Nearly every woman will experience vaginal discharge at some point in life.

What is vaginal discharge?

Vaginal discharge is a fluid or semisolid substance that comes out of the vagina. A small amount of non-smelly clear vaginal discharge is normal, usually a reflection of the body's normal cleansing process. Some women experience normal changes in their vaginal discharge based on where they are in their menstrual cycle. However, a vaginal discharge that is discolored, that has a strange or different consistency, or that smells strange should be something you should watch out for, especially if it's associated with certain symptoms such as significant itching, burning,  irritation or other uncomfortable symptoms.

Most often, vaginal discharge is normal and does need no treatment, and sometimes it's just the first pregnancy sign, but there can be other causes that require medical treatment. 

Distinguishing vaginal discharge:

• Vaginal discharge odor and smell
• Vaginal discharge color
• Vaginal discharge consistency (watery, bloody, etc)

Vaginal discharge during pregnancy

To a certain extent, vaginal discharge is normal during pregnancy. However, there are some changes in vaginal discharge that could be of concern, whether the discharge could indicate that your water has broken or that you are at risk of going into premature labor, especially if the vaginal discharge is watery, mucus-like or bloody. 

Is postpartum vaginal discharge normal? 

After delivery, whether it's a vaginal delivery or a cesarean delivery, it is normal to see some bloody vaginal discharge. In fact, this discharge was given a special name: Lochia.
Lochia may normally last four to six weeks and sometimes even longer.

Normal lochia usually changes as the weeks after delivery pass from initially bright red just after delivery to a darker brown and finally to a creamy tone. 

You should call or see your doctor for any of the following which are not normal:

• Foul-smelling lochia is not normal
• Excessive bleeding (more than a pad per hour) is not normal
• Abdominal pain is not normal
• Fever is not normal

Any change in the vagina's balance of normal bacteria can affect the smell, color, or discharge texture. Here's a list of the most common conditions that upset that balance:

Causes of vaginal discharge

• Normal hormone changes during the menstrual cycle
• Pregnancy
• Imbalance of the vaginal flora
• Infections
• Bacterial vaginosis
• Yeast
• Chlamydia
• Gonorrhea
• Trichomoniasis
• Medications such as antibiotics or steroid use
• Birth control pills
• Cervical cancer
• Medical problems (diabetes)
• Douches, scented soaps or lotions, bubble bath
• Pelvic infections (pelvic inflammatory disease (PID))
• Menopause (vaginal atrophy)
• Vaginitis, irritation in or around the vagina

Change in hormones

A frequent cause of vaginal discharge is a change in hormones during the menstrual cycle, and when you are pregnant. When ovulation occurs, vaginal discharge will change. Normally, vaginal discharge is thick and sticky when a woman is not ovulating. As ovulation approaches, vaginal discharge changes to a thin, stretchy film that helps sperm travel to the egg. 

Yeast-based infection

A common cause of vaginal discharge is a yeast infection. Women can suffer from a yeast infection for various reasons including, but not limited to, taking antibiotics, suffering from diabetes, or being pregnant. Discharge may have an unnatural odor, appear lumpy and white, and be very itchy.

Vaginal infections

Bacteria are present in the vagina at all times, but sometimes the bacteria can build up and cause a bacterial infection. When harmful bacteria grows, it can lead to bacterial vaginosis. This type of discharge will be white and have a faint fishy smell. Prescription creams and antibiotics work well to clear up the infection and stop the vaginal discharge.

Brown vaginal discharge

As uncommon as this is it may not be cause for great concern. Brown vaginal discharge is most often associated with old endometrial tissues. In other words, if your period is late you might get a brown, rather than red, discharge. It could also mean that for whatever reason during your last menses the entire uterine lining failed to make a timely exit. What you are seeing now is the fashionably late exit.

In some cases, however, there is cause for concern. Brown vaginal discharge can also be a symptom of a medical concern that is much more sinister than leftover endometrial cells.

Some common conditions causing brown vaginal discharge include:

• Early pregnancy (implantation)
• Cervical cancer
• Pelvic Inflammatory Disease (PID)
• Perimenopause
• Menopause
• Sexually transmitted diseases like gonorrhea, Chlamydia or vaginal warts
• Premature labor later in pregnancy

Douching and vaginal discharge

A certain amount of vaginal discharge can be normal, and any odor you may notice usually comes from outside the vagina (vulva). Keeping this area clean with gentle soap and water can prevent odor. A vaginal douche is a process of rinsing the vagina by forcing water or another solution into the vaginal cavity. Studies have shown douching is not necessary to keep your body clean and that vaginal douching increases vaginal infections and discharge. Your vagina usually cleans itself. Douching will change the vaginal PH (acid) value and can weaken the natural defense, creating more problems. In addition, there are certain chemicals in most douches that may irritate your vagina and change the normal balance of (helpful) germs in your vagina. Douching can also spread an infection into the uterus, increasing your risk of getting pelvic inflammatory disease (PID), an infection of the fallopian tubes that can cause you to be unable to have children. If you have an abnormal vaginal discharge, it's a good idea to consult with your doctor.

Sexually transmitted disease

Trichomoniasis and gonorrhea are two sexually transmitted diseases with vaginal discharge as a symptom. Trichomoniasis presents with a frothy, green discharge while gonorrhea is typically yellow or hazy looking. Pain may be associated with these conditions in addition to an itchy feeling of the vagina. Antibiotics are necessary to treat the infection.

Cervical cancer

Cancer of the cervix affects the cells in the vagina and may lead to vaginal discharge. The first step in the prevention of cervical cancer is getting regular Pap smears to detect pre-cancerous cells before cervical cancer begins. Vaginal discharge in cervical cancer may look normal but be heavier in volume than normal.

In many cases, vaginal discharge is just the female body working through the ovulation and menstrual cycle. Changes in vaginal discharge occur throughout life as hormone levels change and women move into menopause. If you have any questions or symptoms, ask your gynecologist.