Most of the cases the vaginal discharge is absolutely normal and has an import physiological function. The dead cells and bacteria produced in vagina are carried away by vaginal discharge to keep the vagina and cervix clean. The healthy vaginal discharge is white, thick, odourless. Women often have vaginal discharge before starting and after the end of monthly menstruation cycle, this is absolutely normal.
Some time the appearance of vaginal discharge may change due to some physiological change like pregnancy or because of some infections. If the change is caused due to the infection then it often is associated with itching or burning sensation.
The various causes of abnormal vaginal discharge and their corresponding appearances are given below:-
|Type of Discharge||Underlying cause||Associated Symptoms|
|White, gray, or yellow with fishy odor||Bacterial vaginosis||Itching or burning, redness and swelling of the vagina or vulva|
|Bloody or brown||Irregular menstrual cycles, or less often, cervical or endometrial cancer||Abnormal vaginal bleeding, pelvic pain|
|Frothy, yellow or greenish with a bad smell||Trichomoniasis||Pain and itching while urinating|
|Cloudy or yellow||Gonorrhea||Bleeding between periods, urinary incontinence|
|Pink||Shedding of the uterine lining after childbirth (lochia)|
|Thick, white, cheesy||Yeast infection||Swelling and pain around the vulva, itching, painful sexual intercourse|
- Bacterial vaginosis : When the normal vaginal flora i.e. Lactobacillus is reduced due to use of some antibiotics or other factors and get infected by other bacteria then it called bacterial vaginosis. BV is generally caused by the infection of Gardnerella vaginalis, Mobiluncus, Bacteroides, and Mycoplasma but it may happen due to other bacteria also.
Symptoms : The most prominent symptom is the changed appearance of vaginal discharge like white, gray or yellow colored discharge with a distinct fishy odor. Other symptoms are like itching and burning sensation in vagina with redness and swelling of the same.
Treatments : BV is generally treated with antibiotic and probiotics. Antibiotics like Metronidazole or clindamycin are given either orally or vaginally to treat BV. Probiotics are also effective to regain normal vaginal flora (primarily lactobacillus bacteria ) thus reducing the bacterial infections.
- Cervical or endometrial cancer : Endometrial cancer is the malignancy of the lining of the uterus called endometrium.
Symptoms : Red or brown vaginal discharge, abnormal vaginal bleeding often associated with pelvic pain.
Treatment : The treatments are surgical or radiation therapy or both. Generally abdominal hysterectomy or vaginal hysterectomy is performed in combination with chemotherapy.
- Trichomoniasis : Trichomoniasis is a very common cause of vaginitis. It is caused by an unicellular protozoan named Trichomonas vaginalis. The site of infection is vagina or urethra.
Symptoms : Itching or burning sensation in vagina, urethra or cervix sometime with lower abdominal pain. Yellow or greenish frothy vaginal discharge with a fishy odour may also be present.
Treatment : Trichomoniasis is treated with metronidazole, but this treatment is not suitable for pregnant woman.
- Gonorrhea : Gonorrhea is a common sexually transmitted disease. It is also known as “clap” or “drip. Gonorrhea causes due to the infection of the bacteria Neisseria gonorrhoeae. Generally the sites of infection are cervix, uterus, fallopian tubes and in the urethra, but it may also grow in mouth, anus and throat.
Symmptoms : The symptoms are yellowish vaginal discharge, vaginal bleeding, pelvic pain and pain in the time of urination. Sometimes it may be asymptomatic also.
Treatment : Gonorrhea is managed with injectable ceftriaxone with azithromycin or doxycycline. It is highly recommended to diagnose and treat the sexual partner to prevent the recurring infection.
- Yeast infection : In most of the cases vaginal yeast infection is caused by Candida albicans
Symptoms : Burning or soreness in vagina with thick, white discharge. May also be associated with swelling of valva.
Treatment : Yeast infection is generally treated with topical application of anti fungal like Miconazole, Clotrimazole, Tioconazole, Butoconazole with oral medication of fluconazole. It is very important to keep vaginal region dry to prevent further growth of yeast.
It should be noted that all infections will aggravate if the person has high blood sugar, so besides medications one must control blood sugar level to avoid these infections.