The presence of white vaginal discharge in women is one of the norms, but some features of the consistency and smell should alert you and make you think about visiting a doctor.
Leucorrhoea is a liquid or slightly thick (gelatinous) secretion of a milky white or yellowish color, usually practically odorless. These secretions are a sign that the body has a natural defense against infectious diseases. Lactobacilli create an acidic environment in the vagina, in which pathogenic microbes are destroyed. The remains of dead microorganisms are removed along with mucus.
White vaginal discharge appears from puberty and is produced until menopause. In a healthy woman, they should not be too abundant, no more than a teaspoon (5 ml) per day (1).
In the middle of the cycle, during ovulation, a little more leucorrhoea is produced than usual; it thickens and stretches out, like a translucent thread. However, their color remains pure, without impurities.
Due to an infectious disease, injury or pathology of the genital organs, white vaginal discharge may change color and consistency, acquire an odor, and be accompanied by burning, itching, pain in the lower abdomen, acute discomfort during sexual intercourse and urination (1).
In case of inflammation or other diseases, white discharge immediately gives an “alarm signal”: the quantity changes – there are more of them. This indicates that lactobacilli are intensifying the fight against pathogenic microbes to suppress their activity and remove them from the body.
When determining the type of discharge and its relationship with a possible infection, gynecologists take into account:
- volume of discharge: during illness, it usually becomes abundant;
- are there any accompanying symptoms: itching, burning, discomfort during sexual intercourse and urination, pain in the lower abdomen;
- is there an unpleasant odor, as a result of which patients have to wash themselves more often;
- whether the color of the discharge changes – this can also help determine the potential causative agent of the disease.
Thick white discharge
Too much leucorrhoea, milky in color, with a thick viscous consistency, usually uterine. They can talk about endometrial diseases and tumors.
White curdled discharge
May be a sign of vaginal diseases. The most common among them is thrush, or candidal vaginitis. This is an infectious disease caused by fungi of the genus Candida.
Liquid white discharge
Abundant watery discharge (the kind that makes the laundry wet through) may indicate cancer, as well as sexually transmitted diseases: gonorrhea, chlamydia, trichomoniasis, etc. At first they do not have a strong odor, but later, if there is no treatment, a sharp unpleasant odor appears, foam, discharge may acquire a yellowish or even greenish tint.
White mucous discharge
Mucous, stretchy white discharge is a variant of the norm; it may increase slightly in the middle of the cycle during ovulation or before sexual contact, during periods of strong emotional arousal. But if the smell of mucus becomes pungent and resembles the smell of rotten fish, then a picture of bacterial vaginitis or sexually transmitted diseases cannot be ruled out.
White discharge streaked with blood
The milky tint of leucorrhoea during inflammatory diseases is sometimes supplemented by streaks of blood. They become bloody – pinkish and even brownish in color. If they last more than a few days, this may indicate diseases of the uterus or ovaries (cervical erosion, endometriosis, polyps and neoplasms of various etiologies, for example, cervical polyp or cervical cancer). While taking oral contraceptives, you may notice spotting of a darker, brown color (3).
When is white discharge considered normal?
White vaginal discharge is, one might say, “signal flags” of the female body. They show us that everything is in order, or, on the contrary, they “scream” about obvious trouble. If the color is neutral – just white without impurities, if there is no smell or suspicious inclusions, then there is no reason to worry.
Symptoms of pathological white discharge
In addition to color, there are other changes in the usual discharge that are important to track.
Itching
This symptom is usually not an independent phenomenon; most often it speaks of other diseases, mainly infectious and inflammatory. Itching may be accompanied by swelling and redness of the vaginal mucosa, skin irritation, burning, painful urination, and discomfort during sexual intercourse.
Smell
In a healthy body, vaginal discharge has no odor or is slightly sour due to the presence of lactic acid bacteria, so its appearance is a sign of disease. For example, you can recognize candidiasis by a white, cheesy discharge with an unpleasant odor. A strong odor occurs with sexually transmitted diseases: with bacterial vaginitis, the discharge takes on a fishy odor, a strong smell of pus is felt with gonorrhea and chlamydia.
Consistency
Leucorrhoea in healthy women can vary in consistency depending on the period of the menstrual cycle. At the beginning of the cycle, discharge is usually scanty. During the period of ovulation, they thicken a little and look like a stretching translucent thread. Before the onset of menstruation, in the second half of the cycle, the discharge becomes creamy. After sexual intercourse, leucorrhoea sometimes acquires a yellowish tint, and small clots may appear in it.
You should take a close look at pathological changes in the consistency of vaginal discharge. If they become denser against the background of nagging pain in the lower abdomen and low-grade body temperature, then genital tuberculosis cannot be ruled out. If they acquire a foamy structure, this may be a sign of infectious or inflammatory diseases of the genital organs. Curdled discharge indicates thrush.
Causes of pathological discharge in the intimate area
Imbalances in the balance of bacteria living in the vagina not only cause discomfort, but can also indicate illness.
Candidiasis, or thrush
This unpleasant disease can greatly reduce the quality of life. Fungi of the genus Candida usually exist quietly in the vagina for many years, without interfering in the life of its carrier and without betraying its presence in any way. Only in an extreme situation – such as an infectious disease, pregnancy , decreased immunity – do they begin to multiply uncontrollably, affecting not only the vaginal mucosa, but also the perineal area. The disease is characterized by redness of the skin of the labia majora and minora, itching in the perineum, irritation during urination and sexual intercourse.
Dysbacteriosis and the influence of pharmaceuticals
Dysbacteriosis is an infectious non-inflammatory disease in which in the vagina there is a sharp decrease in the number of lactic acid bacteria, which have protective properties, and an increase in the number of pathogenic microbes.
Dysbacteriosis does not always lead to bacterial vaginitis, but bacterial vaginitis is always a consequence of dysbiosis with the additional influence of provoking factors. Harmful aggressive microbes enter an unprotected weakened environment and irritate the vaginal mucosa.
A common cause of dysbiosis is uncontrolled long-term use of medications that reduce immunity and disrupt the flora in the vagina. This causes more profuse discharge with an unpleasant odor. In addition to medications, dysbacteriosis is provoked by surgical abortions, gynecological operations, birth injuries, and failure to comply with intimate hygiene rules.
Allergic reaction
Intense leucorrhoea sometimes occurs due to intolerance to the components in intimate hygiene products, shower gel or soap, or scented sanitary pads. It can also be triggered by wearing synthetic underwear, especially thongs that cut sharply into the crotch.
Diagnostics and tests
Any appointment with a gynecologist begins with the collection of complaints, anamnesis, and then an examination using mirrors and taking smears/cultures.
1. A gynecological examination is a study of the condition of the mucous membrane of the reproductive organs. The speculum examination is necessarily complemented by a bimanual vaginal gynecological examination (examination with palpation).
2. Endoscopic methods, or colposcopy . This is a study of the epithelium of the cervical mucosa to detect erosion and other changes.
3. Sonography, or ultrasound of the pelvic organs . This is a non-invasive method that reveals signs of inflammation of the uterus and appendages, and large tumors. However, it is not always possible to make an accurate diagnosis based on ultrasound results alone.
4. Laboratory tests . An analysis of vaginal microflora and bacteriological culture of discharge is recommended. If there is a curdled discharge with a strong acidic odor, the smear is examined under a microscope to detect candida fungi. If a tuberculosis infection is suspected, additional tests for mycobacteria are done (4).
In what cases is treatment needed?
If there is any suspicious change in the color, smell or consistency of the discharge, it is recommended not to postpone a visit to a gynecologist. You should not expect that everything will “go away on its own” or use dubious folk remedies. If treatment is not started on time, serious consequences can occur.
1. Inflammatory processes in the pelvic organs . They develop in the vagina (vaginitis, colpitis), cervix (cervicitis), mucous membrane of the uterine cavity (endometritis), fallopian tubes (salpingitis), pelvic peritoneum (pelvioperitonitis), ovaries (oophoritis). These diseases are accompanied by pain of various types – nagging, aching, acute, and in advanced cases – unbearable. Other symptoms are increased body temperature, weakness and fatigue, menstrual irregularities, and discomfort during sexual intercourse.
2. Development of cancer . Pathological cervical and uterine discharge is often a warning about incipient cervical cancer and other neoplasms. A particularly dangerous signal is leucorrhoea with blood clots, spotting that is not associated with menstruation. They are signs of serious illness and require immediate medical attention.
3. Infertility . This diagnosis is widespread throughout the world and ranks third after cardiovascular diseases and cancer. The reason for this is often advanced inflammatory processes in the pelvic organs. If they are not treated in time, they become chronic and disrupt the functions of the cervix, fallopian tubes and ovaries and the entire reproductive system. Fertilization of the egg in these cases is difficult and sometimes impossible (5).
Preventing unhealthy white discharge
Preventative recommendations are not that complicated.
- Follow the rules of intimate hygiene. Wash your face daily with plain water. Each time you wash your face, put on clean underwear.
- When washing or using toilet paper, do not make back-and-forth movements to avoid introducing an infection into the vagina.
- Use barrier contraception as agreed with your partner.
- Wear appropriately sized underwear made from natural fabrics.
- Avoid hypothermia.
- Do not take antibiotics uncontrollably, beyond what your doctor has prescribed.
Maria Menshikova, gynecologist at Teledoctor24 , talks about what can and cannot be done to prevent gynecological diseases:
– Pharmacies sell a lot of drugs for all occasions, and sympathetic pharmacists will recommend the newest, most effective. But such self-medication is harmful. Any medications should be prescribed by a doctor based on your medical history.
You should never wash your vagina for any good purpose. Today this is one of the most common manipulations, leading to a decrease in the normal flora of the vagina and the colonization of it with pathogenic species.
By the way, complete epilation/depilation of the bikini area is also a factor that provokes inflammation. Pubic hair is important, it is a natural barrier that protects the body. Depilation is a traumatic procedure that can increase the risk of infection.
Which doctor should I contact with complaints?
If you notice discharge that is unusual in color or has an unpleasant odor, make an appointment with your gynecologist as soon as possible. He will prescribe the necessary tests and studies.
Explanation of the gynecologist
Gynecologist Maria Menshikova:
– Vaginal discharge – leucorrhoea – accompanies a woman from the beginning of the formation of menstrual function until the onset of postmenopause. The word “leucorrhoea” itself speaks about what normal discharge should look like. Light, almost transparent, odorless and free of foreign impurities, which do not interfere with life.
Immediately after menstruation there are few of them, during the period of ovulation the number increases, they become more sticky and stretchy. By the way, at a time when science had not reached today’s technological heights, the body’s ovulation peak was determined by the stretching of mucus. Then the leucorrhoea becomes less sticky, but “thickens”, remaining light, and its quantity increases. This is the work of progesterone: everything is ready for the implantation of a fertilized egg. If pregnancy has occurred, the amount of discharge may remain increased; this is normal. Well, if it hasn’t arrived, then a new menstrual cycle begins and everything repeats. This is what the picture looks like for a healthy woman.
Questions and answers
Let’s answer the remaining questions about white vaginal discharge.
How to distinguish normal discharge from dangerous ones?
If itching, burning occurs, the amount of discharge increases sharply and their character changes – this is a likely manifestation of the inflammatory process in the vagina, and possibly in the higher organs of the female genital area.
Why does white discharge appear after menstruation?
Changes in discharge are associated with the influence of the menstrual cycle and hormonal levels. Immediately after menstruation, there is no discharge in the vagina, or it is scanty and transparent. Further, closer to the middle of the cycle, during the period of ovulation, the discharge becomes profuse, slimy, viscous, and becomes visually similar to egg white. At the same time, for many women, discharge during the period of ovulation becomes especially abundant, which even requires a change of underwear. In the second phase of the cycle, closer to menstruation, the discharge becomes whiter and may remain profuse. So the cycle repeats monthly.
How often should you visit a gynecologist?
You should visit a gynecologist at least once a year. Even if nothing bothers you, it is better not to postpone your visit. Timely examination is the best disease prevention.