What's coming out of your body is a pretty good indicator of what's happening inside your body. Vaginal discharge colors and consistencies can be key indicators of your vaginal health. While most changes are normal, others can signify anything from an STD to whether you just need to drink more water. To clear up what's normal and what's not, we talked to Dr. Vanessa Cullins, vice president of external medical affairs at Planned Parenthood Federation of America and Dr. Judith Hersh, MD, a board-certified obstetrician and gynecologist who specializes in pediatric and adolescent gynecology at Lifeline Medical Associates.
First things first: what is vaginal discharge? "Vaginal discharge is made of body water, bacteria, usually some yeast, cervical secretions, and dead vaginal cells," explains Cullins. Vaginal discharge is actually what keeps the vagina clean, and everyone's discharge is a little different. "What’s normal for you may not be normal for someone else. Less water or estrogen, or more cells, bacteria, or yeast, usually leads to thicker discharge. Some people have lots of discharge, some people have very little. Some women may notice less or thicker than usual vaginal discharge when they are dehydrated, just like you may notice less, and more concentrated urine when you are dehydrated."
"Get to know your body, so if something about your discharge changes, you’ll know to check in with a doctor or nurse," says Cullins.
Here, we'll go over nine types of vaginal discharge, and just what that discharge might be trying to tell you.
1. Clear, Milky or White Vaginal Discharge
"Normal vaginal discharge is clear to white (or slightly yellow when it dries) and odorless or with a mild, non-foul odor that is not noticeable unless you place the discharge very close to your nose," Dr. Cullins explains. "It can have a mild odor and can vary in thickness throughout your menstrual cycle."
Around the middle of your menstrual cycle is when the discharge gets very white, signifying that you are most fertile. "For the 24 hours that you are most fertile, what you get is this discharge that looks just like egg white. It suddenly goes from being white to clear and very stretchy," says Dr. Hersh. (There's even a name for the stretchiness of the secretion, which doctors use to help predict fertility: spinnbarkeit.) Hersh cautions that it can be very "goopy" and you may need a panty liner — and it's all totally normal.
2. White Vaginal Discharge that Looks Like Cottage Cheese
Yeast infections can produce a thick, white, odor-free vaginal discharge with an appearance similar to cottage cheese. In addition, your vulva may appear raw and red. Yeast infections are very common, and are most often caused by an overgrowth of the fungus candida albicans within the vagina. Certain antibiotics can disrupt the microbiome of your vagina, leading to a yeast infection. Other causes of yeast infection include pregnancy, a compromised immune system, contraceptive use, hormone therapy, and uncontrolled diabetes.
In addition to cottage cheese-like discharge, signs of a yeast infection include: burning during urination, vaginal itching, irritation, and a swollen vulva. If you suspect you have a yeast infection, your best bet is to see a doctor who can diagnose you. Treatment consists of an antifungal medication.
3. Gray Vaginal Discharge
Gray vaginal discharge can be a sign of a common infection called bacterial vaginosis (BV). It is not an STD, but rather an infection that can happen when your vaginal pH balance gets out of whack. BV is often accompanied by strong, fishy odor. Your doctor will treat BV with antibiotics or antibacterial ointments.
Gray discharge can also be a sign of trichomoniasis, which is an STD which can be treated and cured with antibiotics. It's very important to see your doctor at the first sign of gray discharge.
Note: if you've never had a period before, gray discharge can actually be a sign that your body is getting ready to start menstruating. "It's a warning that you're going to get your period in the next 6 months," Dr. Hersh explains. "When you look under the microscope, what you see are mature vaginal cells that are sloughing off. It's really just the lining of the vagina ramping up and the cells are going from immature to mature."
Dr. Hersh notes that sometimes girls and their moms assume it's a yeast infection and treat it with over-the-counter medicine, which can just cause more irritation. "The best way to address it is with water to keep the area as clean as you can and add a protective barrier like A&D ointment or coconut oil — something to protect the vulva, but nothing medicated," Dr. Hersh recommends.
4. Dark Brown, Red, or Pink Vaginal Discharge
Discharge with a red, dark brown or pink tint is usually just a sign that your period is about to begin. It can also be the result of light bleeding (mixed with normal discharge) after penetration.
5. Green or Yellow Vaginal Discharge
"If your discharge is foamy, itchy, yellow, or yellow-green in color, it can be a sign of an STD or other infection," Cullins says. "A doctor or nurse can do exams to figure out whether your yellow discharge is caused by an infection or not," Cullins says.
6. Foul-Smelling Vaginal Discharge with Pain
"Pelvic inflammatory disease (PID) is an advanced infection of the uterus, fallopian tubes, inside of the abdomen, and sometimes, ovaries. It can be accompanied by abdominal pain, pain during pelvic exam, pain during sex, and fever," Cullins says. "It’s usually caused by untreated chlamydia or gonorrhea, but it can be caused by other infections as well. Sometimes PID causes bad-smelling vaginal discharge, but sometimes PID doesn’t cause any noticeable changes in your discharge, so if you have pain symptoms, don’t wait to see a doctor or nurse."
7. Creamy Vaginal Discharge
This could be a sign that you might be pregnant. "During pregnancy most women have more and thicker discharge. Many women’s discharge becomes creamier in consistency," Cullins says. "Vaginal infections can occur during pregnancy, so if something about your discharge doesn’t seem right, tell your prenatal care provider. They can figure out if what’s going on is normal or a possible problem."
8. Heavy Vaginal Discharge
If it just seems like you have more vaginal discharge than usual, it may be due to your menstrual cycle. "It’s normal for the amount of vaginal discharge you have to vary from day to day, depending on where you are in your monthly cycle," Cullins says. "Some days it might seem like you don’t have any, while other days your underwear might be wet with discharge all day. Other days you’ll be somewhere in between."
9. Slippery, Clear Vaginal Discharge
This kind of discharge is usually a sign you're turned on. "If you’re aroused, discharge tends to be more slippery and clear." Cullins says. The clear fluid is called transudate, and it seeps through your vagina walls as blood flow increases to the area. Transudate makes sex comfortable and helps get sperm to eggs.
What to Do If You're Concerned About Vaginal Discharge
If your discharge is out of the ordinary (cottage cheese-like, yellow, green, gray, or foul-smelling) or is accompanied by pain or vaginal itching, don't hesitate to make an appointment with a gynecologist who can diagnose the issue and guide your treatment plan. "Stress and certain medications can cause changes in your vaginal discharge. If your discharge changes drastically or is accompanied by vaginal pain, bleeding during sex, or pain when you pee, talk to a doctor or nurse so they can make sure everything’s okay."
If you do feel like something is wrong based on your discharge, do not douche. "Don’t douche or use over-the-counter cleansers inside your vagina" Dr. Cullins says. "Douching messes with your vagina’s natural cleaning system and isn’t a treatment for vaginal infections. In fact, douching can actually make certain infections worse."
Related: I Have A Vaginal Disease That Affects Nearly a Third of All Women, But No One Is Talking About It
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