A moderate amount of vaginal discharge is common in most women and is considered to be normal. Under certain circumstances, vaginal discharge may become excessive – this may be physiological or pathological.
Excessive vaginal discharge which is not related to any disease process (physiological discharge) may be seen during ovulation and pregnancy. It is usually temporary.
At other times, the excessive vaginal discharge may be related to an underlying disease and this is known as a pathological discharge. While some level of local irritation may be seen with physiological discharge, any excessive and persistent discharge accompanied by vaginal itching (itchy vagina), localized redness, swelling or skin lesions should be considered as pathological. This can be further confirmed by the appearance of the discharge – refer to Abnormal Vaginal Discharge and Vaginal Discharge Color.
Normally, the quantity of vaginal discharge is just enough to moisten and lubricate the vagina but the amount may vary from one woman to the next. This discharge consists of cervical (from the cervix) as well as vaginal secretions. During and following menstruation, there may be some blood, clots and endometrial cells.
Due to its acidic pH, vaginal discharge prevents the overgrowth of naturally occurring bacteria and other organisms that are normally present in the vagina in small numbers. Vaginal discharge essentially acts as a shield against the spread of infection in the vagina and uterus. It also helps to keep the vagina ‘clean’ by removing dead cells, mucus, bacteria and other substances from the vagina.
Causes of Excessive Vaginal Discharge
As mentioned above, the causes of excessive vaginal discharge may be physiological (normal) or pathological (abnormal).
Physiological Vaginal Discharge
Excessive vaginal discharge may be due to normal physiological process, such as :
- Puerperium – immediately after birth of the baby till about 6 weeks it is normal to have reddish, to pinkish, to a gradually colorless discharge. This is known as lochia, which consists of blood, mucus and sloughed-off tissue from the endometrium.
- Lactation – during breastfeeding there may be an increase in vaginal discharge.
- Sexual excitement and during intercourse – increased vaginal secretion helps by lubricating the vagina, thus making intercourse easier.
- Premenstrual – vaginal discharge may increase one or two days before the onset of periods.
- Prepubertal atrophic vaginitis – as a result of the increasing estrogen levels associated with puberty.
- Newborn female baby – there may be excessive vaginal discharge for a few days due to the effect of maternal estrogen. As the estrogen level falls, the discharge decreases and then stops altogether.
- Emotional stress
- Oral contraceptives
- Postmenopausal atrophic vaginitis
Pathological Vaginal Discharge
Vaginal discharge occurring due to some disease process or other abnormality. Causes include :
- Bacterial vaginosis
- Vaginal yeast (fungal) infection
- Sexually transmitted diseases (STDs) such as chlamydia and gonorrhea and less frequently due to genital warts and genital herpes
- Tampon (forgotten)
- Toilet paper
- Retained condom
- Latex condoms and spermicidal gels
- Chemicals present in bubble baths, deodorant pads or tampons, soaps, detergents, lotions or sprays
- Ectopic pregnancy
- Spontaneous abortion (miscarriage)
- Induced abortion
- Septic abortion
- Placenta previa
- Abruptio placentae
- Poor personal hygiene
- Frequent douching
- Following vaginal surgery and procedures such as dilation and curettage
- Cancer of vagina, cervix, uterus or endometrium
- Radiation therapy
- Sexual abuse
- Vesico-vaginal or recto-vaginal fistula
- Cervical erosion
- Cervical polyps