Discharge is one of the most hated words in the English language, so it's kinda ironic that so is panties and they go together. But we are all grown ups here and vaginal discharge is a part of normal life. Well, until it's not, that is. Some discharge is to be expected, though other types can be a sign that there is something wrong.
"Being a female doctor, one of the more common presentations I see is women wondering about their vaginal discharges. It is always a source of great embarrassment for the girls -- the dreaded swabs to be taken with the added stress of a potential cheating partner. Luckily, most often than not, there is a simple explanation for the discharge which does not involve your partner in a compromising position," Dr Lucy Caratti, co-founder of Expand Wellbeing told HuffPost Australia.
Caratti breaks discharge down into two categories: sexually transmitted (STIs), and non-sexually transmitted.
Physiological: clear, non-smelly discharge
"Many women of reproductive age have a normal daily vaginal discharge, which can vary in consistency. In particular, around ovulation time, the discharge tends to get quite clear and stretchy, described as being like 'egg-white'," Caratti said.
Candidiasis (known as Thrush): thick white discharge
"Candida is a fungus that is normally found in our gastrointestinal tract, however can overgrow and spread to other areas in certain situations. When it overgrows in the vagina, a white, thick discharge develops, often described as 'cottage cheese' (I know, you stop eating a lot of things after medical school). There can also be itching and irritation in the vagina."
"Candida can overgrow in situations where there is increased oestrogen, for example when someone is on the oral contraceptive pill or pregnant. Other things that can increase your chances of developing it are antibiotics, diaphragm use and Diabetes Mellitis. Treatment is with an oral tablet or a course of vaginal creams. Should you keep getting the symptoms, it would be worth looking into reasons why this might be happening. Occasionally, there are different strains of Candida that don't respond well to the usual treatment, so a visit to your GP for a swab to determine this is recommended. A good, regular probiotic to assist in good gut health may also be worthwhile," Caratti said.
Bacterial Vaginosis (known as BV): white milky smelly discharge
"The vagina's environment is kept under control by some bacteria called Lactobacilli, which stop other bacteria from overgrowing. In BV, these helpful bacteria are absent, allowing for an overgrowth of other bacteria. This results in a milky white discharge with a 'fishy' smell. The exact cause is not clear, but some risk factors include new or multiple sexual partners, smoking and vaginal douching. Condoms and the oral contraceptive pill seem to help prevent it. Treatment is with either a course of oral tablets or vaginal cream."
Foreign Body: watery, often blood-stained with foul smell
"More common than you might think, a forgotten tampon is another cause of a vaginal discharge. The discharge can range from watery and profuse to blood-stained, but often has a very pungent smell. This is easy to diagnose on examination and removal relieves the symptoms. Occasionally, antibiotics may be given to prevent any infection," Caratti said.
Cervix conditions: blood-stained discharge
"Certain growths and changes on the cervix can cause a blood-stained discharge throughout your cycle. Some of these are simple, minor conditions which do not need any further tests. It is, however, always important to see your doctor if you get any bleeding between your periods for investigation, as this can be a symptom of cervical cancer changes."
Sexually Transmitted Infections (STIs)
"Caused through sexual activity, most commonly unprotected sexual intercourse, although can also be contracted through throat and anus. A simple swab or urine test is done and antibiotic, either oral or an injection, usually cure the discharge completely," Caratti said.
Chlamydia: greyish thin discharge
"Chlamydia is the most commonly reported STI in Australia. While most people are asymptomatic (which is scary given the problems that can happen with untreated Chlamydia, eg. infertility), some women can get a thin greyish discharge, along with other symptoms such as pain during sex and urination. Treatment is very simple with antibiotics, so early detection through a swab or urine test is vital!"
Gonorrhoea: thick green/yellow discharge
"Gonorrhoea is becoming more common, particularly from overseas 'activity'. Again, it can often be asymptomatic, but when a discharge is present, it is generally more noticeable than Chlamydia," Caratti said.
Trichomoniasis: malodorous frothy green/yellow discharge
"While not very common in metropolitan Australia, Trichomonasis is the most common non-viral STI worldwide. It causes a frothy green smelly discharge, with itching and pain."
Other: such as Herpes
"A thin discharge can occur with any inflammation of the vagina or cervix, however with things like Herpes, there are generally other more prominent symptoms such as ulcers," Caratti said.
If you have read this far, good work. Don't be freaked out if you think you might have one or some of the above symptoms. Instead of worrying, head to your doctor.
"If you have any change in your vaginal discharge, a quick visit to your GP can shed a lot of light. Don't let embarrassment prevent you from attending. You can always opt to take a swab yourself," Caratti said.
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