Vaginal discharge is the body’s way of clearing old cells from the vagina and keeping the reproductive organs healthy. It is perfectly normal under certain circumstances and at particular times of the month.
However, changes in the amount, color, or smell of vaginal discharge, are not normal and could signal an underlying condition that requires treatment.
What is Vaginal Discharge?
The vagina is a self-cleaning machine that maintains a mildly acidic pH level and a perfect balance of friendly and harmful bacteria, known as the vaginal microbiome. Vaginal discharge is how old cells and harmful bacteria are flushed from the vagina to keep it healthy.
Produced by glands inside the cervix and vagina, this vaginal fluid is typically clear or white, and odorless. Each day, small amounts of vaginal discharge are excreted from the vagina along with old or dead cells. Some women may notice their normal vaginal discharge, while others won’t.
When is Increased Vaginal Discharge Normal?
It’s normal for women to experience more vaginal discharge at certain times. For instance, during pregnancy, breastfeeding, or the prelude to a girl’s first period. It’s also normal before ovulation, during hormone fluctuations, and when sexually aroused.
When aroused, another set of glands inside the vaginal opening produces fluid that blends with the existing vaginal fluids to lubricate the area for intercourse. This can sometimes appear as increased vaginal discharge for some women.
Before a woman’s first period, and just before ovulation, estrogen levels are higher, which causes an increase in vaginal discharge. As soon as estrogen levels drop, however, vaginal discharge typically returns to normal.
Women on birth control or fertility treatments containing estrogen can also experience more vaginal discharge than usual. And during pregnancy, the production of vaginal discharge is increased to protect the vagina and baby from infection.
When Does Excessive Vaginal Discharge Indicate a Problem?
When increased vaginal discharge is accompanied by additional changes it is typically the body’s way of indicating an underlying infection or condition that requires medical treatment.
These changes include:
- When the odor of your vaginal discharge becomes pungent
- If vaginal discharge changes from clear or white to gray, green, or yellow
- Itching, inflammation, or burning around the vagina
Heavy vaginal discharge accompanied by one or all of the above symptoms can indicate several types of infections or conditions that require different forms of medical treatment. Although many involve antibiotic treatment, the type of antibiotic can vary for each. Therefore, it’s always best to consult with your healthcare provider for a proper diagnosis and treatment.
Common Causes of Increased Vaginal Discharge
Although temporary increases in vaginal discharge can occur monthly and are perfectly normal, experiencing more vaginal discharge that is accompanied by a pungent odor or color changes could be a reason to see your doctor.
The five most common causes of increased vaginal discharge that require attention are outlined below.
1. Vaginal Yeast Infection
Also known as Vaginal Candidiasis, vaginal yeast infections are caused by an overgrowth of a fungus called candida, which is a type of fungus that naturally grows in the vagina and is a part of the vaginal microbiome. As many as 70% of women are known to have at least one yeast infection in their lifetime, with some women experiencing more.
Most commonly caused by bacteria spreading from the anus to the vagina during sex or after bowel movements, yeast infections can also be instigated by wearing pants that are too tight. In these cases, moisture is trapped around the genitals and provides a perfect environment for yeast to grow.
Other factors known to trigger yeast infections include fluctuation hormones, a weak immune system, taking antibiotics for another condition, stress, a poor diet, and untreated diabetes.
With yeast infections, vaginal discharge often increases and changes to a white lumpy texture resembling cottage cheese. While most women don’t notice any odor changes with a yeast infection, some experience a sweet or yeasty smell. Vaginal itching and inflammation are often common, as well as a burning sensation when urinating, and some women also feel pain or discomfort during sex.
2. Bacterial Vaginosis (BV)
BV is the most common vaginal infection among sexually active women aged 14-45. It is caused by an overgrowth of harmful bacteria in the vagina, which alters the mildly acidic pH levels and allows a bacterial infection to take hold.
Although it is not considered a sexually transmitted infection, the alkalinity of semen, the genital chemistry of sexual partners, and fluctuating hormones are thought to contribute to the altered pH levels and bacterial overgrowth associated with BV.
For these reasons, women with several sexual partners and those experiencing hormone fluctuations during pregnancy or perimenopause are often more susceptible to BV infections.
Vaginal discharge typically changes to a gray color with BV and is often accompanied by a fishy odor. Additional symptoms include vaginal irritation and itching, pain during sex, as well as a burning or stinging sensation when urinating.
3. Trichomoniasis
Trichomoniasis is a sexually transmitted infection (STI) that is passed on during unprotected sex. Also known as ‘trich’, it is caused by the spread of a parasite known as Trichomonas Vaginalis. Although it is a commonly transmitted infection, only 30% of people experience symptoms from trich.
When symptoms do occur, they can include a yellow or green vaginal discharge and a foul or fishy odor. Genital itching and inflammation are also common symptoms of trich, as well as a stinging sensation when peeing and pain during sex (dyspareunia).
If trichomoniasis is left untreated, it can increase your chances of contracting and spreading further STIs like chlamydia, gonorrhea, herpes, HIV, and syphilis.
4. Chlamydia & Gonorrhea
Gonorrhea and chlamydia are the two most common STIs in the world, however, they are often asymptomatic in women, meaning no obvious symptoms occur. When they do, the vaginal discharge from both STIs is typically cloudy, green, or yellow with a pungent or fishy odor.
Additional symptoms can include genital itching and inflammation, lower abdominal pain, burning when peeing, pain during sex, and sometimes, spotting between periods.
If left untreated both chlamydia and gonorrhea can result in serious, long-term health issues.
5. Pelvic Inflammatory Disease (PID)
PID is a serious infection of the female reproductive organs including the fallopian tubes, ovaries, and uterus. It occurs when an STI or vaginal infection is left untreated and the bacteria travels through the cervix into the reproductive organs. If PID is not treated, it can cause infertility and long-term pain.
That said, an overgrowth of harmful bacteria that are normally present in the vagina can also cause PID. This occurs when something causes an imbalance in the vaginal microflora such as a vaginal infection, unprotected sex, vaginal douching, or taking antibiotics for another condition.
Heavy vaginal discharge with a foul smell, chronic pelvic pain, pain during and after sex, a frequent urge to pee, a burning sensation when peeing, and severe menstrual pain are common symptoms of PID. Other symptoms can include fever, chills, and spotting between periods.
Conclusion
A temporarily heavier vaginal discharge can be caused by the onset of your first period, ovulation, pregnancy, breastfeeding, or sexual arousal. However, increased vaginal discharge that is accompanied by a color change, genital itching, a burning sensation when peeing, or pain during sex usually signals the presence of a vaginal infection or a sexually transmitted infection (STI).
Although antibiotics are required to treat most vaginal infections and STIs, natural supplements like boric acid suppositories and probiotics help restore a healthy vaginal environment after infection and prevent it from recurring.
References
American College of Obstetricians & Gynecologists – Is it Normal to Have Vaginal Discharge - https://www.acog.org/womens-health/experts-and-stories/ask-acog/is-it-normal-to-have-vaginal-discharge
Bacterial vaginosis. (2022).
https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis
Journal of The American Sexually Transmitted Diseases Association - Boric Acid Addition to Suppressive Antimicrobial Therapy for Recurrent Bacterial Vaginosis - https://journals.lww.com/stdjournal/Fulltext/2009/11000/Boric_Acid_Addition_to_Suppressive_Antimicrobial.13.aspx
Johns Hopkins Medicine – Yeast Infection - https://www.hopkinsmedicine.org/health/conditions-and-diseases/candidiasis-yeast-infection
National Library of Medicine - Clinicians’ use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878170/
National Library of Medicine - Vaginal and oral use of probiotics as adjunctive therapy to fluconazole in patients with vulvovaginal candidiasis: A clinical trial on Iranian women https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006731/
Centers for Disease & Control Prevention – Trichomoniasis - https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm
National Library of Medicine - Successful Treatment of Persistent 5-Nitroimidazole–Resistant Trichomoniasis With an Extended Course of Oral Secnidazole Plus Intravaginal Boric Acid - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010696/
World Health Organization – Sexually Transmitted Infections - https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
Office on Women’s Health – Pelvic Inflammatory Disease - https://www.womenshealth.gov/a-z-topics/pelvic-inflammatory-disease