets
• Low socio-economic status

Diagnosis of Abnormal Vaginal Discharge

Not every vaginal discharge is alarming but if you experience any unusual discharge marked by change in color, consistency, volume, and/or odor, see a doctor on priority. Diagnosis includes:

1. Medical history 

Your doctor may ask you about your medical history including the medicines you've been taking during the past few weeks. The doctor will also discuss your symptoms, the severity of the symptoms, and the time duration of symptoms.

2. Physical examination

Your doctor will perform a pelvic exam to look for the type of vaginal discharge. A sample of discharge might be taken for relevant testing.

3. Laboratory tests

• Examination of vaginal fluid: The vaginal discharge is placed under a microscope to determine the type of bacteria, yeast, or protozoa causing the vaginal infection. Identifying the cause helps the doctor prescribe targeted treatment.
  
  
• Absolute leukocyte count: Also known as WBC count, it also helps examine the vaginal fluid for white blood cells (WBCs), an indicator of any infection. 
  
  
• Genital PAP smear: Your doctor may perform a Pap smear by taking a sample of the cells from the cervix. The sample is then sent to the lab to be examined under the microscope for any cell changes.
  

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• Molecular tests: Sometimes specific tests are required for the diagnosis of STDs causing abnormal vaginal discharge. The standard test is the nucleic acid amplification test (NAAT), and it is generally used for the diagnosis of gonorrhea and chlamydia. This method detects and identifies the genetic materials of bacteria and other pathogens. 

Prevention of Abnormal Vaginal Discharge

1. Maintain personal hygiene

• Keep your private parts clean using lukewarm water. 
• Always pat the private parts dry after urinating using toilet paper or a soft cloth.
• Wipe the right way. Always make sure to clean your private parts from front to back, and not from back to front.
• Avoid harsh soaps, scented feminine hygiene products, douching and bubble baths. These can rob the vagina of good bacteria, leading to the overgrowth of bad bacteria.
• Make a habit of washing and drying your hands before touching the vaginal area.

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2. Be mindful of your sanitary products

• If you are prone to vaginal infections, avoid using scented tampons and menstrual cups. Prefer sanitary pads and liners.
• During your period, changing your pad every 3-4 hours is good hygiene and prevents bad odors.
• If you use panty liners, make sure to change them regularly. 

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3. Pay attention to your clothing

• Wear cotton or cotton-lined undergarments as they absorb moisture and prevent sweat accumulation.
• Wear loose-fitting leggings, tights, and pants. They help in free flow of air.
• Avoid sitting around in damp or sweaty clothing as it can lead to vaginal and skin infections.
• Change your workout clothes immediately after exercising.
• Clean your underwear with a good quality detergent that has bactericidal and fungicidal properties.
  

4. Practice safe sex

• Safe sexual practices are paramount to reduce the risk of sexually transmitted infections (STIs) and vaginal infections.

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• Always urinate and gently wash the area around your vagina every time after indulging in sex.

5. Maintain a healthy lifestyle

• Drink at least 8 glasses of water every day to wash out the toxic substances from the body.
• Eat a well-balanced wholesome diet rich in fresh fruits and vegetables, whole grains, healthy fats, and protein.
• Limit sugar, processed, and packaged foods in your diet.
• Exercise regularly and get enough sleep.
• Learn to manage your stress effectively.
• Limit the consumption of alcohol 
• Quit smoking.

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Specialist To Visit

Doctors that can help with the diagnosis and treatment of vaginal discharge include:

• General physician
• Gynecologist 

A general physician can evaluate the symptoms of vaginal infection and start the treatment. They can refer to a specialist for further assessment. A gynecologist is a specialist in diagnosing and treating diseases that affect the female reproductive system.

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Treatment of Abnormal Vaginal Discharge

Treatment of abnormal vaginal discharge depends on the severity of the symptoms, age, and other factors, such as the underlying causes. It may be caused by STDs; therefore, treating the causative agent is important to stop its recurrence. Management includes:

I. Medications

1. For bacterial infections: If bacterial vaginosis is causing vaginal discharge, the following antibiotics are usually prescribed for its management: 

• Metronidazole
• Clindamycin
• Ceftriaxone 
• Doxycycline 
• Azithromycin 
• Ofloxacin
• Gemifloxacin
• Gentamicin
  

2. For fungal infections: In case of vaginal yeast infections, antifungal medicines are prescribed, such as:

• Miconazole
• Terconazole
• Fluconazole
  
  

3. For protozoa infection: For protozoa infections, such as trichomoniasis, the doctor may prescribe drugs like:

• Tinidazole
• Metronidazole

Note: These medicines are available in the form of creams, ointments, or tablets. The doctor may instruct you on the route of administration of the medicine which depends on the severity and prolongation of the abnormal vaginal discharge.

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Home care for Vaginal Discharge

The following home remedies help in improving the vaginal microbiome and can be an adjunct to conventional treatment:

• Lady Finger (Bhindi): You can boil the ladyfingers in water or use them as the main ingredient of your soup. You can also soak ladyfingers with yogurt which is a natural probiotic. Consumption of this mixture will inhibit the growth of bacteria in the vaginal area.
  
  
• Coriander seeds (Dhania): Soak a teaspoon of coriander seeds in water for the whole night and strain it the next morning. Drink this solution early in the morning on an empty stomach to help relieve vaginal discharge.
  
  
• Yogurt (Dahi): Yogurt is rich in probiotics. Having yogurt in your daily meals can improve the gut microbiome and helps reduce vaginal infections.
  
  
• Basil (Tulsi): It is a wonderful herb with many antimicrobial, anti-inflammatory, and anti-allergic properties. You can prepare tulsi tea by boiling a few leaves with a glass of water. Drink this twice daily as it will help to relieve the symptoms of vaginal discharge.
  
  
• Indian gooseberry (Amla): Amla is rich in vitamin C and has antioxidant, anti-inflammatory and antibiotic properties. Consuming amla or its juice enhances immunity. For the treatment of vaginal discharge, take one teaspoonful of amla powder with a glass of water once daily. 
  
  
• Aloe vera: Aloe vera has multiple medicinal uses. Its consumption is useful for managing excessive discharge, itching, and burning sensation. 
  
• Fenugreek (Methi): Consuming the fenugreek seeds decoction or one teaspoonful with a glass of water balances the pH level in the vagina.
  
  
• Cumin (Jeera): Cumin seeds decoction is beneficial in reducing itching and  discharge.

Complications of Abnormal Vaginal Discharge

Abnormal white discharge is a sign of vaginal infections. These vaginal infections can cause several complications such as: 

1. Pelvic inflammatory disease (PID): Vaginal infections due to bacteria, yeast, virus, or STDs can spread from the vagina to other reproductive organs of females, such as the fallopian tubes, ovaries, & uterus.
The symptoms of PID include chills, fatigue, fever, & abdominal pain, and can lead to reproductive complications, such as: 

•  Dysmenorrhea (painful periods)
•  Chronic pelvic pain
•  Internal abscesses (collection of pus due to infection)
•  Endometritis (inflammation and infection of the uterus)
•  Ectopic pregnancy (attachment of the egg outside the uterus)

2. Infertility: If untreated for a long time, abnormal discharge may affect the chances of a woman getting pregnant.

Alternative Therapies of Abnormal Vaginal Discharge

Alternative therapies can provide relief to a certain extent, however, always seek advice from your doctor before trying these. Some of the complementary therapies that have proven to be beneficial include: 

1. Essential oils

Essential oils like tea tree oil and lavender oil have antibacterial and antifungal effects and have shown promise in the management of vaginal discharge caused by yeast or fungi.

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2. Traditional Chinese medicine

A traditional chinese medicine expert will prescribe chinese oral medicines depending on the severity of the disease for correcting the body’s imbalances. Studies have shown that TCM can be effective in treating excessive vaginal discharge or itching.

Living With Vaginal Discharge

Clear to white light yellow vaginal discharge is normal but its color, texture, and quantity can differ from person to person depending on their age. However, consult your doctor if you feel that it's abnormal and you are getting a heavy discharge frequently with changes in odor, color, and texture.

Though abnormal vaginal discharge can be managed with medications depending on the cause, a few important points to be kept in mind are:

• During heavy discharge, use panty liners as they are meant to be used during non-period days.
• Keep changing your pad at least every 4 to 8 hours during periods.
• Regular health checkup is important to evaluate the presence of any infection and whether the female is receiving the right treatment which helps in clearing the infection or not.
• Hormonal changes due to puberty, pregnancy, and menopause can cause heavy vaginal discharges. Always inform or discuss any changes you experienced while or before the treatment with your doctor.
• Routine test to evaluate blood sugar level is required in case of yeast infection, as yeast overgrows in elevated sugar levels.
  

Watch our expert discuss vaginal discharge in detail.