May 22nd 2018
Sex & Gynae
What your vaginal discharge is trying to tell you
April 4th 2018 / 0 comment
It’s the topic that sexual health experts are asked about the most, from women of all ages. From smell to post-sex secretions and douching, here’s your ‘no holds barred’ guide to what’s “normal”, and what’s not
At a recent book launch at the Norwegian embassy in London, talk turned to discharge. Sure, those Scandis are an open, frank bunch, but we weren’t careering into chat about vaginal secretions from nowhere: this was a get together to celebrate the publication of a particularly brilliant ‘vagina bible’, written by Norwegian medics and sexual health experts Nina Brochmann and Ellen Støkken Dahl. The Wonder Down Under is an accessible, funny, informative and myth busting tome that takes in everything from extreme periods to the hymen myth, but by far the most common question put to Brochmann, Støkken Dahl and their colleagues by women of every age around the globe goes like this…
“Is my discharge normal?”
This question is almost always quickly followed up by a list of concerns about odour. Given that our vaginas have been literally birthing human life, expelling blood, hosting penises and generally effectuating all manner of important tasks since the dawn of time, the fact that women from pre-teens to post-menopause and beyond remain primarily concerned with vaginal mucus, and whether it’s ‘dirty’ or not, probably speaks a lot about our enduring cultural insistence that women be ‘pure and ‘clean’, less than comprehensive sex ed programmes and lingering taboos about women’s health and bodies in general. Well, not here, and not today. It’s time we got candid about vaginal secretions and sorted the ‘red flags’ from the regular, healthy, day to day discharge, starting with one salient, unarguable fact…
Your discharge isn’t dirty
As it happens it’s quite the opposite, as Brochmann and Støkken Dahl explain:
“Discharge isn’t just normal, it’s a must. It makes the vagina into a self-cleaning tube. Its purpose is to keep the vagina clean and to flush out unwelcome guests such as fungi and bacteria, as well as dead cells from the surface of the mucous membrane.
“At the same time discharge lubricates the mucous membranes and keeps them moist. Dry mucous membranes are easily torn and once that happens, problems quickly follow. Just think what your mouth would be like without spit. Without discharge, the mucous membranes in the vagina tear and you get little sores. Sex becomes a nightmare and the likelihood of sexually transmitted infections also increases because the body’s outer barrier has been damaged. In other words, discharge isn’t some dirty thing that should be flushed out of our vaginas, but an important ally.”
In short, don’t let anyone diss your discharge. It’s doing vitally important work by essentially enabling procreation alongside its humdrum bacterial defence role. Let’s promote it, not shame it. Which leads us to the next common discharge dilemma…
It’s meant to smell slightly funky
It’s all down to bacteria, but good bacteria this time. Spokesperson for the Royal College of Gynaecologists and Obstetricians Professor Ronnie Lamont gives us the bacterial breakdown:
“The vagina contains more bacteria than anywhere else in the body after the bowel, but the bacteria are there for a reason, including helping to keep the vagina's pH balance (how acidic the vagina is) at an even level, which helps keep the balance of bacteria healthy.”
The vagina’s main pH balancer is a bacteria called lactobacillus (lactic acid), which, alongside the concentration of sweat glands around your genital area, is responsible for the sometimes tangy scent. The Norwegians even have a fond term for the smell of the vaginal area after a long day/ sweat session, namely a ‘disco mouse’. A vagina that’s had a lovely time on the dance floor, thanks very much, and is now emanating a kind of clammy aroma. Not “bad”, just a tiny bit ‘post-exertion armpit’.
Just as your vulva/ labia/ nose/ face differs to that of the woman next to you, so your natural scent will be unique to you, and whatever you do don’t go ‘masking’ it with strongly perfumed vaginal deodorants and the like- Brochmann and Støkken Dahl compare the use of these on the delicately balanced vagina environment to spraying perfume on your eyeballs. Don’t even. That’s not mentioning the fact that fragranced creams, deodorants and washes often undo all of the efforts of your beneficial bacteria, throwing the pH of your vagina out of whack thus increasing the likelihood of infections. Ditto vaginal douching. You don’t need to take your “wonder down under” to the car wash. Warm water and a pH balanced (around 4.5), fragrance-free body or ‘intimate’ wash is as far as you should go- even regular soap can cause issues.
Other v-care commandments include wearing cotton pants (or at the very least a breathable cotton gusset- not sexy, but then neither is an unhappy vagina) and wiping from front to back after going to the loo to prevent the transmission of bowel bacteria to your sensitively balanced vaginal habitat.
It ebbs and flows
Just as some women experience heavy periods while others literally get off lightly, so the amount of discharge you excrete varies, not only from woman to woman but from day to day. The rough average is a teaspoon a day, but everything from sex to your menstrual cycle affects how much discharge you produce, as gynaecologist Dr Tania Adib explains:
“The amount of discharge you produce depends on which point of your menstrual cycle you are at. Discharge is usually more plentiful and can be quite stringy when you’re ovulating, breastfeeding, or are sexually aroused.”
Discharge is often heavier during pregnancy and before your period, and hormonal changes can also cause discharge levels to fluctuate around the menopause. Its smell can alter slightly during pregnancy, but as long as your discharge is generally clear to milky white in colour and ‘slippery’ in texture, without an unpleasant odour, you should be all good. If you notice any of the following, however, get thee to the GP…
The dodgy discharge checker
A fishy smell
A strong, rotten fish whiff is often characteristic of bacterial vaginosis, which, according to Helen Knox, Clinical Nurse Specialist in Contraception and Sexual Health, is known to affect one in three women of childbearing age at one point or another and can be triggered by everything from tight clothing to perfumed toiletries and panty liners and even sperm, owing to its alkaline pH. Bacterial vaginosis is caused by an imbalance in your vaginal bacteria and it can be effectively treated with a course of antibiotics.
“Cottage cheese” discharge
Sorry to put you off your lunch, but thick, curd like discharge, often accompanied by an itching, burning sensation can be indicative of thrush. You may also notice a more ‘yeasty’ smell than usual, owing to the fact that thrush is a fungal infection. Be assured that almost every woman on the planet will experience thrush at some point during her life, and its easily treated with a course of over-the-counter antifungal medicine, although see your GP if it’s the first time you’ve had it, or if your thrush is recurring. It’s also important to see a doctor if you’ve got thrush while pregnant or breastfeeding. Thrush is especially common during pregnancy and the menopause and in women aged 20-30.
Green, yellow, frothy discharge with an unpleasant odour
Surely the horror story of vaginal secretions, these symptoms could be caused by trichomoniasis, a sexually transmitted infection caused by a small parasite. It can be accompanied with cystitis-esque burning when you pee, and often soreness, swelling and itching in the vaginal area. All in all, not nice, but it can be treated with an antibiotic prescribed by a doctor or sexual health specialist.
Cloudy yellow discharge
This could be a symptom of gonorrhea, which is now one of the most common bacterial STIs in the UK according to Public Health England. The gonorrhea bacteria infects the cervix, where the fluid glands that produce vaginal discharge are located, hence the thick, yellow discharge that can often ensure. You may also experience pain when you pee and bleeding between periods, but if you’re in any doubt, book an appointment with your GP or local sexual health specialist to get tested. Antibiotics should clear things up within a matter of days. More rarely, similar discharge can be caused by chlamydia, so it’s always a good idea to get screened for this too- your local STI or GUM clinic will offer this.
Red or brown discharge
Blood in your discharge can occur if you have an irregular menstrual cycle, but it can also be a sign of an STI, or less commonly, cervical and endometrial cancers. Book an appointment with your GP to be on the safe side, and never ignore pelvic pain, bleeding after sex, vaginal soreness or pain when peeing.
The Wonder Down Under: A User’s Guide to the Vagina, £14.99 (Hodder & Stoughton), buy online