Vaginal discharge helps cleanse and protect the vaginal area, but changes in colour, texture, or smell may signal infection. Bacterial vaginosis is the most common vaginal infection in women aged 15–44.
Contents
What is a Vaginal Discharge?
Vaginal discharge refers to secretions from the cervix and vaginal glands, consisting of mucus, normal flora (such as lactobacilli), dead epithelial cells, and moisture. This discharge supports vaginal health by maintaining acidic pH, regulating microbiota, and preventing pathogen overgrowth.
Physiological variations in vaginal discharge occur during different phases of the menstrual cycle:
- Ovulation: Clear, stretchy, egg-white texture
- Post-ovulation: Thicker, creamier
- Menstruation onset: May appear brownish from old blood
Changes beyond these natural patterns may suggest conditions like bacterial vaginosis, a yeast infection, or sexually transmitted infections (STIs).
What is Abnormal Vaginal Discharge?
Abnormal discharge occurs when there is a noticeable change in colour, consistency, volume, or odour. These changes may be accompanied by additional symptoms such as vaginal itching, burning, discomfort, or pelvic pain.
Abnormal vaginal discharge is often a sign of an underlying condition, which may be infectious (such as a sexually transmitted infection) or non-infectious (such as hormonal imbalance or irritation from personal care products).
Common characteristics and their possible meanings are summarised below:
- Abnormal colour eg yellowish, brownish, thick white or green discharge
- Abnormal consistency eg clumpy, like cottage cheese, thick
- Abnormal smelling unpleasant odor or foul odor eg fishy odor
- Abnormal amount of discharge
- Abnormal symptoms associated eg vaginal itch, soreness, burning or abdominal pain
- Blood streaks seen in discharge
Type/Colour Of Discharge | What It May Mean | Other Associated Symptoms |
|---|---|---|
Transparent |
| usually none |
Cloudy white |
|
|
Clumpy, cottage cheese like |
|
|
Yellowish Greenish |
|
|
Brownish discharge |
|
|
Blood streaked |
|
|
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When to See a Doctor? Seek medical advice if the discharge is persistent, has a strong odour, is accompanied by pain or irritation, or occurs after sexual activity.
Causes of Vaginal Discharge
Vaginal discharge may occur as part of your body’s natural cycle or signal an underlying issue. It is important to understand when discharge is normal and when it may require further evaluation.
Physiological (Normal) Causes
Normal vaginal discharge occurs in response to hormonal changes and usually does not indicate an infection. These include:
- Ovulation: Oestrogen peaks mid-cycle, causing clear, stretchy discharge
- Pregnancy: Hormonal shifts increase cervical mucus production
Sexual arousal: Triggers temporary lubrication - Menstrual cycle changes: Natural variation in volume and consistency
- Hormonal contraceptives: May increase or thin vaginal secretions
Non-Infectious Causes
Not all abnormal vaginal discharge is due to infection. Several non-infectious conditions can also lead to changes in vaginal discharge:
- Atrophic Vaginitis (Postmenopausal Vaginal Atrophy): This condition is linked to oestrogen deficiency, typically after menopause. The thinning and drying of the vaginal walls can cause watery or yellowish discharge, irritation, and pain during intercourse. Unlike cyclical hormonal changes, this is a chronic condition requiring medical management.
- Allergic Reactions or Irritants: Scented soaps, bubble baths, douches, or certain detergents can irritate the vaginal lining, leading to inflammation and discharge.
- Foreign Objects: Retained tampons or contraceptive devices (such as diaphragms or vaginal rings) may cause an inflammatory reaction or infection, resulting in an abnormal vaginal discharge.
- Other Hormonal Imbalances: Changes in hormone levels, particularly due to oral contraceptives or hormonal therapy, can influence the volume and consistency of vaginal discharge. These changes are usually not harmful and often reflect increased cervical mucus production in response to oestrogen.
- Cervical Changes: Conditions like cervical ectropion or cervical polyps can cause blood-streaked discharge, especially after sexual activity.
If discharge becomes persistent, unusually coloured, foul-smelling, or is associated with itching, bleeding, or pain, seek medical evaluation.
Infectious Causes
Abnormal vaginal discharge is commonly due to infection. These include:
Bacterial Vaginosis (BV):
Bacterial vaginosis is the most common cause of vaginal discharge in women of reproductive age. It results from the overgrowth of Gardnerella vaginalis and a disruption in normal vaginal flora, which alters the vaginal pH.
The discharge is usually thin, greyish-white or yellowish, and has a characteristic fishy odour, especially after intercourse.
Factors that may contribute to BV include:
- Use of antibiotic medications
- Unprotected sexual intercourse
- Menstrual cycle changes
- Overuse of feminine washes, douches, and bubble baths
- Pregnancy, which increases susceptibility due to hormonal changes
Yeast Infection (Candidiasis):
Yeast infection is a common vaginal condition caused by the overgrowth of Candida albicans, a type of fungus naturally present in the vagina.
It typically presents with thick, white, clumpy discharge resembling cottage cheese, along with vaginal itching, soreness, and redness.
Yeast overgrowth can occur when the normal balance of vaginal flora is disrupted, commonly triggered by:
- Antibiotic use
- Hormonal contraceptives (e.g. birth control pills)
- Pregnancy
- Feminine hygiene products like sprays or scented washes
- Sexual activity, especially when combined with other risk factors
Pregnant women are more prone to yeast infections due to hormonal fluctuations and changes in vaginal pH.
Sexually Transmitted Diseases (STDs):
STDs include a range of infections that can cause abnormal vaginal discharge. Some may present with obvious symptoms, while others remain silent and only surface during routine screening. Common STD-related causes include:
- Chlamydia and Gonorrhoea: These bacterial infections may result in thick yellow or green discharge, bleeding between periods, and pain during urination or sex. Many cases are asymptomatic.
- Trichomoniasis: A parasitic infection caused by Trichomonas vaginalis, resulting in frothy, yellow-green discharge with a foul smell. Symptoms may also include burning or vaginal irritation.
- Ureaplasma and Mycoplasma: These are sexually transmissible bacteria that may lead to chronic irritation or watery discharge. They often co-exist with other infections and are frequently overlooked.
- Herpes Simplex Virus (HSV): While less commonly associated with vaginal discharge, HSV may cause watery secretions, especially during an active outbreak with sores or blisters.
- Human Papillomavirus (HPV): Most HPV infections are asymptomatic, but certain strains linked to cervical changes may occasionally present with abnormal bleeding or discharge.
STDs can occur without symptoms. Regular STI screening is recommended for sexually active individuals, especially those with new or multiple partners.
Vaginal Discharge Treatment
| Cause | Treatment Approach |
|---|---|
| Bacterial infection (e.g. BV, chlamydia) | Oral or vaginal antibiotics |
| Yeast infection (candidiasis) | Antifungal creams, pessaries |
| Parasitic infection (trichomoniasis) | Oral antiprotozoal medication |
| Atrophic vaginitis (menopause-related) | Local oestrogen therapy or non-hormonal moisturisers |
| Allergic reactions or irritants | Avoidance of triggers, topical anti-inflammatory creams if needed |
| Foreign objects (e.g. tampon) | Removal of object; antibiotics if secondary infection is present |
Important: Do not self-diagnose or begin treatment based on symptoms alone. Different causes of vaginal discharge require different approaches, and the wrong treatment can delay recovery or worsen the condition. Always consult a doctor for an accurate diagnosis and appropriate management. If symptoms persist, worsen, or keep coming back, follow up promptly with your healthcare provider.
What to Expect from your Doctor
STD and non-STD infections can present with similar symptoms, including abnormal vaginal discharge. While some conditions such as yeast infections may show distinct characteristics—like thick, clumpy, cottage cheese-like discharge—co-infection with more than one type of bacteria is common. This overlap makes it difficult, and often inaccurate, to diagnose the cause of discharge based on symptoms alone.
It is therefore extremely important for a doctor to perform a vaginal swab test. This helps identify specific bacteria, yeast, or parasites and ensures that serious infections such as chlamydia or gonorrhoea are not missed. Left untreated, these infections can lead to long-term reproductive complications.
⚠️ Caution: Self-medicating with over-the-counter products or purchasing medication online—without proper medical evaluation—may delay diagnosis and unnecessarily prolong your symptoms.
If you are experiencing abnormal discharge, it is best to have it medically reviewed by an experienced women’s health doctor who can assess, test, and manage your vaginal discharge condition properly.
How to Prevent Vaginal Discharge?
While some vaginal discharge is normal, you can reduce your risk of developing abnormal discharge by maintaining good hygiene habits and avoiding common triggers.
- Avoid using feminine washes or douches, which can disrupt healthy vaginal flora
- Use condoms consistently and correctly during sexual activity to reduce the risk of STDs
- Avoid bubble baths and strong scented products around the vaginal area, which may cause irritation or allergic reactions
- Wipe from front to back after using the toilet to prevent bacterial transfer from the rectum
- Limit the use of foreign objects such as tampons or menstrual cups, especially for extended periods
- Consider taking probiotics if you are using antibiotic medications, to help maintain vaginal flora balance
- Choose breathable cotton underwear that is not too tight, to reduce moisture build-up
FAQs About Vaginal Discharge
You should be concerned when there is a change in the colour, consistency,volume or unpleasant odour that comes with the discharge.
Abnormal vaginal discharge is never normal, and if you are experiencing any signs suggestive of abnormal discharge or infection, it is important to get yourself checked as soon as possible.
Ezra Clinic provides assessment and treatment for a range of vaginal and sexual health concerns, from common infections to fertility and STD screening.
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AUTHOR
Dr Michelle Chia
Medical Director
After graduating from the National University of Singapore, Dr Michelle's journey allowed her to train in Women's Health and Aesthetic Medicine. Her experience has led her to be featured on multiple media platforms including Radio Stations and prominent Magazines like Her World, Women's Weekly and CLEO. Her work has also received recognition both locally and internationally in several Medical Conferences.
Ezra Clinic is a Women’s Health, Wellness and Aesthetic Clinic that is conveniently located at the top floor of Royal Square Medical Suites in Novena, Singapore’s Medical Health Hub.
Helmed by Dr Michelle Chia, Ezra Clinic is your chosen one stop clinic for all your Women’s Health and Wellness needs.
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101 Irrawaddy Road #21-09, Royal Square Medical Centre, Singapore 329565
