Vaginal discharge is something all women experience naturally.
However, when the “color, odor, or volume” changes,
it can be a sign of an abnormality that should be professionally evaluated.

In obstetric and gynecological clinics, many patients seek care for vaginal discharge,
particularly working women experiencing stress, insufficient rest, and hormonal changes.

At Femily Wellness Clinic Ari, we find that
abnormal vaginal discharge is one of the top three reasons women undergo a pelvic exam.

What is considered normal vaginal discharge?

Normal vaginal discharge typically has the following characteristics:

• Clear or slightly milky white

• Odorless

• No itching or burning sensation

• The amount fluctuates according to your menstrual cycle

Physiologically, vaginal discharge is produced by the glands in the cervix and vagina.
It plays a key role in preventing infection and maintaining a healthy vaginal microbiome balance.

Signs of “Abnormal Vaginal Discharge”

You should have a pelvic exam if you experience any of the following symptoms:

• Yellow, green, gray, or blood-tinged discharge

• A strong, unpleasant odor

• Itching, burning, or lower abdominal pain

• Thick, clumpy discharge resembling cottage cheese

• Symptoms accompanied by abnormal bleeding

Common Causes of Abnormal Vaginal Discharge

1. Yeast Infection (Candida)

• Thick, white, cottage cheese-like discharge

• Intense itching

• Often occurs after antibiotic use or during times of lowered immunity

2. Bacterial Vaginosis

• Grayish discharge

• Fishy odor

• Usually related to an imbalance in the natural vaginal bacteria

3. Trichomoniasis

• Greenish or yellowish discharge

• Frothy or bubbly consistency

• Often associated with a sexually transmitted infection

4. Cervicitis

• Blood-streaked discharge

• Lower abdominal pain

• May be linked to gonorrhea or chlamydia

Clinical Perspective

In our clinical experience,
we often see many women buy over-the-counter vaginal suppositories without a proper diagnosis.

The issue is that
symptoms of yeast infections and bacterial vaginosis can be very similar.
Using the wrong treatment can lead to chronic, persistent symptoms.

An accurate diagnosis from the start
greatly reduces the chance of recurrence.

When should you see a doctor immediately?

• Vaginal discharge mixed with blood

• Severe lower abdominal pain

• Fever

• Pregnancy accompanied by any abnormal symptoms

• Symptoms that do not improve after self-treatment

Particularly during pregnancy,
certain infections can increase the risk of preterm labor.

How to Prevent Abnormal Vaginal Discharge

• Use condoms in high-risk situations

• Avoid vaginal douching

• Avoid using vaginal suppositories unnecessarily

• Choose breathable cotton underwear

Frequently Asked Questions (FAQ)

Do I need to avoid intercourse before a pelvic exam?

It is recommended to avoid intercourse for 24 hours prior to your exam to ensure the accuracy of the results.

If there is no itching, but there is a strong odor, should I still get checked?

Yes, you should. This could be a sign of Bacterial Vaginosis, which sometimes does not cause itching.

Summary

Abnormal vaginal discharge is not something to ignore.
While most cases are easily treatable,
getting the correct diagnosis is the most important step.

If you notice any unusual symptoms,
please schedule an evaluation with an OB-GYN specialist.

Written by

Dr. Wichadet Wichulada
OB-GYN Specialist, Maternal-Fetal Medicine Subspecialty
King Chulalongkorn Memorial Hospital

Research published in the International Journal of Transgender Health

References

1. American College of Obstetricians and Gynecologists (ACOG). Vaginitis in Nonpregnant Patients.

2. World Health Organization. Guidelines for the Management of Sexually Transmitted Infections.

3. Williams Obstetrics, 26th Edition.

4. Novak's Gynecology, 16th Edition.