You may never have used a self-cleaning oven, but that’s what doctors use to describe your lady bits. The vagina is flush with good bacteria and discharge, which keeps it healthy and strong and provides a protective barrier against other invading germs. The vagina does not need you to douche or ever put anything inside to clean it because, honestly, it is doing a phenomenal job of maintaining itself. But signs of trouble are brewing when you or your gynaecologist would use terms like curdy or fishy-smelling for your vaginal discharge. I will come to those soon enough. But first, let’s find out what’s normal.
The cells lining the inside of your vagina are in a state of continually producing mucus to keep the vagina from drying up. This mucus lining is constantly flushed out, and it is what you would see as a white discharge. Regular discharge is 100% normal and needed. It protects us against foreign pathogens and provides a place for our healthy bacteria to live in.
Also read: How to make your periods less stressful
Also, the discharge doesn’t look the same at all times of the month either. Once your period flow ends, the discharge begins over a few days. It is neither runny nor dry to start with. As you approach the middle of your menstrual cycle and begin to ovulate, that’s when the consistency of the vaginal discharge changes to more or less an egg white-like feel. It is stretchy and clear, and honestly, nobody could come up with a better description than egg white for it! This consistency facilitates fertilisation, and that’s why it is seen around the time your egg comes. So women trying to conceive, you can watch out for this discharge consistency if you are planning a baby.
As we move ahead in the cycle and the ovulation hormones start to dip, the vaginal discharge is not stringy and stretchy anymore and becomes rather dry. A few more days of decreased discharge later, your period begins. Another fact to remember about vaginal discharge is that it will stain your underwear because it is acidic. Your darker underclothes will see this effect sooner than your lighter-coloured delicates because the acidic nature of the discharge will have a bleaching effect on the colour and fade it to a lighter tone, a perfectly normal state of affairs.
However, there are instances when you need to worry about your discharge. If you observe any of these signs, consult a medical professional immediately.
The curdy white discharge
This kind of discharge is the most common illness I see in women in my practice. The patient complains of curd-like discharge (medicine is weird. We compare diseases to food all the time!), but the main symptom would be itching. An uncomplicated vaginal exam is often sufficient to ascertain the cause of this, which is the fungal infection by Candida albicans. A week’s course of antifungal tablets that need to be inserted vaginally at bedtime offers a cure for this infection and oral tablets if required.
The foul-smelling discharge
Foul-smelling discharge is often caused by a sexually transmitted pathogen called Trichomonas vaginalis. The discharge has a greenish tinge, is quite foul-smelling and is often accompanied by lower abdominal pain. It requires testing followed by treatment of both partners so that the infection isn’t passed back and forth after treating just one sexual partner.
The fishy odour discharge
This kind of discharge is the result of bacterial vaginosis, a condition caused due to the overgrowth of harmful bacteria. The condition, often accompanied by itching and foul-smelling discharge, is easily treatable by antibiotics. One of the surprising causes of this illness is the practice of douching. In case you don’t know, some companies sell products to women where they have to squirt cleaning fluids up their vagina as a part of routine hygiene. And this practice can cause more harm than good in the form of infections like bacterial vaginosis and, in the long run, even cancer.
Other sexually transmitted infections such as chlamydia and gonorrhoea often have no symptoms in women. Still, they can give rise to a cloudy discharge that can alert the patient to the presence of something going wrong. A quick trip to the gynaecologist can ascertain the cause of the change. Like other sexually transmitted diseases, both partners need to be treated simultaneously, and the couple must abstain from intercourse through the treatment.
Bloody vaginal discharge
Even though we all see this at the fag end of our periods, bloody vaginal discharge between menses could need evaluation. Heavy exercise and emotional stress can cause bloody vaginal discharge but if you are around your 40s and 50s, make sure you get checked by your gynaecologist for more sinister causes such as cervical or uterine cancer. These big bad diseases can sneak up on a woman with mundane symptoms such as spotting, so make sure you get your pap smear yearly after your 40s and look after your cervical health.
Dr Farah Adam Mukadam is a Bengaluru-based family physician and author of the book Newborns and New Moms. She vlogs on Instagram and YouTube as Dr Farah_Momstein