29 Aug Vaginal discharge: What’s normal and when to seek help

The ‘Stop Period Poverty’ initiative, driven by the YLED 2023 Cohort and the YLED Give Back Programme, aims to address the issue of period poverty in South Africa. YLED understands the need for education and knowledge-sharing in order to successfully empower girls. Helping them to understand how their bodies work goes hand-in-hand with providing the proper products and support. Vaginal discharge is a natural occurrence in a woman’s reproductive system and often raises questions about what constitutes normal and abnormal discharge. This article delves into the various aspects of vaginal discharge, shedding light on its purpose, composition, and the implications of abnormal discharges.

Why does vaginal discharge occur?

Vaginal discharge is an essential part of maintaining a healthy vaginal environment. It serves several functions, including creating a protective barrier, removing bacteria and dead cells, facilitating sexual intercourse, and supporting reproductive processes. Its volume and character can be influenced by age, sexual activity, menstruation cycle, foreign body (tampon), stress, medication, and diet.

Components of normal vaginal discharge

Normal vaginal discharge consists of a blend of elements that contribute to its unique characteristics and functions:

Protective Barrier

Good bacteria (normal flora) reside in the vagina and help maintain a balanced pH level as well as preventing bacteria from entering the uterus (womb).
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White blood cells stand ready to defend against any potential infections or foreign invaders.

Removing Dead Cells

Sloughing epithelial cells
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Apocrine glands (also found in armpits) in the vulva contribute some sweat content to vaginal discharge and affect the smell.

Sexual Function

Normal vaginal discharge maintains a moist environment within the vaginal mucosa and provides lubrication during sexual intercourse.
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Hormones play a role in keeping the vaginal walls healthy and maintain their elasticity.

Reproductive Facilitation

Nutrients present in the discharge support the survival and mobility of sperm.

Normal appearance of discharge

It typically ranges from clear (transparent ) to whitish and light brown staining on a pantyliner. The discharge’s appearance changes in colour and character in accordance with the different stages of a normal (28-day) menstrual cycle:

Days 1 – 4: Menstrual blood dominates the discharge.

Days 5 – 7: Post-menstrual blood, mixed with vaginal fluids.

Day 14: Ovulation occurs, leading to clearer and more sticky discharge.

Identifying abnormal discharge

Recognising abnormal vaginal discharges is essential for maintaining reproductive health. Here are some indicators of abnormal discharge and potential causes:

Itchy and whitish to yellowish curd-like discharge, associated with discomfort and irritation and sometimes burning urine: indicative of a yeast infection, often caused by Candida.

Greenish/Brownish/Yellowish discharge: This may be a sign of vaginosis caused by bacteria or protozoa (trichomoniasis).

Foul-smelling discharge with or without abdominal pain: This might signal sexually transmitted infections (STIs) especially gonorrhoea and chlamydia or pelvic inflammatory disease (PID), which occurs when bacteria has entered the uterus and is a risk factor for infertility.

Bloodstained discharge outside of menstruation: Blood in the discharge could be linked to conditions like inflammation or tumours (growths) such as fibroids/polyps or cervical cancers.

Steps to take when you have abnormal discharge

• Consult a healthcare practitioner: Seek guidance from a healthcare provider for proper diagnosis and treatment.
• Partners’ involvement: If applicable, involve your partner(s) in discussions about symptoms and potential treatment to prevent further spread.
• If there’s discharge and pain, consider seeing a gynaecologist who can prescribe appropriate treatments, such as antibiotics as some of these conditions if not treated, can result in severe complications such as sepsis (complicated infections that require admission and possibly operation) or infertility.
• Regular check-ups: Regular pap smears are vital for detecting precancerous changes early and ensuring timely treatment.

Steps to maintain a healthy vaginal health

• Abstinence reduces the risk of infections.
• Safe sex practices such as using barrier contraception and limiting the number of partners, can help prevent infections.
• Hygiene and well-being.
• Healthy diet.
• Avoid douching as this removes the normal protective flora present in the vagina.

Understanding vaginal discharge and its nuances is an essential aspect of women’s reproductive health. While normal discharge is a sign of a well-functioning body, abnormal discharge can indicate underlying issues that require attention. By staying informed, seeking medical advice, and practising good hygiene, women can ensure their vaginal health and overall well-being.