Vaginal discharge is not a disease. Rather, it has an important protective function and keeps pathogenic germs at bay. Usually the discharge is whitish, odorless and does not cause any pain. A warning sign, however, is if the color, consistency, amount or smell of the discharge changes. This is often due to an infection with bacteria, fungi or viruses, especially bacterial vaginosis and yeast infections. This is often accompanied by symptoms such as itching, burning or pain. These symptoms are mostly a case for a doctor's visit. However, the infection can be contained well with medication.
Vaginal discharge is not uncommon – every woman has it. It mainly consists of cells from the vaginal mucous membrane and a secretion that the glands on the cervix (cervical glands) form. The discharge has an important function: it cleans and protects the vagina. The pH value of the vaginal mucus is in the slightly acidic range. In this acidic environment, pathogens such as viruses, bacteria or fungi cannot multiply.
White, yellow or brown: which vaginal discharge is normal?
Depending on the point in time in the menstrual cycle, the vaginal discharge changes its consistency and color due to the influence of hormones. Shortly after menstruation, it is thick, lumpy, or sticky. The closer to ovulation, the glassier, more transparent and thinner the mucus becomes. The amount of discharge also increases – it intensifies. In general, the amount of discharge varies from woman to woman. Gynecologists also speak of vaginal discharge or vaginal fluoro. A white discharge that is also odorless is considered normal (physiological discharge).
If the composition, color, quantity or smell of the discharge is changed, doctors call this symptom pathological (diseased) fluorine. So yellow or brown discharge is a sign that you should see a doctor. Some diseases and physical changes increase and change the vaginal discharge. It becomes particularly uncomfortable for women if there are additional symptoms such as itching, pain or burning in the vagina, for example with one Vaginal yeast infection. Be sure to see your gynecologist if you experience these symptoms. Usually the causes are harmless and can be treated well. But there can also be serious illnesses behind it.
Unusual vaginal discharge: The causes are usually infections
A pathological discharge can have various reasons. The most common causes are infections with fungi, bacteria or viruses – for example bacterial vaginosis or yeast infections. If the vaginal environment gets out of balance and protective mechanisms fail, germs have an easy time and multiply rapidly. Hormonal influences, the use of antibiotics or excessive intimate hygiene disrupt the vaginal flora. The consequences are strong and changed discharge, itching, burning, pain, redness and swelling in the vagina and pubic area.
Common causes of vaginal discharge are:
Bacterial vaginosis: the vagina is overly colonized with Gardnerella vaginalis and other bacteria that can survive without oxygen. The discharge smells bad (fishy smell) and is usually greyish in color and has a foamy or thin consistency.
Vaginal yeast infection (vaginal fungus, vaginal fungus): The cause is the yeast Candida albicans. Typical is a white discharge that is crumbly and odorless. In addition, the mucous membrane of the vagina is often reddened.
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Vaginal infection caused by bacteria such as staphylococci or streptococci
Sexually transmitted diseases (STDs, venereal diseases): Examples are infections with chlamydia, human papillomavirus (HPV), trichomonads (single-celled flagellates), the bacterium Neisseria gonorrhoeae (gonorrhea, gonorrhea) or herpes simplex viruses (genital herpes).
Foreign matter in the vagina
Inflammation of the cervix (cervicitis)
Inflammation of the ovaries and fallopian tubes (adnexitis)
Inflammation of the lining of the womb (endometritis)
Uterine polyps, cervical cancer (cervical cancer) and vulvar cancer (vulvar cancer): the discharge is watery, flesh-colored and sometimes contains blood (brownish discharge to brown discharge).
Urogenital tuberculosis: it is characterized by a yellow discharge with a crumbly consistency.
Estrogen deficiency: the lining of the vagina becomes thin and vulnerable, which can lead to easily bloody (brown discharge) or yellow discharge.
High levels of estrogen and a large number of estrogen receptors can lead to excessive discharge (hormonal discharge); however, this usually has no disease value.
Always have an infection with bacteria and other pathogens treated as early as possible. Otherwise there is a risk that the pathogen will rise out of the vagina and spread to the cervix, uterus, fallopian tubes and ovaries. In the worst case, the infection leads to infertility. An untreated chlamydial infection is one of the most common causes of infertility – in women and men. If the discharge changes during pregnancy, it is better to see your doctor. For example, bacterial vaginosis is the cause of heavy discharge during pregnancy. It can lead to complications and even miscarriage.
Vaginal discharge diagnosis: this is how the doctor finds the cause
At the beginning of the diagnosis there is a conversation between you and the doctor, in which he asks you about your medical history and your complaints (anamnesis). Symptoms such as itching, burning or pain in the vagina play a role, for example. As part of the gynecological examination, your doctor will receive initial information about the cause. The appearance, smell and texture of the discharge are important. Doctors also pay attention to skin changes in the genital area.
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The doctor checks the vaginal environment with a pH strip test. A pH value of 4.0 to 4.5 (slightly acidic) indicates a healthy vaginal environment. A pH value above 5 indicates inflammation of the vagina, ovaries or fallopian tubes. The doctor takes a smear from the vagina and examines it under a microscope. In this way, it quickly recognizes whether it is an infection with fungi (vaginal thrush) or bacteria (bacterial vaginosis). If the cause remains unclear, laboratory doctors determine the pathogen more precisely by creating a culture and multiplying it. It can then be identified under the microscope.
The doctor uses ultrasound of the vagina (vaginal sonography) to detect signs of an ascending infection. The colposcopy – a magnifying glass examination with a special instrument – provides insights into the condition of the cervix. The blood test shows whether certain levels of inflammation are increased, such as C-reactive protein (CRP). If the doctor suspects cancer, he takes a cell smear (cytological smear) and a tissue sample from the suspicious area (biopsy).
Vaginal discharge: therapy depends on the cause
Depending on what is causing the vaginal discharge, the doctor will choose a specific treatment:
An infection with bacteria, such as bacterial vaginosis, can be treated well with antibiotics.
Doctors treat vaginal yeast infections with antifungal medicines (antifungal drugs). They are available as creams, gels or suppositories. Women apply antifungal agents locally in the vagina or external genital area; sometimes both are necessary at the same time when the fungal infection has spread further. Doctors only use tablets that have a (systemic) effect throughout the body for stubborn fungal infections.
Doctors treat an infection with herpes simplex viruses (herpes genitalis) with antiviral drugs (antivirals) if the disease is severe. In milder cases, Sitz baths and pain relievers alleviate the symptoms.
It is important to use antibiotics, antifungal agents and antivirals exactly as prescribed and not to stop therapy prematurely. This also applies in the event that the complaints have subsided. If there are still pathogens left, they will multiply again quickly. For many infections and sexually transmitted diseases such as chlamydial infection, trichomonads or gonorrhea (gonorrhea), your partner must also be treated. Otherwise there will be a ping-pong effect, because you will infect each other again and again during sexual intercourse.
If the discharge is caused by a hormone deficiency, such as during the menopause, hormone therapy with estrogens can help. Women apply the medication directly in the vagina. Doctors usually operate on malignant tumors and polyps.
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