February 16, 2019

When is vaginal discharge abnormal?

For many women, vaginal discharge is a common occurrence. It can be difficult to know which discharge is normal and which needs medical attention. Many women try to diagnose themselves, based either on their prior experience or on over the counter tests. However, more than half of women who self diagnose a yeast infection are incorrect in their diagnosis. Additionally, the otc tests, which rely on the pH or acid/base balance of the vagina can be difficult to read and interpret. Results can be confused by other factors as well.

A general rule with vaginal discharge is that it should not be smelly or cause itching or irritation. A discharge that has an unpleasant or fishy odor, and/or is bubbly or frothy could be Bacterial Vaginosis, an upset in the chemical balance of the vagina, which requires prescription antibiotics to treat. An extremely bad smelling discharge can also be a sexually transmitted infection such as Trichomonas, Chlamydia or Gonorrhea. If a discharge causes itching or burning, it could be any of the above. It could also be yeast or even an allergic reaction. While many yeast infections have the typical curdy white thick discharge, some present with other symptoms and can be more challenging to diagnose.

In an Ob Gyn office, the diagnosis of vaginal infection is made not only by examining the discharge, but usually by doing a confirmatory lab test that can detect even low levels of bacteria or fungus. These tests take at least 24 hours for the result to come in and then, if positive for infection,  a prescription can be called in to the pharmacy if needed.

Sometimes a vaginal discharge is examined and the tests do not confirm an infection. A mucousy/ slimy clear discharge can actually be normal since the vagina cleanses itself by producing discharge.  Some people produce more discharge than others do due to factors such as medications, the use of an IUD (intrauterine device) or changes in the menstrual cycle.

In conclusion, there are a wide variety of vaginal discharges, some normal and some not. The best way to distinguish which is which is a trip to the Gynecologist for an exam and testing. While over the counter tests and creams can seem to be time savers, their use sometimes delays making the correct diagnosis and getting the correct treatment for a vaginal infection.

Tamar Gottfried is a Board Certified Obstetrician/ gynecologist  practicing  general Ob/gyn in Mesa Arizona and affiliated with Banner Desert and Banner Gateway Medical Centers. She can be contacted at 480-545-0059. This is a general interest article only and is not intended to be medical advice. See a medical professional before making medical decisions.


1520 S Dobson Rd
Suite 316
Mesa, Arizona 85202

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