11% to 38.4% of women in India make a visit to the doctor’s clinic when they observe the change in vaginal discharge.
Vaginal discharge is actually very common. It can happen at any age but it’s more common after puberty It will change in amount, consistency, colour and smell depending on which day of the cycle is it. It also depends on whether you are pregnant, ovulating or sexually aroused.
Normal vaginal discharge
It is often challenging for the doctors too, to distinguish abnormal from normal discharge.
Many women at times perceive their vaginal discharge as an abnormal discharge at some point in their lives. But commonly seen as a normal physiological discharge. This is a white or clear discharge that varies all throughout the menstrual cycle.
In short, the apperance of vaginal discharge changes throughout the menstrual cycle.
Some women do consider vaginal discharge as a sign of good vaginal health.
Normal changes in vaginal discharge
Considering the menstrual cycle is of 28 days for ease of understanding. During each phase of the period, there will be variations in vaginal discharge. These variations will depend on the hormonal fluctuations that take place on that particular day. So the changes that vaginal discharge goes through during a normal menstrual cycle would be:
- Days 1–5. At the start of the cycle, discharge is usually red or bloody.
- Days 6–14. Till the mid-cycle, with less vaginal discharge than usual. The mucus will be thin and slippery.
- Days 14–25. Mid-cycle till the near end cycle, the mucus will go back to being cloudy, white or yellow, and possibly sticky.
- Days 25–28. The cervical mucus will lighten, and a person will see less of it, before getting another period.
Causes of change in vaginal discharge
Most cervical STIs do not cause any symptoms and will not be able to identify or treat. In order to identify particular pathogens causing inflammation, laboratory testing is necessary.
- Cervical ectopy
- Foreign bodies, such as retained tampon
- Vulval dermatitis
- Non-sexually transmitted infection
- Bacterial vaginosis
- In India, the prevalence of bacterial vaginosis is 24%.
- You may have a higher risk of getting BV if you are pregnant, don’t use condoms, have an intrauterine device (IUD), have multiple sex partners, or use douches.
- Symptoms: profuse and fishy smelling discharge without itch or soreness.
- It is associated with poor pregnancy outcomes, endometritis after miscarriage, and pelvic inflammatory disease.
- Candida infections
- The prevalence of asymptomatic candida in women is approximately 10%.
- Symptoms: Itch and soreness and thick white discharge.
- Candidiasis does not need treatment if there are no symptoms.
- Bacterial vaginosis
- Sexually transmitted infection
- Chlamydia trachomatis
- As per WHO 2008 report, it is the most common STI with 105 million new cases each year, and has been increasing steadily
- Symptoms: A consistent vaginal discharge like pus and can induce inflammation, but most of the women doesn’t have any symptoms
- Untreated chlamydial may reach the fallopian tube and lead to pelvic inflammatory diseases.
- Treatment: It can is easily treated with antibiotics (i.e., erythromycin, azithromycin, or doxycycline),
- Reoccurrence: Almost one-fourth of individuals are reinfected a year after the treatment.
- Neisseria gonorrhoeae
- It is the second most common bacterial STI in the world, with 75 million new cases each year.
- Symptoms: Majority of women don’t present any symptoms but pain during urination and white pus like discharge are common symptoms.
- Treatment: It can be treated with antibiotics (dual therapy with ceftriaxone and azithromycin)
- Trichomonas vaginalis
- The global prevalence has been estimated by WHO is 8.1 % for women suffer from Trichomonas vaginalis
- Symptoms: Most women don’t have any symptoms. But vaginal discharge is often diffuse, smelly, yellow-green, pain during urinating, itching, irritation and abdominal pain are common. And vaginal pH is >5.
- Chlamydia trachomatis
Vaginal discharge flowchart
Prevention is better than cure
It’s always sane to avoid than to find a cure after getting ill. As with all STIs, the only way to prevent STIs is to abstain from sex. Lower the risk by using condoms correctly every time you have sex.
Vaginal discharge colour shades
With no symptoms, if the vaginal discharge is white or yellow in shade then it is a sign of healthy lubrication. But if the white discharge has a viscosity like cottage cheese or is accompanied by a strong odour, it can indicate an infection.
If you are having a red or a pink discharge around the time that you’re expecting your period then this could just be completely normal. It means that there is blood around and that’s what’s causing the red and the pink colour of the discharge. Towards the end of the period, a lot of women find that the discharge becomes more kind of like a dark brownie colour. This is because the flow of the blood is so slow and the blood stays much longer it gives a brown or dark red tinge to the vaginal discharge. This is nothing to worry about.
If the discharge has a very slight yellow hue, it may not mean a problem. This is especially likely with a change in diet or dietary supplements.
Discharge that is a darker shade of yellow, yellowish-green, or green usually signals a bacterial or STI. Almost all the infection shows yellowish-green vaginal discharge. So beware and consult your doctor as soon as possible.
Another time, when you can get a pink discharge or a red discharge is shortly after sex, within the first 24 hours, can be due to the fact that during sex there’s friction. So you can have tiny cuts and scrapes in the vagina which bleed and then cause the vaginal discharge to be like a pinky or reddish colour.
Sometimes some women experience a pinky discharge or red discharge or just blood in between their periods, in medical terms, it is called intermenstrual bleeding (bleeding in between your periods). It is a sign that you need to go and see your doctor.
Another example is if you have entered menopause. So if you’re a woman who hasn’t had a period for like a year or close on a year and then suddenly you start getting vaginal discharge that’s pink or tinged with red even if it’s not bleeding then that is a worrying sign. Because it could be a sign of endometrial cancer. Consult your doctor soon.
Vaginal discharge can be considered as the mirror of vaginal health. So keep an eye on the appearance, viscosity and odour of vaginal discharge. Consult your doctor in case of any significant change in either of the parameters.
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