What does your vaginal discharge tell you?

Vaginal discharge consists of fluid from the uterus, cervix, and vagina. Vaginal discharge, like your menstrual blood, is completely normal and varies in consistency (thick, watery, sticky, etc.), colour, and volume under hormonal influences – where you are in your menstrual cycle, pregnancy, hormonal contraceptive methods/therapy, perimenopause, or menopause.

Your vagina has a lot of micro-organisms (“microbes”) that naturally reside in it and these include bacteria and fungi. These are your good ‘germs’, your besties (well, only if you take care of them!) because they are there to protect you by creating an acidic environment. One important group of bacteria that carry out this function is lactobacillus. This acidity is maintained mainly to:

- Protect against infection. The acidic environment makes it impossible for the real germs to latch on your vagina and cause infections. The reason many, if not all, doctors advise against douching “washing or cleaning out the insides of the vagina with water or other mixtures of fluids” is that it disrupts this natural acidity and predisposes you to infections.

- Create a hostile environment for sperm, making it very difficult for fertilisation to occur.

Vaginal discharge also acts as proof that your vagina is cleaning itself, be it removing sperm, dead cells, or foreign objects. The production of discharge usually starts a few months before a girl’s first menstrual period and generally subsides when a woman reaches menopause. This is due to the effects of oestrogen and progesterone levels in the body, hence the quality and quantity of the discharge changes throughout your menstrual cycle.

What does normal vaginal discharge look like?

A clear/transparent or white fluid, which may be thick or watery, is normal if it is not associated with vaginal irritation, a foul odour, pain, or other discomforts. Normal vaginal discharge can fill up a teaspoon (up to 4ml) a day, except during ovulation. However, we do not have the time and patience to measure our discharges daily so it’s best to know how much is too much for you by being familiar with your cycle.

What are the normal cyclic changes?

At the very end of your period. A brownish discharge represents old blood and it marks the end of your period. This is commonly referred to as “spotting” and may occur in early pregnancy.

Days immediately after your period. Oestrogen levels are rising during this time and women may notice little to no discharge. Vaginal “dryness” is usually reported.

Days approaching ovulation. The rising oestrogen levels cause the cervix to start producing a lot more fluid. The discharge might be white or cloudy, thick, and sticky at first, then change to a more watery and sticky consistency. Of note, during this time you may even notice a yellow discolouration, especially if the discharge dries on your underwear.

Ovulation. Oestrogen levels start to peak around 1-2 days before ovulation. These are the wettest days of your cycle. The discharge is a lot more and the cervical fluid is often described as resembling a raw eggwhite because of its clear and stretchy appearance. Because copious amounts of discharge are produced during this time, you may want to put on unscented pantyliners and change them throughout the day because too much moisture may irritate your vulva.

Days after ovulation and before your period starts again. Soon after ovulation, high progesterone (the dominant hormone during the second half of the menstrual cycle) levels cause the discharge to thicken and lessen, if present at all.

(Adapted from Monistat and Helloclue)

Why does cervical fluid change consistency?

Remember, the cervical fluid is a component of vaginal discharge and it shouldn’t be mistaken with arousal or lubricating fluid secreted by glands close to the vaginal opening. Anyway, on your non-fertile days, the cervical fluid is very thick and forms a mucous plug on the opening of the cervix (for the purpose of this post, we’ll describe the cervix as a division between the vaginal canal and uterus). This plug prevents entry of sperm, for obvious reasons, and also protects the upper female reproductive system (uterus, fallopian tubes, and ovaries) from ascending infections; infections that have traveled up the vagina. The vagina becomes noticeably drier.

On your most fertile days, cervical fluid becomes slippery and thin, like egg white. This change in consistency was specifically designed for procreation as it protects the sperm from the acidic environment of the vagina. It also nourishes the sperm and makes structural changes to facilitate fertilisation. Well, it’s also the wettest days in your cycle so sex is so much sweeter! You are, however, also vulnerable to getting an ascending infection during this time because the protective mucous plug is no longer there.

After ovulation, your body assumes that fertilisation has occurred and the rise in progesterone levels form the mucous plug again, preventing sperm entry.

When should you worry about vaginal discharge?

Infections particularly cause abnormal changes in vaginal discharge. Here are some things you can look out for:

- Increase in volume (more than your normal).

- Foul-smelling discharge (normal discharge isn’t odourless, however, there will be a very strong, insulting, and distinct smell when you have an infection).

- Yellow-green discharge, or any other abnormal colour changes.

- Discharge (which may have a normal appearance) associated with itchiness, lower abdominal pain (almost resembling period pains), burning or difficulty urinating, sores, or other discomforts.

- A clumpy or cottage cheese-like discharge.

It is important to get checked as soon as you show symptoms, sometimes unusual lower abdominal pain may present without discharge and may be worsened by sexual intercourse. This could be a symptom of Pelvic Inflammatory Disease (PID) which is caused by infection of the upper female reproductive system (uterus, fallopian tubes, and/or ovaries). The biggest culprits of this STD are chlamydia and gonorrhoea. Careful evaluation and prompt treatment are required because one of the complications of PID is infertility.

With this information, I hope you start keeping a diary or mental note of your normal discharge so that you know when to ring your doctor. As always, thank you so much for choosing to learn with me. Don’t forget to click on the heart, leave a comment, and subscribe below. Stay safe and enjoy the rest of your weekend.