I’m throwing you all in at the deep end by writing my first ever blog post about vaginal discharge. Yep, that stuff that no one wants to talk about… except when they’re in that little hospital clinic room with me, all on their own, with no one to hear or judge. So thank you to the hundreds of patients who inspired this post and opened my eyes to the mystery and confusion surrounding discharge.
Firstly, vaginal discharge gets a bad rep. It’s not actually a ‘symptom’ as many people believe, it’s something that everyone has, and is pivotal to a healthy female reproductive system. The consistency and character of your discharge changes throughout the menstrual cycle, dependent on the fluctuations in female hormones. Day one of your cycle is the day your period starts, and as the bleeding stops there is often very little discharge because of low levels of oestrogen and progesterone, often resulting in a dry, irritated feeling. It’s probably as close as you’ll get to feeling like a postmenopausal woman, so remember what you’ve got to look forward to. Thankfully, hormone levels start to rise, and discharge becomes thicker and then creamier in consistency with a white-yellowish colour.
By now it is getting on for 2 weeks after your period started, so it’s time for ovulation, which is when your ovary decides it's time to evict an egg or two in the hope of it meeting the sperm of its dreams. At this time, vaginal discharge becomes very thin and watery, and then stretchy with an egg-white consistency. This type of discharge seems to cause the greatest level of confusion. The oral contraceptive pill works by stopping ovulation, so if you’re using this form of contraception you’re unlikely to experience this type of discharge. I see hoards of women who have stopped taking the pill after many years, and aren’t used to this type of ovulation discharge and are really worried it’s something abnormal. But it’s not. It’s a real sign your body is working normally. And also a sign you need to a. stock up on condoms or b. schedule date night whichever way you are inclined on the pregnancy front. Because, this type of discharge folks, as I boldly stated in the title, is the reason we exist. It allows sperm to swim up through the cervix into the uterus (or the womb) and fertilize an egg. Shortly after ovulation, the discharge becomes very thick and sticky and even the Mo Farah’s of the sperm world aren’t going to stand a hope in hell of getting through that stuff. And if the sperm-egg dating game didn’t go so well, your period starts and the cycle repeats itself.
As well as ensuring an ongoing human race, vaginal discharge has many more important roles. Firstly, it contains peptides that we sometimes refer to as ‘natural antibiotics’ that protect us against sexually-transmitted infections, and other bugs that want to wreak havoc, causing abnormal discharge, pelvic inflammatory disease and pregnancy complications including premature labour. But we also have good bacteria in the vagina too, just as we see in the gut and the vaginal bacterial community is known as the vaginal microbiome, which I’ll be writing way more on in another post, but for now, just rest assured in the knowledge that vaginal discharge is a nice, warm and hospitable environment for the growth of these good bacteria, which also play a huge role in keeping infection and inflammation at bay.
Now for two unexpected functions of discharge. Number one – it prevents chafe, and number two it stops you from having a dusty vagina. I’m honestly not joking. Discharge acts as a lubricant to stop friction and irritation, and also provides a way of helping the dead cells from the vagina, cervix, and uterus to make their way to the outside world.
There are of course abnormal types of discharge, which I’ll cover another day. Until then, the ‘Red flag symptoms’ to watch our for are…
Itching
Blood-stained discharge
Foul-smelling discharge
Change in colour
Associated with pain
For now, I will leave you with Dr Mitra’s top tips for healthy vaginal discharge:
Get to know what’s normal for you throughout your cycle so that you can detect anything abnormal quickly and easily.
Maintain a healthy, varied diet, including lots of good prebiotic-containing vegetables and probiotic foods such as greek yoghurt and miso to protect your good vaginal bacteria.
Don’t douche. Especially if you’re doing it because you feel irritated or that your discharge smells. You will only make it worse. See your GP instead.