Discharge that is chunky, a color outside of the normal variations, or foul-smelling is abnormal and should be followed up with a healthcare provider.
This article reviews normal vaginal discharge, symptoms of abnormal discharge, possible causes, treatments, and when to notify your healthcare provider.
Normal vs. Abnormal Vaginal Discharge
Vaginal discharge is fluid made from glands in and around the vagina. It keeps the vagina clean and provides lubrication.
Healthy discharge does not smell bad and is clear, white, or pale yellow. During your period, it can be red because it’s mixed with blood. Toward the end of your period, it often turns brown as old blood is cleared out. Consistency and amount vary with your monthly cycle and differ for each woman.
The following are abnormal variations:
Thick, chunky white (like cottage cheese) Pus (an opaque, white-yellow substance) that may be accompanied by pelvic pain Green, gray, white-gray, or bright yellow Frothy or extremely watery Unpleasant or “fishy” odor
Causes of Vaginal Discharge
Oftentimes vaginal discharge is normal, healthy, and common. However, certain types of discharge are abnormal and are cause for seeking medical care.
Causes of Normal, Healthy Variations
Variations in thickness, amount, and color naturally occur with hormone fluctuations, sexual arousal, and pregnancy. These variations are normal.
Around ovulation—at about days 12–14 of your cycle—discharge becomes more clear and stretchy. Sexual arousal causes an increase in discharge to allow for lubrication. During pregnancy, discharge often increases but is still white, milky, and thin.
Causes of Abnormal Discharge
Abnormal discharge can be caused by infections such as:
Yeast infection: This can cause white and chunky (like cottage cheese) discharge. Bacterial vaginosis (BV): Discharge is gray or yellow and smells fishy. It can also cause bleeding after intercourse. Sexually transmitted infection (STI): Discharge may be green, yellow, like pus, or frothy with a fishy odor. Common STIs include chlamydia, gonorrhea, and trichomoniasis.
Some noninfectious causes include:
Retained foreign objects, such as a tampon or condom Cervical cancer Douching
What Medications Can Cause Vaginal Discharge?
Hormonal contraception (birth control) and hormone therapy can disrupt discharge amounts.
Examples include:
Yaz (drospirenone/ethinyl estradiol): A type of oral birth control Depo-provera (medroxyprogesterone acetate): A type of birth control shot Vagifem (estradiol): A hormone replacement therapy
Femara (letrozole) and Nolvadex (tamoxifen) inhibit estrogen to prevent or treat hormone receptor-positive breast cancer and may decrease amounts of vaginal discharge.
Osphena (ospemifene) treats vaginal dryness due to menopause, and a possible side effect is increased vaginal discharge.
The following medications increase the risk for yeast infections:
Antibiotics such as Cipro (ciprofloxacin) or Amoxil (amoxicillin) can kill the good bacteria that live in the vagina. This good bacteria usually keep yeast under control, preventing it from causing a problem. Steroids such as Deltasone (prednisone) can reduce the immune system’s ability to fight infections. Chemotherapy such as Taxol (paclitaxel) or Adriamycin (doxorubicin) weakens the immune system.
How to Treat Vaginal Discharge
Abnormal discharge is treated based on the cause. Examples include:
Yeast infections: Mild yeast infections are often treated with over-the-counter (OTC) antifungal medications such as Monistat (miconazole). If you’ve never had a yeast infection or have severe symptoms, consult your healthcare provider. Your provider may prescribe an antifungal cream or oral medication called Diflucan (fluconazole). Infections: Bacterial vaginosis or an STI are typically treated with an antibiotic. Foreign body: Your healthcare provider will remove it or refer you to a specialist for removal.
Complications and Risk Factors Associated With Vaginal Discharge
Bacterial infections can lead to pelvic inflammatory disease (PID). When left untreated, PID increases your risk of chronic pelvic pain, infertility, and ectopic pregnancies.
Pregnant women with abnormal discharge are at risk of complications such as preterm delivery.
Are There Tests to Diagnose the Cause of Vaginal Discharge?
The following at-home test kits may help identify changes in discharge:
Ovulation test kit: This is a good option if you have increased clear and stretchy discharge mid cycle and suspect it’s due to ovulation. Pregnancy test: If you have an increase in white discharge and suspect you are pregnant, an OTC pregnancy test is a good first step. pH kits: If you have redness, swelling, itching, or burning, and your pH (acid-base balance) is normal or slightly low, you could have a yeast infection. A pH that is high may indicate bacterial vaginosis or trichomoniasis. STI screening kit: This can be used for sexually active women with green, gray, bright yellow, frothy, or foul-smelling discharge. If you have these symptoms or a positive result, it’s also important to make an appointment with your healthcare provider.
Carefully follow the directions on these tests to ensure you receive accurate results. Contact your healthcare provider if you think you have an infection, if the results are unclear, or if you have any questions. A provider may recommend or perform one of the following tests:
Urinalysis: A urine test can detect pregnancy, yeast, urinary tract infections (UTIs), and STIs. Pelvic exam: Healthcare providers use pelvic exams to check female reproductive organs. This may include a Pap smear to check for cervical cancer or a vaginal swab to test for infection. Blood draw: Blood tests involve drawing blood from your vein using a small needle. Results provide a range of information, including pregnancy and infections.
When to See a Healthcare Provider
Make an appointment with your healthcare provider for the following changes in discharge:
Bright-yellow, greenish, white-gray, or gray Pus Clumpy texture Foul or fishy smell Watery or bubbly (frothy) discharge with an unpleasant odor
In addition, see your healthcare provider for:
Vaginal or urinary painSwelling, redness, itching, or white coating around the vaginaPelvic (between the hips) or abdominal (belly) pain not associated with menstrual crampsVaginal rash or soresSkipped periodWorsening symptoms after periods or sexual intercourseBleeding after sexual intercourseFever
Summary
All women experience vaginal discharge. It keeps the vagina clean and provides lubrication. Normal, healthy discharge is clear, white, off-white, or pale yellow and does not smell bad.
When the color changes to green, bright yellow, or gray, this usually indicates infection. Abnormal consistency is chunky, contains pus, is frothy, or is very watery. A foul odor typically means an infection.
Some medications such as antibiotics and chemotherapy increase the risk for yeast infections. Other medications, such as those that affect female reproductive hormones, can alter the amount of healthy discharge.
Abnormal discharge is diagnosed and treated based on the cause. Yeast infections are treated with antifungals, while bacterial infections are treated with antibiotics.
A Word From Verywell
Vaginal discharge is something all women experience, and keeping track of what is normal for you is important.
It may feel uncomfortable to discuss any changes with your healthcare provider. However, they are used to these conversations and want to help you feel better. They need to know your concerns because early diagnosis and treatment help decrease the risk of complications.
