Vaginal Discharge

Symptom Definition

Normal Vaginal Discharge: May be clear or white, thin or thick. It is not odorous and there is no itching.

• Yellow or green vaginal discharge is usually from an infection
• A foul-smelling discharge is usually from an infection
• A thick, white, itchy, cottage cheese-like non-odorous discharge is often caused by a yeast infection

Common Causes of an Abnormal Vaginal Discharge

• Vaginitis: Vaginitis is a general term that means "vaginal inflammation." Vaginal discharge and genital itching are the symptoms of vaginitis. Vaginitis may occur because of chemical irritation (e.g., excessive douching, or excessive use of over the counter yeast medication) or vaginitis may have an infectious cause. The three main infectious types of vaginitis are:  
  • Candidiasis (thick, white, cottage cheese-like, non-odorous discharge)
  • Trichomonas (foamy, yellow-green foul-smelling discharge)
  • Bacterial vaginosis (white-gray discharge, fishy odor).
• Vaginal Foreign Bodies: Vaginal foreign bodies (e.g., forgotten tampon) must be removed to prevent vaginal infection. Sometimes these are not discovered until after the woman goes into the doctor for a bad-smelling vaginal discharge.
• Sexually Transmitted Diseases: Gonnorrhea and Chlamydia are sexually transmitted diseases the symptoms of which may include a new or abnormal vaginal discharge. Other symptoms can include pain with urination, pelvic pain, and bleeding.

Caution - Pregnancy

• The possibility of pregnancy must be considered in all women in their childbearing years.
• In the second half of pregnancy, increasing vaginal discharge can be a subtle sign of preterm labor.

• Urination Pain - Female

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Yellow or green vaginal discharge occurring with a fever
• Genital area looks infected (e.g., draining sore, spreading redness) and fever is present
• Severe abdominal pain
• Constant abdominal pain for more than 2 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen
• Abnormal color of vaginal discharge (i.e., yellow, green, gray)
• Bad smelling vaginal discharge
• Blood in vaginal discharge (EXCEPTION: normal, regular menstrual period)
• Genital area looks infected (e.g., draining sore, spreading redness)
• Grouping of small blisters in vaginal area
• Pain in vagina or painful rash in vaginal area
• Mild lower abdominal pain comes and goes (cramps) than lasts longer than 24 hours
• Pain with sexual intercourse
• You are pregnant

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• You are worried you might have a sexually transmitted disease
• You have diabetes mellitus or a weakened immune system (e.g., HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy)
• Symptoms of a possible "yeast infection" (i.e., white, thick, cottage-cheese-like discharge that is itchy, not bad smelling) and you have not previously seen a physician for this
• Home treatment for 3 or more days for a "yeast infection" and you have not improved

Self Care at Home If

• Symptoms that are similar to prior yeast infection (i.e., white, thick, cottage-cheese-like discharge that is itchy, not bad smelling) and you don't think you need to be seen
• Normal vaginal discharge and you don't think you need to be seen

HOME CARE ADVICE

• Pregnancy test, when in doubt:
  • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
  • Follow the instructions included in the package.
• Antifungal Medication for Vaginal Yeast Infection: There are a number of over-the-counter medications for the treatment of vaginal yeast infections.
  • Available in the U.S.: Femstat-3, miconazole (Monistat-3), clotrimazole (Gyne-Lotrimin-3, Mycelex-7), butoconazole (Femstat-3).
  • Available in Canada: miconazole (Monistat-3) and clotrimazole (Canesten-3,
    Myclo-Gyne).
  • If you are pregnant, speak with your doctor before using.
  • Do not use yeast medication during the 24 hours prior to a physician appointment (Reason: interferes with examination).
  • Read and follow the package instructions closely.
• Prevention of Vaginitis:
  • Keep your genital area clean. Wash daily.
  • Keep your genital area dry. Wear cotton underwear or underwear with a cotton crotch.
  • Do not douche.
  • Do not use feminine hygiene products.
• Call Your Doctor If:
  • Pregnancy test is positive
  • You have difficulties with the home pregnancy test
  • There is no improvement after treating yourself for a vaginal yeast infection
  • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer:

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult HouseCalls Online.
Portions Copyright 2000-2008 Self Care Decisions LLC; Copyright LMS, Inc.
David A. Thompson, M.D.

Reviewed: 03/15/2008
Revisited: 03/31/2008

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