X
September 08, 2022
Vaginal discharge with different STDs
It is normal for females to have a vaginal discharge. It is called "normal" vaginal discharge, and it serves an important housekeeping function. The fluid produced by vaginal and cervix glands removes dead cells and harmful bacteria. It helps keep the vagina clean and free of infection.
But sometimes the discharge becomes abnormal:
- It is thicker
- Its color is different
- It has an unusual odor
- Or it is simply more abundant
If this is something you are experiencing, you might have an STD (also known as a sexually transmitted infection, or STI).
In this article, we'll talk about vaginal discharge with different kinds of STDs.
Let's begin!
What is normal vaginal discharge?
Before we dive into STDs and discharge, we'll briefly go over normal vaginal discharge.
So, what is normal vaginal discharge? As with any norm, it's a range. Every female (after puberty) should have a vaginal discharge within the normal range.
To describe normal vaginal discharge, we'll talk about average vaginal discharge texture, amount, color, and odor, as well as how discharge changes at different times during the menstrual cycle.
Normal vaginal discharge texture, amount, color, and odor
Below is a summary of normal vaginal discharge texture, amount, color, and odor:
Texture. The texture of normal vaginal discharge ranges from watery and sticky to gooey, thick, and pasty. It changes throughout the month. Your hormones cause these changes.
Amount. Some females produce a lot of vaginal discharge and some produce less. Certain factors can affect the amount of discharge: oral contraceptive pills, ovulation, and pregnancy, among others.
Color. It is usually clear or white.
Odor. Vaginal discharge has an odor, but it isn't unpleasant or very strong.
Normal vaginal discharge during different days of the menstrual cycle?
The amount of vaginal discharge and its texture and color can change from day to day, depending on where the person is in their menstrual cycle:
Days 1-5. This is a beginning of the cycle-the "period," and the discharge is usually red or bloody. It is a sign that the uterine lining is being shed.
Days 6-14. After the period, the amount of vaginal discharge decreases. As the egg begins to develop and mature, vaginal discharge becomes cloudy and white or yellow. It may feel sticky.
Days 14-25. Before ovulation, the mucus will be thin and slippery, similar to the consistency of egg whites. After ovulation, the mucus will go back to being cloudy, white or yellow, and possibly sticky or tacky.
Days 25-28. There will be less vaginal discharge before another period begins.
Every female has normal vaginal discharge every month (usually) that's personal to her. And what's normal varies significantly from person to person.
It's important for every female to know what's normal for her so she'll recognize any changes, which can be considered abnormal.
Any deviation or sudden change in a person's normal vaginal discharge could mean that something is wrong. One of the common possibilities is a sexually transmitted disease or infection (STD or STI).
Vaginal discharge with various STDs
The vagina (like the gut) is full of friendly bacteria also known as normal vaginal microflora. It is believed to play a protective role. These bacteria produce lactic acid, making the vagina acidic and less hospitable to infective germs. But infection can still occur.
When infection happens, it can (though it doesn't always) change the vaginal microflora. If that happens, "normal" or "regular" vaginal discharge may change a little. There may be a change in color, consistency, amount, or odor. Any of these changes can be a sign of an STD.
But abnormal vaginal discharges are not associated only with STDs. Two very common benign vaginal conditions—yeast infection (vaginal fungal overgrowth) and bacterial vaginosis (overgrowth of certain "normal" vaginal bacteria)—are more common causes of abnormal vaginal discharge than STDs.
Both of those conditions can be caused by any of the following:
- Antibiotic or steroid use
- Douches, scented soap or lotion, bubble baths
- High estrogen birth control pill
- New sexual partner
To help you decide if it's time to get tested for STDs, continue reading to find out more about what STD-related discharges look like.
Vaginal discharge with chlamydia
Chlamydia is one of the most common STDs affecting sexually active woman of any age; females between the ages of 20 and 24 are most at risk.
Most females with chlamydia—up to 75%—don't develop any symptoms. That makes chlamydia a very serious, slowly evolving condition that can hurt a woman's reproductive system irreversibly, causing infertility.
But the good news is that chlamydia is a curable infection when it is detected. The combination of chlamydia being an insidious condition and having the potential for serious complications prompted the CDC to advise chlamydia testing annually for young, sexually active women.
When chlamydia is contracted, only 25% of cases present with symptoms. The symptoms might not appear for several weeks (one to three).
Here are common chlamydia symptoms in females:
- Vaginal discharge
- Pain with urination
- Bleeding with intercourse
- Bleeding between periods
- Pelvic pain
Chlamydia vaginal discharge has the following characteristics:
Amount: Usually, very insignificant
Color: Yellow, gray, or white
Consistency: Mucous-like or milky
Odor: Often strong
Vaginal discharge with gonorrhea
Most females with gonorrhea (as with chlamydia) do not have symptoms. Eighty percent of females have no symptoms of any kind, only 20% are symptomatic. Symptoms might appear three to seven days after the disease is contracted.
These are common gonorrhea symptoms in females:
- Vaginal discharge
- Pain with urination
- Bleeding with intercourse
- Bleeding between periods
- Pelvic pain
These are the characteristics of gonorrhea vaginal discharge when it is present:
Color: Yellowish discharge with green hue
Amount: Unlike chlamydia, gonorrhea can produce abundant discharge
Consistency: Usually thick
Odor: Usually, no distinct odor
Vaginal discharge with trichomoniasis
Unlike chlamydia and gonorrhea, trichomoniasis is more common among older women, and it has fewer complications.
According to the CDC, the presence of trichomoniasis can increase the chances of contracting other, more serious STDs.
Only 30% of trichomoniasis cases present with symptoms, which might take 5 to 28 days to appear
Common trichomoniasis symptoms in females are the following:
- Vaginal discharge
- Itch and burning of the vagina
- Vaginal swelling
- Pain with urination
- Pain with sex
Here are the characteristics of trichomoniasis vaginal discharge when it is present:
Color: Yellowish-green
Amount: "Trich" produces an abundance of discharge
Consistency: Thin (watery); it can be frothy (filled with tiny bubbles)
Odor: Very distinct and fishy
Vaginal discharge with Mycoplasma
Mycoplasma genitalium (aka MG) is as common an STD as chlamydia infection. Sometimes MG coexists with other STDs (chlamydia and gonorrhea) and non-STDs (bacterial vaginosis).
Mycoplasma is not commonly tested for. If left untreated, it can cause a lot of complications, such as pelvic inflammatory disease (PID) and infertility in females.
Only 15% of cases of mycoplasma genitalium present with symptoms. Symptoms might take 2-28 days to appear.
The following are common mycoplasma symptoms in females:
- Vaginal discharge
- Vaginal itch
- Burning with urination
- Pain with intercourse
- Lower abdominal pain
- Pelvic pain
These are the characteristics of mycoplasma vaginal discharge when it is present:
Discharge with mycoplasma genitalium is very nonspecific.
Color: Most of the time, yellowish- green discharge; less commonly, whitish
Amount: Minimal
Consistency: Thin (watery)
Odor: Mycoplasma discharge can have a fishy smell since it can coexist with other infections-BV and chlamydia-with a specific fishy smell
When vaginal discharge is not an STD
Yeast infection and bacterial vaginosis (BV) are two non-STDs that commonly cause vaginal discharge. "Non-STD" means the infection can be induced by sex or occur for otherreasonsbut the infection does not come from a sexual partner and the partner does not need to be treated or tested.
Candida discharge
Vaginal candidiasis, or yeast infection, is a very common condition, and three of four females get it at some point in their lifetime. Many females experience at least two lifetime episodes.
Up to 20% of yeast infections have no symptoms. It is a good idea to pay attention to the normal look, feel, and smell of the vulva and vagina so it's easier to notice any changes.
Mild yeast infection can clear up on its own withing 2-3 days. But moderate to severe infection can take 1-2 weeks to clear.
Here are common vaginal candidiasis symptoms:
- Vaginal itch
- Pain during intercourse
- Pain with urination
- Abnormal vaginal discharge
Vaginal candidiasis discharge has the following characteristics:
Amount: minimal increase in the amount of discharge
Color: white
Consistency: thick, often described as "cottage cheese"
Odor: usually odorless but might smell like bread and yeast, and occasionally is foul smelling
Bacterial vaginosis discharge
Bacterial vaginosis is a very common vaginal problem for females ages 15 to 54.One in three females in the US gets it at least once in their lifetime.
Fifty percent to 75% of people with BV are asymptomatic (that is, they don't exhibit symptoms).
Untreated BV is not a dangerous condition on its own, but it can increase the risk of getting an STD: HIV, herpes, chlamydia, gonorrhea, and/or pelvic inflammatory disease.
The most common BV symptoms for symptomatic females are the following:
- Pain, itch, and burning of the vagina
- Burning with urination
- Significant vaginal discharge with a strong odor.
Vaginal candidiasis discharge has the following characteristics:
Amount: large volume
Color: white or gray
Consistency: thin
Odor: significant foul smell; commonly described as "fishy smell"
When vaginal discharge is possible but not common
Genital herpes and genital warts can present with abnormal vaginal discharge, but less frequently than other STDs, such as chlamydia, gonorrhea, trichomoniasis, and mycoplasma, and non-STDs, such as BV and yeast infection.
Herpes discharge
Genital herpes is a very common STD,affecting females more than males. One in 5 females have genital herpes, while one in 10 men do. Female genital anatomy-more vaginal mucosa-putsfemales at more risk than males.
Most females with genital herpes, between 75% and 90%, are not even aware they have herpes and never get symptoms.
For people that get symptoms, the incubation period can range between 2 and 12 days (the average is 4 days).
Having herpes does not lead to any long-term medical condition and does not affect life expectancy. People with herpes live perfectly normal lives.
Experiencing herpes symptoms is referred to as having a herpes outbreak.Here are common symptoms of a herpes outbreak:
- Tingling, burning, and mild itch in the area of the outbreak
- Blisters forms, burst, and leave an open sore
- Significant pain (7/10) in the outbreak area during the blister and open sore stages
- Unusual scanty vaginal discharge is possible
Herpes vaginal discharge has the following characteristics:
Amount: discharge is minimal and occurs for a very short time (when the blister roof comes off)
Color: transparent
Consistency: watery
Odor: no odor unless other conditions are present
HPV discharge
HPV is a very common infection, and about 80% of females get at least one type of it at some point in their lifetime.
As with Herpes, many women don't know they have the condition because it's usually asymptomatic and most of the time is cleared by the immune system over time. Nine of 10 times, HPV goes away on its own.
For those people whose HPV does not go away on its own, it usually presents as a visible genital wart (bump or group of bumps in the genital area) or cervical dysplasia (abnormal precancerous cells in the cervix that are detected via a Pap smear test).
High-risk HPV strains start as abnormal cells in the cervix and lead to cancer if left untreated.
Unfortunately, there are no signs of early cervical cancer, but some signs of HPV might include:
- Bleeding between menstrual periods
- Longer and heavier menstrual periods
- Pelvic pain
- Pain during sex
HPV vaginal discharge has the following characteristics:
Amount: minimal increase in the amount of discharge
Color: pale, pink, brown, and bloody
Consistency: regular
Odor: can range from non-smelly to foul smelling
What to do about abnormal discharge
If you think you have an abnormal discharge, and this is the first time it's happened, talk to a doctor as soon as possible.
This is especially important when other symptoms are also present:
- Abnormal urination: pain and increased frequency of urination
- Bleeding after intercourse
- Bleeding between periods
- Fever and chills
- Unexplained weight loss
- Abdominal pain
The vaginal discharge work-up—how do doctors
approach abnormal vaginal discharge?
Step 1. History of the discharge—what is the possible cause?
The first step with any type of the vaginal discharge is investigating the history of the discharge to determine what could have caused it:
- Possible sexual exposure (new partner, open relationship)
- Recent antibiotic use or systemic steroids
- Oral contraceptive pills
- Douching
The possible cause of the discharge can tell the doctor if it's something that needs to be addressed urgently (that is, if this is something that may affect the person long term).
Step 2. Vaginal pH test
If, based on the discharge history, an STD is not assumed to be the most likely cause, determining the pH of the vaginal discharge using pH indicator paper can be a useful and quick first step.
- Normal discharge and yeast usually have a pH of less than 4.5
- A pH of more than 5 may indicate trichomoniasis or bacterial vaginosis
Step 3. Vaginal swab for common STDs and non-STDs
If an STD is suspected, vaginal swabs need to be done to test for chlamydia, gonorrhea, trichomoniasis, mycoplasma, bacterial vaginosis, and yeast infection. It might take 3-4 days for the results to come back.
Step 4. Vaginal swab for other causes
If common STDs and non-STDsare ruled out by the initialtesting, the next step isto check for ureaplasma overgrowth by culturing for ureaplasma urealyticum and parvum.
Step 5. Herpes swab test
A herpes swab can be done if there are visible blisters and sores.
Step 6. HPV pap smear test
A Pap smear test for HPV (and cervical cancer) is necessary if the history of the discharge and other symptoms (bleeding, weight loss, etc.) indicate HPV (cervical cancer) as a possible cause.
Common vaginal discharge treatment
Treatment of vaginal discharge depends on the cause.
Some common conditions can be treated with over-the-counter medication,but for some conditions prescription medication is the only option.
Vaginal yeast infection treatment
Over-the-counter treatment for yeast infection (candidiasis)
- Miconazole (Monistat)
- Tioconazole (Vagistat)
- Clotrimazole (Gyne-Lotrimin)
Prescription medication for yeast infection
- Diflucan 150 mg tablet taken as a one-time treatment
Bacterial vaginosis (BV) treatment
Over-the-counter treatment for BV
No FDA-approved over-the-counter medication is advised by doctors for BV.
Some females use boric acid and probiotics with some success.
However, neither of thesetreatment options has been widely studied in clinical trials.
Prescription medication for BV
- Metronidazole can be given orally or as a vaginal gel
- Clindamycin vaginal cream
Trichomonas vaginalis treatment
Trichomoniasis is treated with prescription medication only: metronidazole (Flagyl). It can be given as a one-time dose or over a seven-day period.
Chlamydia treatment
Chlamydia is treated with prescription medication only: doxycycline or azithromycin.
Gonorrhea treatment
Gonorrhea treatment is a one-time ceftriaxone shot given at the doctor's office.
Mycoplasma genitalium treatment
Mycoplasma genitalium is treated with prescription medication only. Due to high infection resistance,a combination of two antibiotics (doxycycline and moxifloxacin) is advised. Seven days of doxycycline is followed by seven days of moxifloxacin.
Ureaplasma urealiticum (and parvum) treatment
Ureaplasma is treated with prescription medication: 10 days of doxycycline.
What should you do if you notice an unusual vaginal discharge?
If you have an unusual vaginal discharge and think it might be an STD, the best thing to do is to take action early and see your healthcare provider or our experienced STD doctor. Talk to a doctor and consider getting tested.
