That vaginal discharge: When should you worry?

Any change in the vagina’s balance of normal bacteria can affect the smell, colour, or discharge texture. Seek medical assistance if this happens. File Photo

What you need to know:

  • Vaginal discharge is often normal. However, there are certain types of discharge that can indicate an infection.

It is normal and healthy to have vaginal discharge after puberty. This discharge is a mixture of fluid and cells that help to keep the vagina clean and moist and prevent infection. That said, the amount and type of vaginal discharge varies among women.
Dr Othman Kakaire, a consultant obstetrician and gynaecologist at UMC Victoria Hospital, says there are several normal discharges in women.
For example, it is yellowish after periods, granular because of oestrogen dominance, watery mucal discharge and heavy when ovulating. It is clear milky when there is progesterone dominance.
However, when the discharge changes colour, has an odour or increases in amount or is associated with irritation or other uncomfortable symptoms, it could be an infection.

Abnormal discharge
In normal circumstances, the uterine cervix and the vaginal walls have a gland that produces a small amount of fluid that naturally cleans the vagina. This discharge is usually clear or milky without an odour. However, in the presence of an infection, the amount, colour, smell and consistency changes.

Vaginal yeast infection
Dr Paul Kato, an obstetrician and gynaecologist at MildMay Hospital, says this could also be called candidiasis and will occur when there is an influx of yeast in the vagina. He says usually, the overgrowth is due to the use of antibiotics or other factors that tamper with the natural balance and make up of bacteria in the vaginal area.

“Someone with this infection will have a thick white discharge with a texture akin to cheese. However, the discharge is odourless. Other signs include pain during sexual intercourse or urinating, burning, and soreness,” says Dr Kato.

According to Dr Kakaire, this is a sexually transmitted disease (STD) caused by a bacteria called Neisseria gonorrhoeae. It may not produce any signs and symptoms among women. However, some may experience symptoms of a urinary tract infection such as pain or burning when urinating, frequent urination, sudden urge to urinate, frequent urge to urinate without much urine passing, and urine that is milky, cloudy or bloody with a foul smell as well as increased vaginal discharge. He adds that gonorrhoea can also affect a gland near the vaginal entry called the Bartholin’s gland causing Bartholin’s absses which is very painful.

Bacterial vaginosis
This condition is due to an imbalance in the bacteria found in the vagina. Dr Kakaire says the cause is a reduction in the lactobacilli.
“When they are replaced by other bacteria, the acidity of the vagina is reduced hence fight against bacteria such as gardnerella vaginitis.” Some women with the condition will have no symptoms.

That said, one with bacterial vaginosis usually produces a foul fishy smelling thin and greyish discharge.
He adds that lubrication of the vagina is reduced and a bad foul smell is produced when a woman with it has a sexual encounter. “It is common among women who clean from back to the front as well as those that take lots of antibiotics as they kill the lactobacilli,” he adds.

It is another STD that is caused by chlamydia trachomatis. It may also come without symptoms but Dr Kato says some may have increased vaginal discharge with urinary tract infection symptoms.

This infection is caused by a single-celled parasite known as Trichomonas vaginalis and is transmitted through sexual contact. One with the condition produces a frothy, yellow-green extremely itchy discharge with a foul odour. Other symptoms may include discomfort during urination and intercourse not to mention itching and irritation of the vagina.

Avoiding foul discharge
Both Dr Paul Kato, an obstetrician and gynaecologist at MildMay Hospital and Dr Othman Kakaire, a consultant obstetrician and gynaecologist at UMC Victoria Hospital, say that practicing proper hygiene goes a long way in helping one avoid infections and reduce any odour coming from their sexual organs. It is essential to:

•Clean the genitals after sexual intercourse.
•Wear loose-fitting, breathable clothing. For women, cotton underwear is preferable.
•Being faithful to your partner.
•Avoiding sexual activity when either partner has an STI or other infection.


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