Vaginal Discharges
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 Vaginal Discharges

 Vaginal Discharges

What is a vaginal discharge?

Vaginal discharge is the secretion of fluid in the vagina. It may be clear, white, yellow or greenish in colour.

Not all vaginal discharge is abnormal.

Normal secretions (“physiological discharge”) from the vaginal lining and cervix cause a discharge that can vary with age, the menstrual cycle and sexual activities.

The most common causes of discharge are: physiological, bacterial vaginosis and thrush.

What causes vaginal discharge?

Sexually Transmitted Infections (STIs)​ Non-Sexually Transmitted Infections
• Chlamydia
• Gonorrhoea
• Trichomonas vaginalis (TV)
• Genital herpes​
• Bacterial vaginosis (BV)
• Thrush (candidiasis)​
 

Vaginal discharge which is excessive in amount, yellow or green in colour, blood-stained, foul-smelling or itchy is considered abnormal.

Sometimes vaginal discharge may be due to non-infectious causes, eg. abnormal cervical tissue growth, cancerous growths, foreign bodies (e.g. tampons).

Chlamydia

Chlamydia is a bacterial STI. Most women with chlamydia do not have any symptoms.

• May present as a vaginal discharge 1 to 3 weeks after sex with an infected partner.
• May also present with pain when passing urine.
• Cause bleeding during or after sex.
• Only a test can diagnose if the vaginal discharge is because of chlamydia or some other infection such as gonorrhoea and trichomonas.

Infected mothers may pass the infection to the newborn and cause eye and lung infections.

Diagnosis Treatment​
• Cervical swab
• Rectal swab (if you have anal sex)
Or
• Urine sample ​
• Oral antibiotics ​

 

Gonorrhoea

Gonorrhoea is a bacterial STI. It may cause a greenish-yellow vaginal discharge. There may also be a burning and painful sensation when passing urine. However, often there are no symptoms.

Diagnosis Treatment
• Vaginal swab
• Cervical swab
• Rectal swab (if you have anal sex)
• Throat swab
Or
• Urine sample ​
Single dose of antibiotic injection and oral antibiotics to cover chlamydia​

 

Untreated chlamydia and gonorrhoea infection may spread to the surrounding organs in the pelvis (eg. fallopian tubes and ovaries) resulting in pain, complicated pregnancy and infertility.

Trichomoniasis

TV is an STI caused by a single cell organism (protozoan). Symptoms may include:

• Large amounts of vaginal discharge which is greenish in colour and smelly.
• Itch and soreness of the vulva and vagina.

Untreated TV in pregnancy can cause complications such as early labour and a premature baby.

Diagnosis Treatment
• Vaginal swab​ • 1 week course of oral antibiotics​
 

Bacterial Vaginosis

BV is not generally passed on during sexual intercourse. However, it is more common among women with multiple sex partners and often develops soon after intercourse with a new partner. BV may be caused by douching (washing inside the vagina) which is not recommended, as it disturbs the balance of healthy and unhealthy bacteria in the vagina.

BV is caused by the overgrowth of certain types of bacteria that may normally be in the vagina. This can cause symptoms like a thin white-grey vaginal discharge or vaginal odour (fishy) that can be worse after sex or menses.

Diagnosis Treatment​
• Vaginal swab ​ • Oral antibiotics (avoid alcohol when taking this medication)​

 BV does not need to be treated unless you are experiencing bothersome symptoms, if you are about to have a procedure that could allow bacteria into the uterus (such as termination of pregnancy) or if you are pregnant. 

Some women find they have BV repeatedly. Other things you can do to reduce repeated BV:

• Never douche (wash inside the vagina).
• Always wipe from front to back when using toilet paper to prevent introducing bacteria from the anus into the vagina.
• Some women find avoiding semen being left in the vagina (by using condoms or partner not ejaculating inside the vagina) may reduce BV. 

Thrush / Candidiasis

Women normally have yeast spores on the skin and in the vagina, but sometimes under certain conditions (diabetes, pregnancy, use of steroids, oral contraceptives, antibiotics) they grow and multiply rapidly to cause vaginal discharge (often thick and clumpy) and genital itch.

Thrush is not an STI but some sexual partners of infected people may develop skin rashes on the penis.

Diagnosis Treatment​
• Vaginal swab​ • Antifungal pessaries inserted into vagina​

The underlying condition should be controlled or removed if possible eg. diabetes, antibiotics

Women with repeated thrush may be prescribed longer term treatment (maintenance therapy).

How are vaginal discharges diagnosed?
 
A detailed medical history, pelvic examination and relevant laboratory tests will enable your doctor to identify the cause.
 

Important Notes

 
• Seek medical treatment immediately.
• Avoid sex.
• Avoid self-medication.
• Inform your doctor of any drug allergies.
• Complete the course of treatment prescribed by your doctor.
• Notify your sex partner(s) to get tested and treatment if you have been diagnosed with an STI.

If you have been diagnosed with an STI, avoid sexual contact until you have completed treatment. With some types of STIs (e.g. chlamydia, gonorrhoea, trichomonas), your sexual partner(s) needs to be treated as well before you resume sexual activity.
 

Disclaimer

 
We have attempted to provide full, accurate and up to date information in this patient information leaflet, based on current medical evidence and opinion. However, information and advice may vary from different sources, and over time. If you have any further questions, see your doctor or healthcare provider.
 
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Last update on 23 Sep 2014
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