Normal vaginal discharge is usually clear or whitish in color and a small amount of it should not cause much concern. This is discussed further under Normal Vaginal Secretions. However, if the color changes to yellow, cheesy white, gray, brown, green or is tinged with blood, it is not normal. A visit to the gynecologist is advisable, especially if there are other associated symptoms such as vaginal itching or irritation, redness, swelling and burning sensation. Refer to Itchy Vagina.
White Vaginal Discharge
White discharge from the vagina is also known as leucorrhea. The discharge consists of secretions from the cervix and vagina, exfoliated or dead vaginal skin cells, and bacteria and other organisms that are normally present in the vagina.
- A thin or thick, clear or opaque white vaginal discharge in small quantities is normal in most women. If there are no other symptoms such as an unpleasant odor or vaginal itching, this can usually be ignored.
- Vaginal white discharge may increase in amount or become thicker during certain situations such as at the time of ovulation, during sexual excitement and during pregnancy.
- In early pregnancy, there may be excessive flow of white discharge from the vagina due to increased secretion of hormones, particularly estrogen, and also due to greater blood flow to the vaginal area during pregnancy.
- During late pregnancy, it may be a sign of impending labor. Clear white watery discharge in pregnancy could be due to leakage of amniotic fluid.
- White, cottage cheese-like or curd-like discharge is usually indicative of vaginal yeast or fungal infection. Intense itching around the vulva and vagina with swelling and burning sensation are common associations. Pregnant women and diabetics are more likely to suffer from a fungal vaginal infection.
- A white, thin discharge may occur due to bacterial vaginosis which sometimes does not cause any other symptoms. However, a foul odor may be present.
Yellow Vaginal Discharge
Yellow vaginal discharge is in most cases seen where there is a vaginal infection. The presence of a large number of live white blood cells such as neutrophils in such cases gives the yellow color to the discharge. As the infection becomes more chronic, it may become yellowish-green or green in color. A yellow discharge may also be seen in immune reactions due to the presence of eosinophils.
- Normal vaginal discharge may appear slightly yellowish when it comes in contact with air and is seen dried on undergarments.
- A white, gray or yellowish vaginal discharge may be a sign of bacterial vaginosis. A fishy odor, along with redness, swelling, vaginal itching and burning may be present.
- A thin, watery, yellowish or greenish frothy discharge may be caused by a trichomonal vaginal infection (trichomoniasis). This discharge is usually foul smelling and is likely to be accompanied by itching and burning during urination.
- A yellowish vaginal discharge with itching (itchy vagina) and burning while passing urine (dysuria) may indicate an infection with chlamydia or gonorrhea.
- Other causes of yellow vaginal discharge includes :
- Sexually transmitted diseases (STDs) and other infections of the vagina or uterus.
- Septic abortion.
- Foreign body, such as forgotten tampon in the vagina.
Green Vaginal Discharge
Green vaginal discharge may be seen in the presence of a chronic infection. Neutrophils are a type of white blood cell which usually increases in number and become more active in case of an infection. Dead neutrophils disintegrate to release a green pigment known as verdoperoxidase, which gives the green color to the discharge. Verdoperoxidase is the enzyme which is responsible for peroxidase activity of pus. Refer to Green Mucus.
- A yellowish-green bubbly discharge with a foul smell is most likely to be due to trichomoniasis.
- Vaginal warts.
- Lichen sclerosis.
Brown Vaginal Discharge
The red color of blood is due to hemoglobin contained in the red blood cells. As the blood degrades, it undergoes certain chemical changes which cause the color to change from red to brown. This is also discussed under Brown Vaginal Bleeding.
A brownish vaginal discharge is a sign of old blood (which may have been retained within the uterus or vagina) being expelled from the vagina. It may be caused by :
- Missed abortion – in early pregnancy, when the fetus is dead but is retained within the uterus without spontaneous abortion).
- In some cases of induced abortion.
- Implantation bleed – at the time the fertilized ovum implants or gets embedded in the endometrium.
- Cervical or endometrial cancer – it is likely to be accompanied by abnormal vaginal bleeding.
- Irregular periods or intermenstrual bleeding – vaginal bleeding or pelvic pain may be present.
- Pelvic inflammatory disease (PID).
- Genital warts.
- Sexually transmitted diseases (STDs) such as chlamydia and gonorrhea.
Blood Streaked Vaginal Discharge
Small amounts of fresh blood coming out of the vagina mixed with mucus may be seen as blood stained or pinkish discharge. It may be seen in the following situations :
- Blood stained vaginal discharge, as occurring towards the end of the menstrual cycle.
- During puerperium (from delivery of the baby till about 6 weeks after that) the discharge that comes out of the vagina is known as lochia. It consists of blood and sloughed off tissue from the endometrium (lining of the uterus).
- Implantation bleeding.
- A thick mucus discharge tinged with blood (show) may be a sign of impending labor.
- In case of cancer of the vagina, cervix or uterus.
- Chronic infection of the uterus or vagina.
- Spontaneous abortion (miscarriage) or ectopic pregnancy – if seen in early pregnancy.
- Placenta previa or abruptio placentae if the discharge occurs in late pregnancy.