Vaginal discharge is one of the commonest complaints doctors are asked about. Patients are sometimes embarrassed and have put up with it for some time before seeking help. Some discharge is normal or 'physiological' and is part of the body's defence against infection. It can also increase or change during pregnancy, at different points in your menstrual cycle or when using hormonal contraceptives like the pill.
However if you have a change in your discharge, then you may need to seek help. If it becomes heavier, smelly, itchy, changes in colour or there is some bleeding when you are not expecting a period then you MAY have an infection which needs treatment. Some infections are sexually transmitted, but some are not.
Common infections include thrush, bacterial vaginosis and Chlamydia. Chlamydia is the commonest sexually transmitted infection (STI) in people aged 16-24 in the UK and if left untreated can cause long term pain and infertility.
What causes vaginal discharge?
Thrush is an extremely common cause of discharge. It is a yeast infection and is not thought to be sexually transmitted, so male partners rarely need treated. Most women will have at least one episode in their lifetime. It can affect anyone, at any age. It usually causes thick white discharge, vaginal itching and soreness and if severe can cause swelling down below as well. It is sometimes caused by antibiotics but some people, especially diabetics are prone to it. About 20% of women carry the thrush bug all the time and will suffer from recurrent attacks. It is very easily treated with vaginal tablets or pessaries, cream for relief from the itching or sometimes a tablet that can be swallowed is used instead. These treatments are available on prescription from your GP, or from your pharmacist.
Bacterial vaginosis is one of the commonest vaginal infections. It tends to cause a thin grey discharge with a fishy smell, which a lot of women find is stronger after they've had sex. Some women complain of feeling very sore down below as well. It is not an STI and your partner does not need treatment. It is very easily diagnosed by your GP or in your local sexual health or genitourinary medicine or GUM clinic. The nurse or doctor can take a swab, or in some parts of the country do a simple bedside test to tell you immediately if you have this infection. Treatment is a simple course of antibiotics or sometimes vaginal antibiotic cream is used.
One of the commonest, well known causes of vaginal discharge in the 16-24 year old age group is chlamydia. 1 in 10 people in this age group are positive for Chlamydia. It sometimes causes no symptoms at all, but can cause a yellowish discharge, irregular bleeding, pain passing urine or lower tummy pain sometimes worse during or after sex. If left untreated it can cause infertility, pelvic pain and a condition caused pelvic inflammatory disease, which can cause long term pain. Luckily though testing is extremely simple and doesn't always need an examination. Chlamydia can be tested for by taking a swab from your cervix, but can also be tested for on a 'self-taken vaginal swab' which is a bit like just popping a long cotton bud into the vagina, which the doctor or nurse can ask you to do on your own without needing an examination. Urine samples can also be tested. Chlamydia is very easy to treat with a simple dose of antibiotics, usually just one dose, with no further need for testing. The clinic who treats you will either offer to contact your recent partners for you, anonymously of course, so that they can be treated or tested, or you can do it yourself!
The second commonest STI in the UK is gonorrhoea, but how common it is varies a lot depending on where you live in the country. It sometimes doesn't cause any symptoms, but about 50% of women with this infection will have a yellowish discharge, and sometimes irregular bleeding, pain during sex and tummy pain. Gonorrhoea infection if untreated can cause pelvic inflammatory disease like Chlamydia, fertility problems and chronic pain. Testing is best done in a GUM clinic, as gonorrhoea is a difficult bug to grow, although modern techniques are much improved on older lab systems. You can find your local GUM clinic by searching on the British Association of Sexual Health and HIV or BASHH website; www.bashh.org by searching their 'find your nearest clinic' facility. Treatment is very effective, with antibiotics, and the GUM clinic can contact previous partners for you as well.
Trichomonas is another STI that can cause a frothy green yellow vaginal discharge. It is unpleasant but tends not to cause serious long term complications like other STI's. It is diagnosed by having a swab of the discharge taken. Treatment is very straightforward with antibiotics, and partners also need to be treated.
Rarely problems with your cervix can cause a vaginal discharge. Cervical Ectropion is a harmless but sometimes annoying condition which can cause a watery vaginal discharge which can be quite heavy. It basically means that the delicate lining of your cervix has spread onto the surface of the cervix and 'leaks' fluid causing a discharge. It sometimes happens during pregnancy or when on the pill when oestrogen levels are higher.
It's worth mentioning cervical cancer, as although it's a very rare cause of discharge in young women, it IS a recognised cause of vaginal discharge, sometimes blood stained. It is very important to make sure that your smear tests are up to date.
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