There is wide, wide range in what is considered "normal" vaginal discharge. Color can vary from clear to milky white to light tan or beige. Consistency, watery or gel-like depending on the stage of the menstrual cycle and on the degree of hydration. Volume can be low enough that it is only noted as moistness upon touching the vaginal opening and high enough to require use of a daily panty liner. However, vaginal discharge can be abnormal if it forms a crust on the pubic hair, stains the underwear, or is associated with odor, irritation, soreness, itching, and/or burning.
What Symptoms Can Be Associated with Abnormal Vaginal Discharge?
Irritation, itching, and burning that occurs on a daily basis.
Irritation that is made worse with exercise and perspiration.
A yellowish-green vaginal discharge associated with subtle odor, itching and burning on the outside.
The tissues feel swollen like it’s inflamed and especially around sexual intercourse.
It is wet, sticky, and slimy.
It dries like a crust on pubic hair and the underwear.
Clear vaginal discharge persists after having completed a course of antibiotics. There is external irritation and enough discharge to need a daily pad.
Intermittent discharge dates back to the early teenage years. It varies from greenish to yellowish and has a periodic odor with itching and burning. Birth control pills do not help.
Intermittent yellowish-white discharge with itching that is worse after sex.
Creamy discharge with mild odor for years, sometimes with orange color and copious enough to need daily panty liners.
Itching on the labia associated with a discharge that varies dramatically from thick, clumpy white to very thin clear. Despite the discharge, there is a sensation of vaginal dryness.
What Are Causes Abnormal Vaginal Discharge?
The most common causes of abnormal vaginal discharge are bacterial vaginosis, yeast vaginitis, atrophic vaginitis, and sexually transmitted infections. A much less common cause is cancer of the uterus, cervix, and/or vagina.
Then there is the concept of altered vaginal flora, in which one or more measures of vaginal health is suboptimal, but the symptoms that can occur in association can range from annoying to agonizing.
The vagina has a normal micro-flora ecosystem consisting of 30+ co-existing strains of bacteria at any one time. Normally, the “good” bacteria known as lactobacilli predominate and are numerous enough to coat the entire vaginal mucosal surfaces forming a protective barrier. Lactobacilli make lactic acid by using the glycogen provided from the squamous epithelial cells lining the vaginal wall. These cells require estrogen to make glycogen. The low pH caused by the lactic acid in conjunction with the hydrogen peroxide and other peroxidases secreted by lactobacilli suppress the other “bad” bacteria naturally present in the vagina to keep them at low concentration levels where they rarely cause harm. Problems arise when the lactobacilli do not thrive and a shift in the microflora balance occurs. The 30+ other “bad” bacteria strains proliferate resulting in one of several “altered vaginal micro-flora patterns.” The “bad” bacteria that dominate the vaginal microbiome in these patterns consist of a host of aerobic and anaerobic microbes. The resulting secretions bathe the vaginal walls all the way down to and including the tissues surrounding the vaginal opening which is believed to cause symptoms of abnormal vaginal discharge plus other symptoms such as odor, irritation, itching, burning, and urinary urgency/frequency depending on the innate sensitivity of the vaginal and vulvar tissues. A bacterial culture may be taken by an otherwise well meaning practitioner, but it will just grow out one of the 30+ “bad” bacterial strains such as Escherichia coli (E. Coli), Klebsiella pneumonia, Enterococcus (Group D streptococcus), Staph Epidermidis, Group B Streptoccocus (Beta Strep), Gardnerella Vaginalis, etc. All this shows is the predominate bacterial strain present in the vagina at that time. This is not the cause of the problem, just one of the manifestations. When a course of antibiotics is prescribed for these bacteria, a transient response may occur then symptoms typically relapse.
What Are Treatment Options?
Treatment is always individualized to address the root cause or most likely cause(s) of the problem. Fowler Gyn International prescribes local topical medication, custom compound medications, and non-medication regimens directed at restoring a healthy vaginal flora.
