Women experience vaginal secretions throughout their menstrual cycle, especially on the days leading to their ovulation. This is a sign of health and is not a cause for concern. But what signs should you look out for that may indicate something is off with your vaginal discharge?
In this article, we put together all you need to know about vaginal discharge – the good, the bad, and the unusual.
So, let’s delve into this topic without inhibitions, shall we?
What is vaginal discharge?
Vaginal discharge is the fluid, usually white or clear, that is released by the uterus, cervix, and vagina at the exterior orifice of female bodies. It includes arousal fluid, lubrication fluid secreted by the Bartholin glands (glands located on the sides of the vaginal opening) as well as cervical fluid. The latter is the main component of the discharge, and changes in response to hormones throughout the menstrual cycle. Scientists have found that cervical mucus secretion differs from day to day and correlates with the probability of pregnancy. It increases in quality and quantity in response to estrogen [1].
Vaginal secretions are the body’s way of maintaining a healthy natural balance in your reproductive environment. It helps eliminate dead cells and bacteria from the reproductive tract to keep it clean and healthy. Furthermore, the amount and thickness of the discharge vary throughout a woman’s menstrual cycle, which is linked to the changing hormone levels during the cycle [2].
This observation that vaginal discharge varies with the menstrual cycle, encouraged John Billings, an Australian physician, to study vaginal secretions as a method of predicting ovulation. Dr. Billings followed the discharge of hundreds of women and complemented their report with laboratory-based hormonal ovulation prediction tests. He observed dry discharge just before and after a period. Post-period, the discharge appeared clear and sticky, then followed by a wet, stretchy, and slippery substance at the time of ovulation. The method studied by Billings was then promoted as the “Billings Ovulation Method” for family planning [3]. When this method is combined with hormonal monitoring, women have the opportunity to gain scientific knowledge about their monthly cycle and hormone trends.
“The mucus is the most reliable sign of fertility - it is not only a sign of fertility, it is fertility.”
Dr. Billings
Based on cutting-edge endocrine and reproductive science, the inne minilab, on top of tracking your progesterone levels, has a feature that provides a mobile tracker for your cervical fluids, allowing you to monitor your period with accuracy. It helps women understand when they are most fertile, and when they are at their low fertility days.
What does normal discharge look like?
Normal discharge is clear, or milky white, with a slippery to a mucus-like texture, maybe with a subtle odour that changes over time. These changes in thickness, colour, and scent are natural and are associated with ovulation [4]. While every woman is essentially different, research reveals that a healthy woman produces one half to one teaspoon (2 to 5 ml) of vaginal fluid every day [5]. You may now begin to ask what keeps vaginal discharge normal? What is the natural balance? And how is it maintained?
The human body maintains a natural balance of vaginal flora or microbiome, acidic pH, and discharge that guard against vulvovaginal infections. They act as the critical components of the natural immune system. The acidic vaginal pH (3.8 to 4.5) is maintained by resident bacteria that compete with other harmful or disease-causing bacteria. Interestingly, vaginal flora also releases antimicrobial compounds, i.e., bacteriocin, that resists other invading infectious bacteria [6].
How does discharge change throughout my cycle?
Depending on the menstrual cycle, vaginal discharge may change from day to day.
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At the onset of, and after the menstrual cycle: Dry
At the start of the menstrual cycle and right after periods, women usually experience dry days. At this time, the follicles are growing in the ovaries and getting ready to release an egg at ovulation. These follicles are responsible for estrogen hormone production that causes more discharge at the time of ovulation. -
Before ovulation: Sticky and Creamy
Before the egg release, the discharge becomes thick, glue-like in consistency, and cloudy white, or yellow in colour, especially when it dries on the underwear. You may notice this type of discharge prior to ovulation. Here, the egg is in the developmental stage. -
Immediately prior to ovulation: Runny, Stretchy, and Egg White
Just 1-2 days before ovulation, the discharge gets clearer, watery, stretchy, and slippery. Here, estrogen peaks, and the mucus feels more like a raw egg white that can be stretched between the thumb and forefinger [7]. Every woman may experience a different amount of discharge at this time; however, research says it is 10-20 times more than any other menstrual stage [8].
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During ovulation: Runny, Stretchy, and Egg White
As estrogen level peaks, ovulation discharge continues to be clear and stretchy, like a raw egg white. Research has shown that cervical secretion is 95% water and 5% other cellular components [9]. This fluid's pH and runny texture help the sperm swim into the uterus, and survive for up to 72 hours to fertilise the egg. For this reason, it is an ideal period for a couple to conceive [10]. -
The Luteal phase: Sticky and Dry
After day 1 or 2 of ovulation, the luteal phase starts, where the vaginal discharge decreases and changes once again. The progesterone hormone peaks and estrogen level drops, thereby inhibiting the cervical secretions. The discharge gets more fibrous, thick, and sticky. It also becomes almost difficult for the sperm to pass the cervix and reach the uterus [11]. Afterwards, the discharge before periods continues to be less and less, until eventually getting dry till the end of the menstrual cycle [12]. This takes us to menstruation, and then the menstrual cycle begins again.
Why is tracking discharge important?
Monitoring your cervical fluid can help trace the menstrual cycle, identify when you are fertile or not, notice your natural patterns, and understand your body. This discharge tracking, coupled with hormone monitoring, according to studies, provides the best chances of success for natural family planning [13] [14]. Many women wonder when the best time is to check their discharge. According to Dr. Billings, the best time to examine for amount, colour, and consistency is the evening to ensure you have moved enough for your discharge to come out [15].
While tracking discharge creates a simple strategy for understanding vaginal health, the menstrual cycle, and hormonal changes, it is always advised that you visit your doctor or healthcare provider to understand your needs and make the best of these methods.
What does discharge during pregnancy look like?
As pregnancy progresses, vaginal discharge increases with the rising estrogen levels during pregnancy [16]. It also gets heavier as it moves towards the end of pregnancy. This healthy cervical discharge is termed “leucorrhoea”. Usually, the discharge is thick in consistency, odourless or with a mild odour, and generally clear to white.
What is ‘atypical’ and when should you consult a doctor?
What does brown or yellow discharge mean? Why am I having a thick white discharge? You could find yourself struggling with such questions.
If you begin seeing irregularities in your vaginal discharge that bother you, it could be a sign of a vaginal infection. It’s best to consult with your gynaecologist to determine the cause and get proper treatment.
Vaginitis, or vaginal infections caused by microbes, does not only result in discomfort but it may also lead to reproductive health complications if left untreated.
The following are signs of an abnormal vaginal discharge and symptoms of vaginal infection:
- Fishy odour
- Cottage cheese-like texture
- Itchiness
- Yellow/brown/green/greyish discharge
- Redness and swelling
Causes of atypical vaginal discharge
It is important to know the possible causes of your vaginal discharge so you can seek appropriate help. Having a stinky situation down there could affect your confidence as a woman. More importantly, it poses a threat to your feminine health that needs to be addressed without delay.
- Bacterial vaginosis: Bacterial vaginosis is the most common sexually transmitted bacterial infection (STI), affecting about 29% of women. It causes increased cervical discharge, usually with a sturdy, foul and fishy smell [17].
- Yeast infection: Vaginal yeast infection, also called candidiasis, is a fungal infection that usually involves itching of the vulva and burning sensations. Research reveals that these symptoms are mostly noticed on days 19-24 of the menstrual cycle [18]. Yeast infection discharge is a thick white discharge similar to cottage cheese [19]. Typically, yeast resides in the vagina, however, when it grows uncontrollably, it causes infection [20]. Birth control pills, stress, pregnancy, diabetes, and the use of antibiotics may contribute to a vaginal yeast infection [21].
- Chlamydia and gonorrhoea: These are STIs that cause abnormal discharge. During these infections, the secretions may appear greenish, yellow, or milky in colour [22].
- Trichomoniasis: Trichomoniasis is another STI caused by a protozoan parasite called Trichomonas. Many women acquire an asymptomatic infection that has no apparent clinical features. However, typical clinical symptoms include green or yellow and frothy vaginal discharge with a foul smell. It could also come with irritation, pain, and inflammation sometimes [23].
- Human papillomavirus (HPV): HPV is the most common viral STI affecting the reproductive tract. It is the leading cause of 95% of cervical cancer cases. It may also cause genital warts. Women with HPV infection usually secrete foul-smelling, dark brown, bloody, or watery vaginal discharge [24].
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Pelvic inflammatory disease (PID): This infection affects women’s upper genital tract and is caused by various microbes that attack the reproductive organs. The common symptoms include foul-smelling and heavy vaginal discharge, lower abdominal pain, fever, and bleeding between periods [25].
Prevent A Discharge Scare Through Feminine Care
It’s important to understand your natural discharge patterns in line with your hormonal fluctuations. The inne minilab helps you understand your baseline female health, so you can detect abnormalities. To protect your vagina and the rest of your reproductive tract, it is important to have healthy habits and a mindful lifestyle.
Remember, a happy and healthy woman should take charge of her life. And it all begins with your body.
Interested in more readings about vaginal discharge? Why not check our related content: “The Wonders of Our Cervical Fluid”.
References
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2. Rice, A., et al., Vaginal discharge. Obstetrics, Gynaecology & Reproductive Medicine, 2016. 26(11): p. 317-323.
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