Vaginal Discharge - What is Normal?

>> Friday, October 2, 2015

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Many of you are really struggling with an overabundance of vaginal discharge and write to me. You are concerned about whether it is normal, or perhaps due to some type of infection. It may go away for a week after the prescribed treatment, only to have it return again and again, sometimes only days later. I just want you to know, you are not alone. I see women in my office every day who struggle with this and feel that they are the only ones.

First, discharge is normal if you are a young adolescent or pre-menopausal female. It is secreted from special glands in the vagina that help keep us healthy by acidifying the vagina. This helps to fight off abnormal bacteria and yeast and provides moisture, so sex is not painful. Having no vaginal discharge would be like having no saliva in your mouth. Your teeth would decay, your tongue would stick to the top of your mouth, and you wouldn't be able to eat.

But some of you worry that you have too much discharge and actually need to use panty liners to stay dry. ‘Too much’ is not something I can determine, because what is normal for one woman may not be normal for another woman.

Vaginal discharge changes throughout our cycle, in both consistency (from thin and runny, to sticky and gooey, to thick and creamy). During ovulation it even has the consistency of mucous and a texture that is stretchy in nature. The changes correlate with hormone changes in our bodies. That's why the amount can change from woman to woman, as some women naturally have higher estrogen than others. We see this in pregnancy, and any woman who has been pregnant knows she had more discharge then, due to the higher hormone levels.

Besides making us feel 'wet' all the time when there is too much discharge, what you need to look for as abnormal is a sour or fishy odor, or itching that is uncontrollable. The first can be a sign of a bacterial infection (BV), and the second can be a sign of a yeast infection. Both are easily treated with prescription vaginal gels or tablets.

The odor can be exceptionally upsetting, as it lingers, and no amount of showers or baths will cure it because it is not from being unclean. Persistent discharge can also cause rashes and irritation, sort of like diaper rash in infants.

Recurrent yeast (candida) infections need to be checked out, as sometimes it can be a sign of a compromised immune system, like we see with diabetes, lupus, thyroid disorders, and HIV patients.

If you are struggling with constant yeast and bacterial infections, and feel you have way too much discharge, your gynecologist may prescribe Metrogel and Diflucan tablets to clear the infection. But for those of you who use the medications, only to find they return within a few days or a week, the best treatment is often to repeat the treatment 3-4 times back to back.

If you have an IUD, yeast and bacterial infections can happen more often, and it may take longer to normalize the vaginal pH to prevent recurrent infections.

I would also recommend purchasing and using a WaterWorks, as it is FDA cleared for vaginal cleansing and odor, and is all natural – with no harsh chemicals or perfumes.

As for surgery, like cryotherapy of the cervix for chronic cervicitis, or endometrial ablation, if you have no intentions of future pregnancy, it may help. But these need to be discussed with your gynecologist.
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