Vaginal discharge

Vaginal discharge is fluid made by the vagina and cervix, which is the opening to the womb. It helps keep the vagina moist and removes old cells.

Some discharge is normal. Its amount and texture can change during the menstrual cycle, pregnancy, sexual arousal, or when using hormonal contraception. Normal discharge is usually clear or white and does not cause strong odour, itching, or pain.

A noticeable change may be caused by an infection, irritation, a retained object such as a tampon, or another condition. Colour or texture alone cannot confirm the cause.

You may notice more wetness than usual or discharge on your underwear. Normal discharge may be thin and slippery, especially around ovulation, or thicker and white at other times.

Changes that may need assessment include:

• A strong, unpleasant, or fish-like smell
• Grey, green, yellow, frothy, or blood-stained discharge
• Thick discharge with itching or soreness
• Burning when urinating
• Pain during sex
• Redness or swelling around the vulva, the external genital area
• Bleeding between periods or after sex

These features can overlap between conditions. For example, not everyone with thrush has thick white discharge, and some sexually transmitted infections cause few or no symptoms.

Normal hormonal changes can alter the amount and thickness of discharge. This may happen around ovulation, during pregnancy, with sexual arousal, or after starting hormonal contraception.

Bacterial vaginosis happens when the usual balance of vaginal bacteria changes. It often causes thin grey or white discharge with a fish-like smell. It does not always cause itching.

Vaginal thrush is an overgrowth of Candida yeast. It may cause itching, soreness, redness, and thick white discharge. Thrush is not usually classed as a sexually transmitted infection.

Sexually transmitted infections, including trichomoniasis, chlamydia, and gonorrhoea, can cause unusual discharge. Other possible symptoms include pain when urinating, pelvic pain, or bleeding after sex. Many people have no other symptoms.

Less common causes include irritation from scented products, vaginal washing or douching, and a tampon or other object left in the vagina. Lower oestrogen levels around or after menopause can make vaginal tissue dry, thin, and more easily inflamed.

Rarely, persistent watery or blood-stained discharge may be linked to changes affecting the cervix, vagina, or womb. This is more important to check after menopause.

Arrange a routine appointment if the discharge is new or keeps returning, or if it has an unusual smell, colour, or texture. You should also book an appointment for itching, soreness, pain during sex, burning when urinating, or bleeding between periods or after sex.

Seek prompt testing if you may have been exposed to a sexually transmitted infection. Avoid sexual contact, or use condoms, until you have received advice and any recommended testing.

Seek same-day medical care if discharge occurs with:

• Fever or chills
• Lower abdominal or pelvic pain
• Vomiting or feeling significantly unwell
• Pregnancy with pain or vaginal bleeding
• A retained tampon that you cannot remove

These symptoms can sometimes occur with pelvic inflammatory disease, which is an infection involving the womb, fallopian tubes, or nearby tissues.

Call emergency services for severe or sudden abdominal pain, fainting, confusion, difficulty breathing, or heavy bleeding. If pregnancy is possible, severe pain, faintness, or shoulder-tip pain also needs emergency assessment.

A clinician may ask when the discharge began, how it has changed, and whether you have pain, itching, bleeding, or urinary symptoms. They may also ask about pregnancy, periods, contraception, medicines, and possible exposure to sexually transmitted infections.

Depending on your symptoms, they may examine the vulva and vagina and take a small sample of discharge with a swab. Urine, pregnancy, or sexually transmitted infection tests may be offered. Appearance alone is not always enough to identify the cause.

Normal discharge does not need treatment. Treatment for an infection depends on its cause. Bacterial infections and some sexually transmitted infections may need antibiotics like amoxicillin or doxycycline. Thrush is treated with antifungal medicine. A retained object needs to be removed safely.

If this is your first suspected episode of thrush, you are pregnant, or symptoms keep returning, get medical advice before treating yourself. Using the wrong treatment can delay finding another cause.

While waiting for assessment:

• Wash the outer genital area gently with water or an unscented cleanser
• Avoid douching, deodorants, scented wipes, and perfumed vaginal products
• Wear comfortable underwear and change out of damp clothing
• Do not use leftover antibiotics or another person’s medicine

If a sexually transmitted infection is found, current or recent partners may also need testing or treatment. Follow the advice you receive about when it is safe to have sex again.

Discharge caused by normal hormonal changes may come and go with your cycle. With the correct treatment, symptoms from many infections begin improving within several days, although the full course of treatment may take longer.

Return for follow-up if symptoms do not improve, become worse, or return soon after treatment. Repeated symptoms may need testing rather than repeated self-treatment.

Is white discharge normal?

It often is. Clear or white discharge without a strong smell, itching, pain, or bleeding is commonly part of normal vaginal function.

Can discharge colour identify the cause?

No. Colour, smell, and texture can provide clues, but different conditions often look similar. Testing may be needed.

Should I use vaginal washes to reduce discharge?

No. The vagina cleans itself. Douching and scented products can irritate tissue and disturb the normal balance of bacteria.

Is extra discharge normal during pregnancy?

More thin, clear, or milky discharge can be normal in pregnancy. Contact your maternity team promptly for bleeding, pain, fever, a bad smell, green discharge, or a sudden watery leak.