Vaginal Discharge – Top Questions answered by a doctor
“Leucorrhoea” or in simple terms vaginal discharge is one of common presentation in family physician clinic. As a doctor, I see patients with vaginal discharge regularly and most of them don’t even need treatment.
In many cultures, it is not considered normal to discuss vaginal secretion which is understandable but this leaves women with many unanswered questions. Today I am going to break myths and tackle this taboo topic. I am going to provide you with answers to those questions which women hardly ask.
1. I am having vaginal discharge, is it normal?
Yes, of course, it is. Every woman of reproductive age has vaginal secretions which are normal. Vaginal discharge changes during a normal menstrual cycle.
- From start of cycle till ovulation (can be around 14-21 from first day of menstruation), female hormone oestrogen is high which makes vaginal secretions thick, sticky and slightly white.
- At the time of ovulation, it becomes clearer, wetter, stretchy and slippery.
- After ovulation, it becomes thick and sticky again.
2. I have heard about vaginal ph? Is there anything like that?
- Yes, it is, the vagina has a normal ph of 4.5 which is due to Lactobacillus (commensal bacteria of the vagina). Vagina has some other bacteria in it as well. All these are important to maintain normal flora of the vagina and to prevent infection. Changes in vaginal pH can be responsible for infections such as thrush.
3. What are the signs of abnormal vaginal discharge?
Normal vaginal discharge hardly has any smell. Any strong smell can be a sign of infective or non-infective cause, which needs an evaluation from a doctor.
Vaginal discharge is normally clear or can have a slight tinge of whitish colour. But if it has any colour such as curdy white, green, yellow or blood-tinged then you should see your doctor to rule out any infection or other causes of abnormal discharge.
if you have itching, discomfort or lower abdominal pain then these can be signs of abnormal vaginal discharge.
4. What are the causes of abnormal vaginal discharge?
such as thrush, bacterial vaginosis or sexually transmitted illness
such as a forgotten tampon or even polyp or growth in cervix, vagina or uterus.
5. What should I expect at the doctor clinic if I attend with vaginal discharge?
- Your doctor will take a thorough history to begin with. This can include detailed sexual history. An honest and open answer is important as it is crucial to rule out serious or sinister infections.
- Your doctor can also consider doing internal examination depending upon on your history. The doctor can take some swabs (collection of secretions from long cotton bud like instrument) to send for tests if needed.
- You should expect the details of the examination and also investigations before the doctor can proceed with it, as your informed consent is crucial. Last but not least you deserve respect, privacy, and confidentiality at your doctor clinic.
6. I clean my vaginal regularly, is that ok?
- Cleaning of the vagina is not required as the vagina is a self-cleaning organ. If by cleaning mean, outer skin which is called vulva then it’s fine. You can wash that area with water or sometimes with simple soap. But washing the vagina from inside can lead to more problems rather than helping. It can disturb the pH of the vagina which can cause thrush or bacterial vaginosis. Vaginal douching is not recommended by doctors. Few women use scented products or glittery stuff in the vagina, this can cause infections and sometimes can lead to long term issues.
7. I have vaginal dryness? What should I do?
- Pain during or after sex
- Repeated urinary tract or bladder infection
- If you need to pee more often
- Itch or soreness in vagina
- Hormonal: such as menopause, breastfeeding, medication ( contraceptive pills or anti-depressant etc), hysterectomy, chemotherapy
- Non- Hormonal causes: Poor arousal during sex, vaginal douching, cleaning with soap, using perfumes or scented products, or underlying conditions such as diabetes etc
- Use water-based lubricants before sex
- Use a vaginal moisturizer after discussion with your doctor.
- Use un-perfumed soap or washes to wash around the vagina
8. What are the top tips to manage normal secretions?
- Use simple cotton underwears for routine use.
- Do not wash the vagina from inside with any soap.
- Do not use any material inside the vagina unless recommended by your doctor.
- Change your tampon or pads regularly during periods.
- Wash with clean lukewarm water after intercourse
- Use simple panty liners if you have slightly heavy secretions.
- Don’t use petroleum jelly inside the vagina in case of vaginal dryness, as it can lead to infections
- Use moisturizer and lubricants in the vagina which are made for it and better to use only after consulting your doctor
- If any concern then see your family doctor. You can search for a physician through doctors list from here.
Author Dr. Farah Ansari completed her MRCGP in 2013. She was a lead GP in 02 main practices in Glasgow and was cluster lead for Bridgeton cluster in Glasgow. Read Here more about her.