What is Abnormal Vaginal Discharge?

Women normally secrete fluids made by glands inside the vagina and cervix which function to carry away dead cells and bacteria, keeping the vagina clean and free from infection. The amount of vaginal discharge can vary, and the color can range from clear to a milky white, depending on the period in her menstrual cycle, whether is pregnant or breastfeeding, or if she is just sexually aroused.

Vaginal discharge may be considered abnormal if the character such as color and odor change, and if it is accompanied by other symptoms like intense itching, burning pain, fever and other local skin changes. The discharge may be white and appear cheesy, or yellowish, green, brown or bloody. It may be accompanied by an offensive, fishy odor that does not improve by just washing.

Factors that Cause Abnormal Vaginal Discharge

There are many factors that may influence changes in the normal balance of bacteria in the vagina which leads to abnormal vaginal secretion. These include:

  1. Use of steroids, antibiotics, birth control pills -usually associated with yeast infection
  2. Diabetes - high blood sugar levels encourage growth of yeast in the vagina
  3. Pelvic infection after surgery
  4. Pelvic inflammatory diseases -usually associated with gonorrhea
  5. Cancer of the uterus, cervix or vagina
  6. Vaginal atrophy - drying and thinning of the vaginal walls, common in menopausal women
  7. Vaginitis - a local inflammation around the vagina
  8. Bacterial vaginosis - infection which is common in pregnant women and those with multiple sexual partners
  9. Rectovaginal or vesicovaginal fistula - an abnormal canal links the rectum (large intestine) or the urinary bladder with the vagina, where the fluids are secreted
  10. Sexually transmitted diseases (STD) - like gonorrhea, Chlamydia, Trichomoniasis
  11. Non-STD infections - like yeast infection (Candidiasis)
  12. Lowered resistance due to HIV or other medical conditions - may cause yeast infection

The following table may help in distinguishing the possible cause of abnormal vaginal discharge.

Character of Abnormal Discharge and Possible Causes

Character of Discharge

Possible Causes

Other Symptoms

Bloody or brown

Irregular menstrual cycles Cancer of the cervix or uterus

Abnormal vaginal bleeding, pelvic pain

Clear or white, no odor

Vaginitis Vaginal atrophy

Itchiness, or no other symptoms

Uncharacteristic discharge

Chlamydia

No other symptoms, but vaginal bleeding can also occur

Discharge similar to feces or urine

Rectovaginal fistula or vesicovaginal fistula

No other symptoms

Cloudy or yellow

Gonorrhea Pelvic Inflammatory Disease

Bleeding between periods, urinary incontinence, abdominal pain, fever

Grayish, yellow or greenish with a bad smell; appears frothy

Trichomoniasis

Pain and itchiness while urinating

Thick, white, looks like cottage cheese

Yeast infection (Candidiasis)

Swelling, itchiness and pain around the vulva; pain during sexual intercourse

White, gray, or yellow with fishy smell

Bacterial vaginosis

Itchiness, burning pain, redness

How Abnormal Vaginal Discharge is Diagnosed

In general, symptoms that should prompt you to see a doctor about an abnormal vaginal discharge include:

  • Change in the character of discharge, such as color, odor and thickness
  • Intense itching, burning pain around the vagina
  • Pain on urination or sexual intercourse
  • Abnormal vaginal bleeding
  • Fever
  • Lower abdominal or pelvic pain

To diagnose the cause, a doctor will ask you about your symptoms and other relevant questions in your medical history. He/she will then conduct a physical examination which will include a pelvic exam and possibly, a Pap smear. A sample of the discharge may be taken during the pelvic exam and this will be sent to the laboratory for microscopic examination. This will help identify the definite cause of your abnormal vaginal discharge and other symptoms.

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