Vaginal discharge

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Vaginal discharge
Classification and external resources
DiseasesDB 28137
MedlinePlus 003158
MeSH D019522

Vaginal discharge is the biological fluid secreted from the vagina. While most discharge is normal and can reflect the various stages of the menstrual cycle, some discharge can be a result of an infection.[1] During consensual sexual play, alone or with other(s), increased vaginal fluid is a positively associated factor indicating increased female desire and physical arousal.[2]


Nonpathological vaginal discharge ranges in pH from 3.8 to 4.2 and is typically white or clear in color, though it can be yellowish. Nothing is visible under a microscope in a vaginal wet mount and treatment with KOH does not give off an odor, which could indicate pathology.[1][3] It is produced by cervical and vaginal glands.[1]

Menstrual cycle[edit]

Vaginal discharge amounts vary as the menstrual cycle progresses. Ovulation can increase discharge.[4] Menopause or low estrogen levels can cause a decrease in discharge.[1]


In neonates, vaginal discharge sometimes occurs in the first few days after birth. This is due to exposure to estrogen while in utero. Neonatal vaginal discharge may be white or clear with a mucous texture, or it may be bloody from normal transient shedding of the endometrium.[3]

In pregnancy[edit]

During pregnancy, vaginal discharge volume can increase significantly.[1]

Other factors[edit]

Vaginal discharge may increase due to stress or sexual arousal.[1]


Pathological discharge can occur in a number of conditions, including infections and imbalances in vaginal flora or pH. Unusual vaginal discharge may also be idiopathic (the cause is not determined). Diagnosing the cause of abnormal vaginal discharge can be difficult, though a potassium hydroxide test or vaginal pH analysis may be used. When abnormal discharge occurs with burning, irritation, or itching on the vulva, it is called vaginitis.[3]

Co-occurring symptoms[edit]

In bacterial vaginosis, co-occurring symptoms include a fishy odor that worsens during menstruation or after vaginal sex. In a vaginal yeast infection (candidiasis), abnormal discharge may be accompanied with itching and burning. Trichomoniasis can cause a foul odor, itching, light bleeding (spotting), and painful urination. Other bacterial infections, such as those caused by Streptococcus, Staphylococcus, or E. coli may cause itching.[3]

Color, texture, and volume[edit]

Speculum exam in candidal vulvovaginitis, showing thick, curd-like plaque on the anterior vaginal wall. A slightly erythematous base is visible close to the center of the image, where some of the plaque was scraped off.
Workup of bacterial vaginosis, with a pH indicator to detect vaginal alkalinization (here showing approximately pH 8), and a microscope slide to microscopically detect clue cells.

The color and texture of vaginal discharge can indicate pathology. In bacterial vaginosis, discharge can appear thin, gray, or white, increase in volume, and is adherent. In yeast infections, discharge is described as resembling cottage cheese. Trichomoniasis causes greenish-yellow, adherent, frothy discharge and can cause an increase in discharge. Bacterial infections can cause discharge containing pus.[3]

Potassium hydroxide test[edit]

The potassium hydroxide test assess whether or not a fishy odor is given off when vaginal discharge is exposed to the strong base. In bacterial vaginosis it is almost always positive, and it may be positive in trichomoniasis infections.[3]

Vaginal pH[edit]

The pH of vaginal discharge may change depending on the disease present. Normally, the pH of vaginal discharge is between 3.8 and 4.2. In aerobic vaginitis,[5] bacterial vaginosis, trichomoniasis, and bacterial infections, it is raised above 4.5, becoming more alkaline (basic). In candidiasis, it is below 4.5.[3]

Vaginal wet mount (using a potassium hydroxide preparation and light microscopy) in candidal vulvovaginitis, showing slings of pseudohyphae of Candida albicans. A chlamydospore is visible at left.

Microscopic examination[edit]

A microscopic examination of vaginal discharge may indicate pathology. In candidiasis, a potassium hydroxide preparation can show hyphae and buds of the fungus. In bacterial vaginosis and trichomoniasis, a saline wet mount will show clue cells and trichomonads, respectively. Bacterial vaginosis may also cause white blood cells and clumps of bacteria to be visible in the discharge. In bacterial infections, a large number of white blood cells will be seen under the microscope.[3]

See also[edit]


  1. ^ a b c d e f "Vaginal itching and discharge – Adult and adolescent: MedlinePlus Medical Encyclopedia". Retrieved 2015-10-30. 
  2. ^
  3. ^ a b c d e f g h Hoffman, Barbara; Schorge, John; Schaffer, Joseph; Halvorson, Lisa; Bradshaw, Karen; Cunningham, F. (2012-04-12). Williams Gynecology, Second Edition. McGraw Hill Professional. ISBN 9780071716727. 
  4. ^
  5. ^ Donders, Gilbert G.G.; Vereecken, Annie; Bosmans, Eugene; Dekeersmaecker, Alfons; Salembier, Geert; Spitz, Bernard (2002). "Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis". BJOG 109 (1): 34–43. doi:10.1111/j.1471-0528.2002.00432.x. PMID 11845812