Vaginal Discharge
One of the things that often come up in conversation with my patients is vaginal discharge. How much is too much? What is normal? What isn’t? How come I don’t have vaginal discharge anymore?
Vaginal discharge is a normal part of everyday life for most women and plays a very important role in vaginal health. The composition of the fluid varies depending on the stage of sexual and reproductive development, as well as the timing of the menstrual cycle. On average, a woman in her reproductive years will produce approximately 1.5 grams (1/2 to 1 teaspoon) of vaginal discharge daily.
So what exactly IS vaginal discharge? This fluid is a combination of mucous, liquid, shedding vaginal epithelial cells, and bacteria. Its purpose is to lubricate, cleanse and protect the vagina. It is made by the glands of the cervix, the vaginal walls and also the glands within the vagina (Skene’s and Bartholin’s glands).
After puberty, the prominent bacteria that naturally live in the vagina are called Lactobacilli. They feed on glycogen cells within the vagina and produce lactic acid and hydrogen peroxide. This keeps the pH of the vagina acidic which then inhibits the growth of other (infectious) bacteria, as well as serves as a natural defense against bacterial vaginosis as well as yeast and urinary tract infections. Menstrual blood and semen are alkaline and therefore will significantly increase the pH of the vagina (temporarily), predisposing the patient to bacterial vaginosis.
Normal vaginal discharge typically is odorless or has a mild odor. It tends to be clear, white, or off-white in color. Ovulation creates a thinner, almost clear fluid and changes to a thicker consistency closer to menses. As a person reaches menopause, there may be a significant decrease or no longer any vaginal discharge. This is because the vaginal tissues are no longer stimulated by estrogen released by the ovaries, and thus the vaginal liquid is formed in much lesser quantities. This may eventually lead to symptoms of vaginal dryness. The post-partum period is also a time when women may experience vaginal dryness, particularly while breastfeeding. This is due to the suppression of ovulation and the decreased amount of circulating estrogen. Once menses return, the dryness typically resolves and normal vaginal discharge resumes.
Things to be concerned about which may be indicative of an infection or pH imbalance of the vagina or cervix: sudden change in quantity or quality of the discharge (particularly an increase or a new malodor), associated symptoms (vulvar itchiness, bu
rning, pain with urination), vaginal bleeding or pelvic pain/pain with intercourse. These are all reasons to seek medical attention to ensure there is not an issue that requires treatment.
By: Dr. Jennifer Adams, MD Gynecologist , MAUD Medical Clinic Education Lead.
