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What Cause Vaginal Discharge

What Cause Vaginal Discharge

What is vaginal discharge?

Vaginal discharge is the term for fluid or mucus that comes from the vagina. Vaginal discharge normally helps the vagina clean and moist, lubricates vagina and protects it by fighting off bad bacteria and infection.

Its main source is the cells lining the vagina and the glands of cervix under the influence of the female hormone, estrogen. Women who are menopausal normally have minimal vaginal discharge as a result of lower levels of estrogen.

Vaginal discharge is a common concern among women, and leads many women to see their health care provider.

Which vaginal discharge is considered normal?

Having vaginal discharge is normal as it cleans and keeps vagina healthy. Discharge from vagina is a natural and normal process unless it occurs with itching, burning, or other bothersome symptoms. In these cases, a gynecologic examination is recommended to determine the cause because different problems can have similar symptoms.

Normally, discharge contains vaginal skin cells, bacteria, and mucus and fluid produced by the vagina and cervix. A normal discharge often has a slight odor and may cause mild irritation of the vulva. This discharge helps to protect the vaginal and urinary tract against infections and provides lubrication to the vaginal tissues.

It is normal to have some amount of discharge every day. In women who are at reproductive ages, everyday discharges those transparent, almost clear or white in color, egg white-like consistency, thick and sticky, slippery and wet, sometimes with a faint or odorless, bloodless, acidic pH (3.8-4.5) and approximately one-half to one teaspoon (2 to 5 mL) in a day are considered normal. It does not smell bad, and its thickness may change throughout the menstrual cycle.

It may leave slight moisture in underwear. Some women produce more discharge than others, while others notice very little. The amount can also vary at different times during the menstrual cycle. It may become more noticeable at certain times, such as during pregnancy, with use of birth control pills/patch/vaginal ring, near ovulation, and in the week before the menstrual period. Sudden changes in the amount of vaginal discharge might mean something is wrong.

Does the vaginal discharge change during pregnancy?

The amount of vaginal discharge increase during pregnancy related to the higher levels of estrogen and progesterone for to prevent infections from traveling up to the uterus. When changes in vaginal discharge are noticed during pregnancy contact with a healthcare provider is required.

When a vaginal discharge considered abnormal?

Changes in the color, texture, smell or amount of usual vaginal discharge can be a sign of infection or disease. Most causes of abnormal vaginal discharge are treatable with medication.

  • An increase in the amount of vaginal discharge
  • Irritation, itching or pain in or around vagina
  • Itching of the vulva, vaginal opening, or labia
  • A change in texture or consistency of the discharge
  • Redness, burning, soreness, or swelling of the vulvar skin
  • A change in the color of the discharge: Foamy or greenish-yellow discharge, dark yellow, brown, green or grey discharge
  • A foul-smelling odor: Bad odor­- a fishy or foul smell
  • Blood-tinged vaginal discharge
  • Pain with intercourse or urination
  • Abdominal or pelvic pain

What are the causes of a vaginal discharge?

The most common causes of vaginal discharge are:

  • Vaginal infections-yeast or bacterial infections, trichomonas.
  • An object in or near the vagina: The body's reaction to a foreign body (such as a forgotten tampon or condom) or substance (such as spermicide, soap).
  • A condition called atrophic vaginitis: Changes that occur after menopause related to low estrogen levels can cause vaginal dryness, a vaginal epithelium thinner than normal and chances in the normal balance of healthy bacteria especially during sex, as well as a watery vaginal discharge or other symptoms.
  • An irritation or rash from something (an object or chemical) that causes an allergic reaction. This could be from detergents, soaps, sexual lubricants or materials used in condoms or sex toys.
  • During pregnancy, more discharge helps to protect from infection.
  • Vaginal discharge become extra slippery and wet during ovulation time to help sperm swim up to reach an egg for fertilization.
  • Changes in the normal balance of healthy bacteria
  • Sexual excitement can also cause vaginal discharge

What causes vaginal infections?

Some types of infections are spread by having sex with an infected person. The risk is higher with:

  • Having sex without protection or with more than one partner.
  • Untreated or under-treated diabetes.
  • Birth control pills.
  • Antibiotic treatment.
  • Having an HIV infection or have a decreased immunity.
  • Use certain soaps, sprays or detergents.
  • Vaginal douche.

What are the signs of a vaginal infection?

Vaginal discharge might be a sign of an infection if it:

  • Causes itching,
  • Causes swelling,
  • Has a foul-smelling or fishy-smelling odor
  • Is green, yellow gray, dark yellow, or brown, foamy,
  • Is bloody,
  • Looks like cottage cheese or pus,
  • Accompanied by symptoms such as pain, burning or pain during urination, and abnormal bleeding.

Which infections cause vaginal discharge?

There are a number of infections that cause vaginal discharge. Some of these infections can be caused by having sex with someone who has the infection.

Yeast infection

Fungal Infections- (Candida Albicans) 75% of women experience fungal discharge at least once, 50% of them 2 or more times, 5-10% of them 4 or more times in their lives.

There may be complaints of itching, irritation, burning, stinging, pain during sexual intercourse or urination along with odorless white discharge in the form of a thick, white, cottage cheese-like discharge. It is the second most common cause of vaginal discharge. It is not in the group of sexually transmitted diseases. Antifungal medications treat a yeast infection.


It is the most common cause of sexually transmitted vaginal discharge. A parasite causes trichomoniasis.

There may be copious, bubbly or frothy, yellow-green colored, foul-smelling discharge and itching. It may be accompanied by burning during urination, frequent urination, pain during sexual intercourse. However, about half of women with Trichomas vaginitis may not have any complaints.

Multiple partners, low socioeconomic status, not using condoms, and a history of sexually transmitted disease are risk factors. It is treated with antibiotics and partner treatment is also required.

Bacterial vaginosis (BV)- Gardnerella Vaginalis

The most common cause of vaginal foul-smelling discharge is bacterial vaginosis infection. The vaginal discharge is transparent, usually colorless, copious, white or gray discharge fishy smelling. Smell is felt more prominently in intercourse.

It is not sexually transmitted, but is associated with sexual activity and sexual intercourse is a risk factor. It’s treated with antibiotics.

Gonorrhea and Chlamydia

They are the two common sexually transmitted diseases. The complaints are yellow or green vaginal discharge, frequent urination and burning when urinating. Edema, burning, itching and pain may develop in the external genital area due to the discharge.

If left untreated, the infection may spread, causing pelvic inflammatory disease with pelvic pain. The infection spreads to the upper genital area, severe abdominal pain and fever occur in the lower abdomen and both groins. However, about 60% of women with gonorrhea may not have any complaints. Both infections are treated with antibiotics and partner treatment is required.

Ureaplasma and Mycoplasma Infections

Ureaplasma Urealyticum-Mycoplasma Hominis: Ureaplasma and Mycoplasma are found in the normal genital flora of many sexually active and healthy men and women. Colonization is higher in young women and in societies with low socioeconomic status. However, it can also be transmitted through sexual intercourse.

Ureaplasma and Mycoplasmas can cause vaginal discharge, which is an important symptom of vaginal infections, cervical infection called cervicitis, and pelvic inflammatory disease, which is an upper genital tract infection. However, they often do not show any symptoms.

Foul-smelling genital discharge is the most common symptom in Ureaplasma and Mycoplasma. The discharge may be yellow-green in color. There is no itching in general. There may be burning and pain after urination.

If Ureaplasma and Mycoplasmas are not treated, they can spread to the upper genital tract and cause pelvic abscesses, groin pain, high fever and pain during sexual intercourse, obstruction in the tubes causing infertility, and urinary tract inflammation.

Ureaplasma and Mycoplasmas may pass to the baby during pregnancy and delivery causing placental infection called chorioamnionitis in pregnant women, low birth weight baby birth, miscarriage and premature birth, postpartum fever and be responsible for respiratory system diseases and meningitis in the newborn.

When a gynecological examination is required?

Vaginal discharge is the way the vagina stays clean and healthy. Normal discharges can change throughout the menstrual cycle. It is reasonable to contact with doctor in case if there are changes in the discharge amount, color, becomes heavier or smells different or it is accompanied by other symptoms such as pelvic pain or itching, burning, swelling or soreness around vagina.

Sometimes, it is not possible to know if vaginal discharge is normal or not without an examination. Gynecological examination and testing by taking a vaginal sample is the most accurate way to determine the cause of vaginal discharge.

Using any medicine at home before the examination can make it difficult to diagnose accurately. Starting treatment before attending to the gynecologic examination based on the internet or social media is not recommended.

How a vaginal discharge is examined?

Before gynecologic exam, any pain in the back, abdomen, or pelvis, any new sexual partner, last mentrual period, the medicines, pads, tampons, douches, "female hygiene" products, lubricants, pH-modifying treatments, or boric acid that are used recently will be asked.

A gynecologic examination covers the evaluation of the entire outer genital and internal area including vagina and cervix. Bimanual examination and a vaginal scan is done to rule out an upper genital tract infection. Samples of the discharge to test for infection, evaluation of the pH or acidity of the secretions (bacterial vaginosis and trichomoniasis cause the pH to be higher than normal) can be performed.

Does douche help to get rid of vaginal discharge?

Vagina naturally keeps itself clean with the help of healthy bacteria called lactobacilli. These bacteria keep vagina acidic, which prevents microorganisms and fungus from growing out of control.

Some women say douching makes them feel cleaner, better and fresher to get rid of unpleasant odors, and menstrual blood after their period and to avoid sexually transmitted diseases and pregnancy after intercourse. However, vaginal douching can upset the natural balance of the organisms in the vagina and increase the risk of infections, pregnancy complications, and other health problems.

How can the vagina be kept clean, healthy and smelling good?

Having some vaginal odor is normal. However, if you notice a very strong odor, it could be a sign of infection.

  • Sprays, perfumes or douches to improve the smell of vagina gives harm and not recommended.
  • Simply wash the vulva externally with warm water and mild soap, avoid using perfumed soaps, gels, wipes or other feminine products and take care not to get soap inside vagina is enough to keep clean.
  • Do not clean the genital area with normal soap or shower gel, you can use special liquid soaps with a pH of 4.5 and below, specially produced for the genital area.
  • The genital area must be kept dry. Moisture increases itching. Underwear should be changed at least twice a day.
  • Avoid wearing tight underwear, bathing suits or sweaty clothes for long periods of time.
  • Synthetic nylon, colored and dyed underwear can reduce airflow to the vaginal area and might cause allergies. White, pure cotton underwear should be used.
  • Do not use daily pets.
  • Change pads frequently during menstrual bleeding, and wash your hands before and after each change.
  • Tight clothes can squeeze the groin and genital area, disrupt their ventilation and irritate them. Loose clothes should be preferred.
  • Perfumed and dyed soaps, laundry detergents and fabric softeners should not be used for cleaning underwear. Ironing with a hot iron is beneficial.
  • Hands should be washed regularly to prevent the spread of bacteria.
  • Wiping vagina from front to back will prevent bacteria getting into vagina from rectum.
  • Bubble baths or other scented products that may irritate the vagina and urinary tract should be avoided.
  • Condom use is beneficial in protecting against vaginal discharge and infections.
  • Care should be taken in choosing the sexual partner.
  • If you have given medications for vaginal infection, be careful to apply your treatment properly and avoid sexual intercourse during this time.
  • Consume plenty of water.
  • Do not use creams containing vaseline as a lubricant.
  • Oro-genital or ano-genital sexual intercourse increases the risk of infections.
  • Limit the amount of sugar and processed foods that you consume. Yeasts use sugar to grow.
Update Date: 01.04.2023
Prof. Dr. Nilgün Turhan
Prof. Dr. Nilgün Turhan
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Prof. Dr. Nilgün TurhanProf. Dr. Nilgün TurhanGynecology, Obstetrics and IVF Treatment Specialist
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