All About Discharge: What is it, what's normal, and when to see a doctor!

This post was written by Sarah Cox, a third year medical student at UTHSCSA studying to become an OBGYN. 

Like most changes that come with puberty, vaginal discharge can be unsettling. But typical vaginal discharge is actually normal, healthy, and incredibly cool!

Additionally, certain types of abnormal discharge can be important clues about vaginal infections, and can tell us when we need to see a doctor to get treatment. 

Normal Discharge

What is normal vaginal discharge? 

Normal vaginal discharge is clear to white in color, and can vary in texture throughout the menstrual cycle. Textures include watery, sticky, elastic, and/or mucus-like.  Discharge usually has a mild odor. 

The level of discharge changes during the menstrual cycle, and is also different from menstruator to menstruator. Many people are surprised at how much discharge is normal: ½ to 1 teaspoon (2-5 mL) daily is average. 

Why do we have discharge?

The discharge is made by the skin cells of the vaginal wall and cervix, and is usually not noticeable until it leaves the vagina and ends up in underwear. It’s produced when the body has higher levels of estrogen, which is why discharge increases with the onset of puberty (when estrogen increases) and decreases with menopause (when estrogen decreases). 

The vagina is an example of a “mucous membrane.” These are areas of the body that are moist and are regions of entrance/exit of the body; other examples are the mouth and nose. All of these areas need to stay nice and wet to do their jobs, and use fluid to self-clean and keep bacteria out. Vaginal discharge is important the same way that saliva, snot, and earwax are important to keep these mucous membranes moist, clean, and protected. 

The vagina uses discharge to keep itself clean, which is truly incredible! 

Does having discharge mean your first period is coming?

During puberty, there is an increased amount of the hormone estrogen that leads to many of the changes you will notice. One of these changes is that the amount of vaginal discharge increases. Because discharge changes is not a commonly discussed aspect of puberty, it can be a surprise for many, and lead to complaints about the amount of discharge and concerns that something is wrong.

Experiencing more discharge before getting your first period is normal, and goes along with the many changes of your body: pubic hair, body odor, breast development, and more. The average start of discharge is after the beginning of breast development and about six months before the first period, but there is a wide range of normal timelines.

All bodies are unique! Some girls have more discharge than others, and discharge that starts earlier or later than others in relation to other puberty changes is normal. Most discharge increase during puberty is normal.

If you experience a sudden change of color or smell of the vaginal discharge, this could be a sign of infection and a reason to visit the doctor.  

Abnormal Discharge

Although most vaginal discharge is normal and healthy, some discharge can be the body’s way of telling us that there is an infection. Signs of abnormal discharge and infection include:

  • Discharge associated with itching or burning of the vagina and/or labia
  • Redness and swelling of the vagina and vulva
  • Strong and unpleasant odor
  • Discharge that is thick and white (like cottage cheese), green-yellow and foamy, gray discharge, or pus-like
  • Vaginal/vulvar pain with putting in a tampon, a pelvic exam, having sex, or urination

    If you are experiencing any of these symptoms, go to your health care provider for an evaluation!

    Vaginal Hygiene 

    Certain products or behaviors can actually irritate the vagina and increase discharge to an abnormal amount or even lead to infections. It’s important to remember that vaginas are self-cleaning and aren’t supposed to smell pretty. 

    Additionally, the vagina and vulva area need to breathe to be healthy; wearing restrictive underwear or a pantyliner everyday makes the vagina think that something is wrong and increases the amount of discharge.

    Things to avoid:

    • Douches, “feminine hygiene” sprays, or rinses  
    • Scented tampons, pantyliners, or pads
    • Using scented toilet paper or baby wipes
    • Wearing tight, restrictive, or synthetic underwear 
    • Some doctors advise not to wear a pantyliner everyday. 

      (Some people wear a pantyliner to absorb their discharge, but it may be increasing the amount of discharge. While not dangerous, it may be counterintuitive to the person’s goal of managing discharge.)

      Good hygiene practices:

      • Wear breathable cotton underwear
      • Wash the vulva with plain water and your hand only. Gently pat (don’t rub) to dry. You can use non-scented soap on areas in which hair grows, but only plain water for inside the labia and vaginal canal. 
      • Use non-scented tampons, pantyliners, and pads
      • Use non-scented toilet paper

        There are lots of products out there that intend to make people with vaginas feel bad or gross about normal vaginal odor and discharge. Know instead that vaginas are amazing self-cleaning defense systems that aren’t supposed to smell like flowers!

         

        Want to learn more about your body and periods? We can help! 

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