What Is It?

Normally, vaginal discharge is clear or white. It may become stretchy and slippery during ovulation, about two weeks after your menstrual period. A change in the color or amount of discharge, accompanied by other symptoms, may indicate that you have an infection.

The vagina normally contains bacteria. Bacterial growth is controlled and affected by many different factors, such as acid level (pH) and hormones. Anything that upsets this balance may increase your risk of infection or overgrowth of any of the normal bacteria or by yeast. Possible triggers include:

• Antibiotic use
• Birth-control pills
• Douching
• Diabetes
• Pregnancy
• Stress
• Tight or synthetic undergarments

Vaginal discharge may result from infection with:

• Yeast, also called Candida, a type of fungi that is part of the normal flora of human skin but can also cause infections
• Gardnerella, a type of bacteria found normally in the female genital tract that is the cause of bacterial vaginosis
• Trichomonas, a type of protozoa, an organism made up of one cell

Sexually transmitted diseases such as gonorrhea or chlamydia also can cause vaginal discharge. Other noninfectious possible causes include atrophic vaginitis (inflammation of the vagina, which usually occurs following menopause), diabetes (commonly associated with recurrent yeast infections), or irritation from a scented product such as soap, douches, pads or tampons.

You may notice a change in the color, amount or odor of discharge. A white, curdlike discharge that looks like cottage cheese is a classic sign of yeast infection. Yellow, green or gray discharge is usually a sign of trichomonas or bacterial vaginosis. Bacterial vaginosis also is marked by an unusual, fishy odor.

Itching is usually most noticeable with a yeast infection, though it may occur with any type of infection or irritation. An irritated vaginal lining, which may be particularly itchy or painful during intercourse, is usually a more prominent symptom of atrophic vaginitis. A new vaginal discharge accompanied by fever, abdominal pain or pain with intercourse may indicate a sexually transmitted disease, such as gonorrhea or chlamydia. However, gonorrhea and chlamydia usually don’t cause any symptoms at all.

First, your health-care provider will ask you a variety of questions to help pinpoint the cause of discharge, including questions about recent antibiotic use, whether you have a new sexual partner, menopausal symptoms, diabetes symptoms and other recent changes in your health or lifestyle.

Your health-care provider will perform a pelvic exam using a device called a speculum to look at the cervix directly. During the pelvic exam, a sample of discharge is collected for testing in a laboratory. By looking at the discharge under a microscope in the office, your health-care provider can make the diagnosis of yeast infection, bacterial vaginosis or trichomonas infection right away and start treatment. Based on the appearance of the vaginal walls, your health-care provider may make a diagnosis of atrophic vaginitis

A manual exam is performed to detect tenderness of the cervix, uterus or ovaries. During this exam, the examiner places his or her fingers inside your vagina. Tenderness may indicate the presence of a sexually transmitted disease or pelvic inflammatory disease. Diagnosing gonorrhea or chlamydia requires the results of laboratory tests, which may take a few days.

Vaginal discharge from bacterial or yeast infections responds to treatment within a few days to a week. Sexually transmitted diseases also should respond to antibiotic treatment within a week. If infection progresses to pelvic inflammatory disease beyond the vaginal area, it may take longer to treat.

Atrophic vaginitis responds best to hormonal therapy with vaginal creams or hormone-replacement therapy by mouth. It usually takes a few weeks to go away. Mild symptoms may be relieved within a few days by vaginal water-based lubricants. If symptoms are caused by an irritant, identifying and removing the irritating factor should relieve symptoms within a week.

Working with your health-care provider, identify factors that may have led to infection, such as antibiotic use, wearing non-cotton underwear, wearing tight-fitting undergarments during exercise, using scented products that irritate the vaginal lining, or using birth-control pills. If you use birth-control pills, you may not need to stop to prevent recurrent infection. Changing the type or the strength of the hormone in the pill may be enough to stop hormones from returning.

If you are diabetic, controlling blood-sugar levels may help to avoid recurrent infections, especially yeast infections.

Infections are treated with antibiotics. Often just one dose of antibiotics by mouth is enough. Alternatively, you may use vaginal cream forms of antibiotics, especially if you have significant side effects from taking antibiotics by mouth. Also, the vaginal cream can be more soothing for the inflamed, sore vaginal lining. If you are diagnosed with bacterial vaginosis or trichomoniasis, you may be prescribed an antibiotic called metronidazole (Flagyl). If your doctor suspects you have a sexually transmitted disease based on your history and physical exam, your doctor may prescribe antibiotics administered by injection and by mouth in the office before the tests results can confirm the diagnosis.

If you have recurrent yeast infections and recognize the symptoms, you may use over-the-counter antifungal creams first without a prescription. If your symptoms do not improve, you should see your health-care provider for an exam to confirm the diagnosis and make a change in treatment.

Atrophic vaginitis (inflammation of the vagina) may develop with hormonal changes, for example, after pregnancy or while on birth-control pills. More commonly, it occurs during or after menopause. After menopause, hormone-replacement therapy may be administered by mouth or vaginally. Vaginal administration exposes you to lower levels of hormones. For mild cases, using a water-based lubricant may be enough. If you take birth-control pills, changing the type or strength of pill may help to get rid of atrophic vaginitis.

Sexual partners do not have to be treated unless you are diagnosed with a sexually transmitted disease, or you experience recurrent infections and no other factor is making you prone to infection. If your sexual partner experiences a new discharge or discomfort when urinating or during intercourse, he or she should be evaluated by a health-care provider.

If you had a previous yeast infection, and you have repeat symptoms that are similar, you can start treatment with an over-the-counter antifungal medication. If your symptoms don’t improve, make an appointment to see your health-care provider. See your health-care provider regarding any new discharge that does not improve when you stop using potential irritants to the vagina. If you develop abdominal pain or a fever with a new vaginal discharge, you should be seen by a health-care provider the same day.

Usually, the conditions that cause vaginal discharge respond to treatment within a few days. Atrophic vaginitis may take a few weeks to respond to hormone treatment because the vaginal layer takes time to strengthen. Occasionally, infections come back. Your health-care provider may determine a more effective course of treatment, suggest ways to self-treat at home or help you eliminate potential causes of infection.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.