Vaginal discharge: when is it abnormal?

What is vaginal discharge?

Vaginal discharge is mucus or fluid that comes out of the vagina. It’s completely normal at any age and is your body’s way of keeping the vagina clean and moist, to help protect it from infection.

The amount of discharge you have can vary, and often changes if you're pregnant, sexually active or using birth control. Normal vaginal discharge doesn’t have a strong or unpleasant smell, is clear or white, and can be thick and sticky or slippery and wet.

There are a number of things that can cause changes in your discharge and may give it an abnormal smell, colour and consistency. Read on to discover what these are, when to see a doctor, and how you can treat abnormal vaginal discharge.

Causes of abnormal vaginal discharge

Your vaginal discharge may be unhealthy and a sign of infection if:

• it’s heavier or thicker than usual
• it has a pus-like consistency
• it’s white and clumpy (like cottage cheese)
• it’s grey, green or yellow, or looks bloody
• it has an unpleasant or fishy smell
• your genitals are also itchy, burning or sore, or you have a rash
• you also have pelvic pain or bleeding
• you also have blisters or sores on your genitals

There are many possible causes of abnormal discharge, but let’s look at the most common.

Thrush

Thrush (candidiasis) is a common yeast infection. It can cause a white discharge, which is often thick and looks like cottage cheese. Your vagina and outer genitals (vulva) may itch or burn, particularly after sex, and your genitals may become red and swollen.

Bacterial vaginosis (BV)

BV is an infection that happens when the balance of bacteria in the vagina changes. It can cause vaginal discharge that’s greyish-white, thin and watery. You might have a lot more discharge than usual and it can have a strong, fishy smell, particularly after sex.

Trichomoniasis

Trichomoniasis is a sexually transmitted infection (STI) that can cause thick, thin or frothy vaginal discharge that’s yellow-green in colour. You may also have more discharge than usual, with a fishy smell.

Trichomoniasis can also make the area around your vagina sore, itchy and swollen, and cause pain or discomfort when peeing or having sex. However, it’s also possible to have no symptoms at all.

Gonorrhoea or chlamydia

Gonorrhoea and chlamydia are STIs that commonly cause abnormal vaginal discharge. If you have gonorrhoea, your discharge may be very thick and green or yellow. If you have chlamydia, your discharge may be thick and yellow.

Both infections can cause bleeding between periods and pain when peeing or having sex. But it’s also possible to have gonorrhoea or chlamydia and not have any symptoms.

Genital herpes

Genital herpes is an STI that can cause abnormal vaginal discharge. Other symptoms include small blisters that burst and leave red, open sores around your genitals, anus, bottom or thighs; tingling, burning or itching around your genitals; and pain when peeing.

Less common causes of abnormal vaginal discharge

These include:

• pregnancy
• menopause
• using birth control
• pelvic inflammatory disease (PID)
• cervical cancer

Things that can increase your risk of thrush or other infections that cause abnormal vaginal discharge include:

• taking antibiotics (these can kill the good bacteria in your vagina, increasing your risk of thrush or BV)
• using soaps, bubble baths, scented sprays, powders or rinses on your genitals
• putting water or other liquid in the vagina to clean it (douching)
• period blood or sexual fluid from a penis (semen) in the vagina
• diabetes

When to see a doctor about vaginal discharge

You should see a doctor or visit a sexual health clinic if you’re worried about your vaginal discharge, or if you have abnormal vaginal discharge and:

• lumps or skin growths around your genitals
• a rash
• blisters and sores around your genitals
• itchy or sore genitals
• pain during or after sex
• bleeding between periods or after sex
• constipation
• feel sick (nausea) or are being sick (vomiting)
• pain in your lower back or pelvis
• pain when peeing or blood in your pee
• are peeing or pooing more than usual
• swelling in 1 or both legs

Seek emergency medical help or go to hospital if you have abnormal vaginal discharge and:

• you feel confused, have slurred speech or aren’t making sense
• your skin, lips or tongue are blue, pale or blotchy
• a rash that doesn’t fade when you roll a glass over it
• trouble breathing or breathlessness, or you’re breathing very fast
• sharp, sudden, intense pain in your tummy
• severe pain in your side, back or pelvis
• you feel dizzy or you faint
• you’re suddenly very pale
• a high temperature (fever)
• heavy vaginal bleeding
• a lot of blood in your pee
• have lost control of your bladder or bowels

How to treat and prevent abnormal vaginal discharge

Treatment for abnormal vaginal discharge varies depending on the cause, so it’s important to work out what’s causing it. Here are the usual treatments for common causes, as well as self-care tips for prevention.

Thrush treatment

To treat thrush, you’ll usually need an antifungal medicine from a pharmacist or doctor. This can be a cream you apply, a tablet you take or a tablet you put in your vagina (pessary). It should clear up within 7 to 14 days of starting treatment.

If you keep getting thrush (more than 4 times in 12 months) you should speak to a doctor: you may need a longer course of treatment (up to 6 months) or there may be an underlying reason. There are also things you can do to prevent thrush.

Bacterial vaginosis (BV) treatment

BV is usually treated with antibiotic tablets, cream or gel from a doctor or sexual health clinic. It’s common for BV to come back, often within 3 months.

If you have BV more than twice in 6 months, you’ll need to have long-term treatment (up to 6 months) to stop it coming back again. Read more about the treatment and prevention of BV.

Trichomoniasis treatment

A doctor or sexual health clinic will usually prescribe an antibiotic called metronidazole. Your sexual partner(s) should also be treated, even if they don’t have symptoms.

For the treatment to work and to avoid reinfection, you need to complete the whole course of antibiotics and not have sex until both you and your partner(s) have been treated. Read more about the treatment and prevention of trichomoniasis.

Gonorrhoea or chlamydia treatment

Gonorrhoea is usually treated with an antibiotic injection followed by an antibiotic tablet. Your symptoms should improve within a few days, but you should avoid having sex until you’ve been told you no longer have the infection. Read more about the treatment for gonorrhoea.

Chlamydia is also treated with antibiotics. You may be given some tablets to take all in one day, or tablets to take over a week. Read more about how to treat chlamydia.

If you have gonorrhoea or chlamydia, you shouldn’t have sex until you and your sexual partner(s) have finished treatment.

Genital herpes treatment

There’s no cure for genital herpes, and while symptoms can clear up by themselves, blisters can come back. If you get genital herpes for the first time, you may be prescribed antiviral medicine to stop symptoms getting worse and cream for the pain.

If blisters come back, you might be prescribed antiviral medicine again to help shorten the outbreak by a few days. Most of the time, outbreaks settle by themselves, so you may not need treatment. Read more about how to treat genital herpes.

Self-care tips for prevention

These self-care tips can help you avoid infections and abnormal vaginal discharge:

• gently wash the skin around your vagina with warm water only
• avoid feminine hygiene products such as soaps, deodorants and scented wipes
• don’t wash inside your vagina (douche)
• avoid hot baths and scented bath products
• wear cotton underwear and avoid thongs and Lycra
• don’t wear panty liners every day
• use a condom or dental dam every time you have vaginal, anal or oral sex. Read more about the different types of contraception and how to prevent STIs
• don’t share sex toys. Read more about how to clean sex toys

How long does it take for abnormal vaginal discharge to return to normal?

Your vaginal discharge should go back to normal once you’ve had the right course of treatment. If you still have symptoms after finishing treatment, see a doctor or visit your local sexual health clinic.

Key takeways

• normal vaginal discharge doesn’t have a strong or unpleasant smell, is clear or white, and thick and sticky or slippery and wet
• abnormal vaginal discharge is commonly caused by thrush, bacterial vaginosis (BV) or a sexually transmitted infection (STI), such as trichomoniasis, gonorrhoea, chlamydia or genital herpes
• see a doctor if you notice a change in the amount, colour, smell or texture of your discharge, have bleeding between periods or after sex, pelvic pain or pain when peeing, or sore and itchy genitals
• treatment for abnormal vaginal discharge varies depending on the cause, and can involve antifungal, antibiotic or antiviral medication
• vaginal discharge should return to normal after treatment. See a doctor if your symptoms don’t improve