What Is Vaginal Discharge?
Vaginal discharge is a fluid or semisolid substance that flows out of the vaginal opening. Most women have vaginal discharge to some extent, and a small amount of vaginal discharge is a reflection of the body’s normal cleansing process. The amount and type of vaginal discharge also varies among women and with the woman’s menstrual cycle. A change in vaginal discharge (such as an abnormal odor or color or increase in amount), or the presence of vaginal discharge associated with irritation or other uncomfortable symptoms, can signal that an infection is present.
What Are the Signs and Symptoms of Vaginal Discharge?
Vaginal discharge may range in color from clear to gray, yellow, greenish, or milky-white and may have an unpleasant smell. The symptoms and character of vaginal discharge depend upon the specific condition that is the cause of the discharge.
- Bacterial vaginosis: Not all women with bacterial vaginosis will have symptoms, but bacterial vaginosis typically produces a discharge that is thin and grayish-white in color. It is usually accompanied by a foul, fishy smell.
- Trichomonas: Trichomonas infection produces a frothy, yellow-green vaginal discharge with a strong odor. Associated symptoms can include discomfort during intercourse and urination, as well as irritation and itching of the female genital area.
- Gonorrhea: Gonorrhea may not produce symptoms in up to half of infected women, but it can also cause burning with urination or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area.
- Chlamydia: Like gonorrhea, Chlamydia infection may not produce symptoms in many women. Others may experience increased vaginal discharge as well as the symptoms of a urinary tract infection if the urethra is involved.
- Vaginal yeast infection: A vaginal yeast infection is usually associated with a thick, white vaginal discharge that may have the texture of cottage cheese. The discharge is generally odorless. Other symptoms can include burning, soreness, and pain during urination or sexual intercourse.
How Do Doctors Diagnose the Cause of Vaginal Discharge?
After reviewing your symptoms and medical history, the health-care professional will likely perform a pelvic examination, which includes examination of the external genital area and the insertion of a speculum to examine the vaginal walls and cervix.
Depending upon the examination, the health-care professional may take swabs of the vaginal discharge for culture or for examination under a microscope to help define the cause of the vaginal discharge.
What OTC Medications or Home Remedies Treat Vaginal Discharge?
Yeast infections may be treated using over-the-counter medications, but other causes of vaginal discharge require prescription medications. It is critical to take the entire course of medication as prescribed or recommended by your doctor, even if the symptoms improve. If you are uncertain as to the cause of your vaginal discharge, it is important to visit a health-care professional to determine the cause rather than starting OTC medications if you are unsure.
Some alternative medical approaches recommend douching for the treatment of some causes of vaginal discharge. However, douching is not recommended by most physicians. The body has a natural way of cleansing the vaginal canal by itself, and douching can disturb the normal environment of the vagina, potentially leading to inflammation and even worsening of the symptoms. The American College of Obstetricians and Gynecologists and most doctors recommend that women avoid douching unless specifically prescribed by a doctor.
What Prescription Medications Treat Vaginal Discharge?
The choice of medication depends upon the type of infection. Antibiotics and antifungal medications are the mainstay of treatment, administered either in topical, injection, or oral form, depending upon the particular infection.
Oral, injectable, and topical (applied as tablets or cream into the vaginal area) medications are used to treat the various causes of vaginal discharge.
- A number of medications may be effective in the treatment of bacterial vaginosis, including metronidazole(Flagyl), tinidazole(Tindamax), and clindamycin cream (Cleocin). These medications are also effective in the treatment of trichomonas infections.
- Trichomonasis treated either with metronidazole (Flagyl) or tinidazole (Tindamax), given by mouth in a single dose. It is important for sex partners to be treated at the same time to avoid re-infection.
- In the past, penicillin was the drug of choice for treatment of uncomplicated gonorrhea. However, new strains of gonorrhea have become resistant to various antibiotics, including penicillins, and are therefore more difficult to treat. Gonorrhea may be treated by an injection of ceftriaxone(Rocephin) intramuscularly or by oral cefixime(Suprax). Other antibiotics may also be used.
- Chlamydiais typically treated by oral azithromycin (Zithromax, Zmax) or doxycycline (Vibramycin, Oracea, Adoxa, Atridox and others).
- Vaginal yeast infectionscan be treated by topical creams such as butoconazole (Gynazole 1), clotrimazole (Lotrimin), miconazole (Monistat 3, Monistat 5, Monistat 7, M-Zole Dual Pack, Micon 7), and terconazole (Terazol 3, Terazol 7). Nystatin (Mycostatin, bio-Statin, Nilstat) is also available in vaginal tablet form. Oral medications such as fluconazole (Diflucan) can also be used if necessary.
It is important to take the full course of antibiotic or antifungal medication as prescribed, even if the symptoms have gone away. Should symptoms recur or persist despite treatment, contact your health care practitioner.
Antibiotic and antifungal medications are effective in eradicating the major infectious causes of vaginal discharge. Both gonorrhea and Chlamydia, when untreated, may progress to more severe infections involving the internal genital organs, known as pelvic inflammatory disease (PID). PID can cause damage to the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences.