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What Your Doctor Probably Didn’t Tell You About Vaginal Discharge

A field guide to one of your body’s most underrated vital signs.

12 minutes

14 Citations

If there’s one thing most of us were taught growing up (explicitly or not), it’s that vaginal discharge—and vaginas, by association—are gross. It’s a myth so profoundly entrenched in our culture that it’s keeping a multi-billion dollar “feminine hygiene” industry thriving.1 The reality, of course, is that there’s nothing gross, wrong, or embarrassing about vaginal discharge. It’s just one of the many misunderstood aspects of female health. In fact, vaginal discharge is nothing short of miraculous. 

“It’s a healthy, beautiful thing. Everyone makes discharge,” says Ava Mainieri, Ph.D., a geneticist and evolutionary biologist specializing in female reproductive health. “It’s normal and, maybe more importantly, necessary.”

Vaginal discharge is a daily occurrence for almost everyone with a vagina, and it plays a few critical roles in your reproductive and overall health. It keeps your vaginal tract clean and lubricated, it can tell you what days you’re most fertile, and it reflects the state of your vaginal microbiome—the ecosystem of bacteria and fungi that live inside your vagina and protect it from infections. 

“I think of discharge as a vital sign,” explains Dr. Mainieri. It’s similar to how the shape, size, and consistency of your poop gives you insight into what’s going on in your gut microbiome

Here, we give you the full lowdown on vaginal discharge, including how to know what’s healthy vs. abnormal, how it can change throughout your cycle (and life), and why it’s such a fundamental aspect of female health.

What Is Vaginal Discharge?

Vaginal discharge—or leukorrhea (loo-ko-ree-ah), as it’s medically referred to—is an umbrella term for any fluid that’s produced by the reproductive tract and comes out of your vagina. But discharge, as we’ve come to know (and love), is a mix of cervical mucus, bacteria, dead cells from the vaginal epithelium, and vaginal fluid. 

The glands in the cervix (the opening that connects the vagina to the uterus) produce and release cervical mucus, which can change in volume and texture in response to hormonal fluctuations during your menstrual cycle. That’s why you might notice that the amount of discharge you make changes throughout the month (more on that later). 

Aside from cervical mucus, vaginal discharge is also made up of bacteria that live in the vaginal microbiome.2 For most people, that bacteria is lactic acid-producing Lactobacillus species. “The vaginal microbiome, like most of the microbiomes on your body, plays a really critical role in female physiological and reproductive health,” Dr. Mainieri says. 

“If you think of your vaginal microbiome as a forest, it’s teeming with trillions of microscopic organisms that collaborate to shield it from ailments and foster optimal health. So just one little drop of vaginal discharge can contain up to a billion individual bacteria.” 

These bacteria are also responsible for keeping your vagina (and discharge) acidic to prevent infections, which explains why many people find that their discharge “bleaches” their underwear. “This happens because an optimal microbiome has a pH that is acidic,” Dr. Mainieri says. “It’s normal, and it’s your body telling you that things are going well.”

The Vagina: A Self-Cleaning Oven

As we mentioned above, one of the primary roles of discharge is to keep your vagina clean—but maybe not in the way you’d think. “We all hear the vagina is a self-cleaning organ, and discharge is the thing that does it,” Dr. Mainieri explains. “But when we say ‘clean,’ what does that really mean? In our common vocabulary, we think of clean as sterile, but you don’t want your vagina to be sterile.” 

Instead, it should be full of bacteria. Specifically, “good,” protective bacteria. “So the purpose of discharge is twofold: to keep the vagina clean, as in promoting the growth of this healthy protective bacteria, and to flush out any unwelcome pathogens.” 

The fact that the vagina is self-cleaning also means it’s pretty low-maintenance and doesn’t need to be washed, contrary to what years of marketing may have led you to believe. In fact, using intimate washes and douches can do more harm than good because they can affect the pH of the vaginal microbiome.

Douching, for example, has been associated with vaginal dysbiosis (an imbalance of the vaginal microbiome), which can put you at a higher risk of bacterial vaginosis (BV), a vaginal infection caused by the overgrowth of disruptive bacteria.2 It’s also linked with pelvic inflammatory disease (PID), an infection of the upper genital tract that can cause long-term reproductive health complications, such as infertility.

Discharge isn’t a dirty thing you want to flush out, but an important ally.

Dr. Ava Mainieri

The TL;DR is: The vagina doesn’t need any help in the hygiene department, and all you really need to clean your vulva is warm water.

But on top of keeping your vagina clean, discharge is also there to prevent discomfort. “It also lubricates the mucous membranes in your vagina, keeping them moist,” Dr. Mainieri says. “Dry mucous membranes are easily torn, and problems quickly follow once that happens. Imagine having sex or using a tampon, and you have a really dry mucous membrane; of course, you’re going to have an irritation, which can lead to inflammation, and may cause small little tears in your vagina’s epithelial layer. Without discharge, sex can become a nightmare, and the likelihood of getting an STI also increases because the outer barrier has been damaged. So, in other words, discharge isn’t a dirty thing you want to flush out, but an important ally.”

The Evolutionary Benefits of Discharge

The vaginal microbiome, and therefore vaginal discharge, is like an extension of the immune system. It’s there to keep you healthy and infection-free, so much so that some researchers believe these processes have an evolutionary component.3 

“A prevailing theory is the Red Queen hypothesis,” Dr. Mainieri says. In evolutionary biology, the Red Queen hypothesis (named after the Alice in Wonderland character) states that species must constantly evolve, adapt, and reproduce to survive. It also explains the benefits of sexual reproduction, a.k.a. why humans have sex to reproduce. 

“We evolve to create genetic changes in our offspring, so they contain traits that we don’t necessarily have,” Dr. Mainieri explains. “And the point of that is to outrun and protect against pathogens. With vaginal discharge, a big part of it is protection from unwanted pathogens and parasites.” The theory is that by keeping you safe from pathogens, discharge also protects humans as a species. 

“You could make an informed hypothesis that humans have so much lactobacilli, as opposed to other organisms, because we have a lot of sex with different partners and a very long reproductive lifespan,” Dr. Mainieri says. “And keeping your reproductive organs healthy and optimal is kind of the main point of the vaginal microbiome.” 

Emerging research is also finding more and more links between the vaginal microbiome and fertility and your likelihood of getting pregnant. Several studies found that having a higher amount of Lactobacillus bacteria in the vaginal microbiome can actually be beneficial for fertility, while vaginal dysbiosis was linked to infertility.4,5 One recent meta-analysis of 17 different studies even showed that an imbalance of vaginal bacteria in couples undergoing in vitro fertilization (IVF) was associated with both early pregnancy loss and a lower chance of pregnancy success.6  

“We know that having a dominance of Lactobacillus crispatus has the lowest risk of infertility and preterm birth, and ​​there’s so much data around the association between an optimal vaginal microbiome and good fertility outcomes,” Dr. Mainieri adds.

Healthy vs. Unhealthy Discharge: How to Tell the Difference

Discharge exists on a broad spectrum, and the smell, consistency, and color can tell you a lot about what’s going on in your body—such as when you’re most fertile or if you’ve contracted a sexually transmitted infection (STI). So, having vaginal discharge is a good thing, even if it might feel like an inconvenience. 

“The amount of discharge depends on the individual person, like where they are in their cycle and their vaginal health,” Dr. Mainieri explains. “Some people will go to their doctor and ask, ‘How much should I have? I feel like I have a lot today.’ And the answer is, ‘Well, it depends on whether this is normal or abnormal for you.’” 

Although the amount of discharge someone makes changes from person to person, or depending on where you are in your cycle, it’s normal to have about one-half to one teaspoon (2 to 5 mL) of discharge daily.7 But, of course, that can change. “If you’re on hormonal contraception, your discharge levels might increase. We know that in pregnant individuals, discharge increases, and throughout the month, if you’re not on hormonal contraception, that consistency also changes.”

One of the many fascinating aspects of vaginal discharge is that it comprises a rich tapestry that communicates what’s going on inside your body. Knowing how to decode your vaginal discharge can be a cheat code for your health. 

In general, healthy discharge ranges from clear to white or pale yellow in color and slippery or creamy in consistency. That said, everyone’s vaginal microbiome is unique, which means everyone’s discharge is different too. The key is knowing what is normal for your body. Nevertheless, it can be helpful to be aware of some discharge red flags: 

  • White, clumpy discharge that looks like cottage cheese can be a telltale sign of a yeast infection, especially if accompanied by vaginal itching and burning.8 
  • Gray, watery discharge with a foul or fishy smell is most commonly a symptom of BV.9
  • Green or gray frothy discharge with a strong, unpleasant smell can indicate a STI called trichomoniasis.10 
  • Sticky, yellow, or green discharge that has a “rotten” smell can be a sign of a vaginal infection called aerobic vaginitis.11 
  • White or yellow discharge that has a really bad smell and is accompanied by burning or pain can be a symptom of chlamydia.12
  • And finally, gonorrhea can cause really high quantities of greenish or yellow discharge.13 

How your discharge smells is often the biggest giveaway that something’s up. “There is this huge spectrum of vaginal smells,” Dr. Mainieri says, and it’s okay for genitals to smell like genitals (not flowers), but an especially strong, fishy, or rotten smell might indicate the presence of harmful bacteria in your discharge. “It’s because you have too many of these anaerobic bugs (those that can survive without oxygen), which are responsible for these fishy or rotten smells because they produce chemicals called ‘amines,’ like putrescine and cadaverine.”

The general rule of thumb when it comes to discharge is that any drastic change in the color, consistency, or smell that doesn’t fit within your normal should get alarm bells ringing. Getting up close and personal with your discharge can make it easier to spot when your body sends you warning signs that something is wrong.  

“Of course, it’s hard to say, ‘Well, what is normal for me?’” Dr. Maineri adds. “That requires having some sort of body literacy and being comfortable with the fact that your discharge smells so that when you have an actually bad smell, you know what it could be telling you.”

How Vaginal Discharge Changes With Your Cycle

Speaking of changes in quantity and consistency, discharge is a creature of habit and can follow a fairly predictable pattern throughout the menstrual cycle. 

When you’re on your period, menses mix with your cervical mucus so that you won’t notice any discharge per se. You may produce very little or no discharge in the days following your period. If you see brown discharge, don’t panic—it’s just old, oxidized blood. 

As you approach ovulation, in the follicular phase, estrogen levels rise, and your cervix produces more mucus. This increase in mucus can result in a milky white discharge that is thick and creamy. The thick consistency of your vaginal mucus acts as a barrier to prevent sperm from reaching your uterus.

During ovulation, you may notice an increase in discharge. This is because estrogen levels peak one to two days before ovulation, and your cervical mucus becomes clear, slippery, and stretchy to help sperm travel up toward the egg. If you can stretch your discharge between your index finger and thumb, it’s a reliable sign that you’re ovulating and have a better chance of conceiving.

After ovulation, there is a noticeable change in the quantity and texture of your discharge. Discharge during the luteal phase may feel sticky, dry, or be absent altogether. This change occurs as progesterone (responsible for supporting a potential pregnancy) peaks. Progesterone inhibits the secretion of cervical mucus, acting as a barrier to stop sperm from entering the upper reproductive tract. Thicker mucus also helps prevent bacteria, fungi, and infections from reaching the uterus during the implantation of the fertilized egg.

If you’re trying to conceive, tracking your discharge can help you figure out when you’re ovulating and can get pregnant. This is called the “cervical mucus method” or “natural family planning.” 

How Hormones Affect Discharge

Aside from the cyclical fluctuations you might notice throughout the month, other factors can affect your discharge. 

Hormones, for example, play a role in vaginal discharge beyond the menstrual cycle. In early pregnancy, as levels of estrogen increase, you might notice an increase in thin, clear, or milky white color with a slight odor. Your body produces more discharge to shed dead cells and keep bacteria from entering the uterus from the vagina. 

​​Something similar happens when you take hormonal birth control. Most forms of birth control contain synthetic versions of estrogen and progesterone, which suppress ovulation and thicken cervical mucus. A common, temporary side effect of birth control is creamy, white vaginal discharge, so don’t be alarmed if you notice a change in the first few months of taking a new type of birth control. 

But it’s not just the increased levels of hormones that can change your discharge—their absence also affects it. In the lead-up to menopause, for example, estrogen levels plummet, and you produce less cervical mucus. Estrogen is essential for maintaining vaginal health as it helps to keep the vaginal mucosa thick, lubricated, and elastic. As a result, one of the most common symptoms of menopause is vaginal dryness.14

Vaginal Discharge: A Glimpse Into Your Microscopic World 

While vaginal discharge is often misunderstood and stigmatized, it’s a true wonder of the female body. It serves as an indicator of reproductive health, offering insights into our fertility, microbial balance, and overall well-being. This seemingly ordinary bodily function is invaluable data that enables us to piece together the significance of whatever other vaginal symptoms we’re experiencing—a crucial snapshot of the state of our vaginal microbiome.

Embracing and understanding our vaginal discharge is a significant step toward appreciating the complexity and beauty of the female reproductive system, dispelling myths, and recognizing this natural and vital aspect of our bodies.

Citations

  1. Faizullabhoy, M. (2020). Menstrual Hygiene Management Market – by product (Sanitary pads, tampons, menstrual cups, panty liners, menstrual underwear), by usability (Disposable, reusable), by distribution channel & forecast, 2022 – 2030. In Global Market Insights Inc. https://www.gminsights.com/industry-analysis/menstrual-hygiene-management-market#:~:text=Feminine%20Hygiene%20Market%20size%20was,the%20importance%20of%20personal%20hygiene
  2. Holdcroft, A. M., Ireland, D. J., & Payne, M. S. (2023). The Vaginal Microbiome in Health and Disease-What Role Do Common Intimate Hygiene Practices Play?. Microorganisms, 11(2), 298. https://doi.org/10.3390/microorganisms11020298
  3. Amabebe, E., & Anumba, D. O. C. (2018). The Vaginal Microenvironment: The Physiologic Role of Lactobacilli. Frontiers in medicine, 5, 181. https://doi.org/10.3389/fmed.2018.00181
  4. Vitale, S. G., Ferrari, F., Ciebiera, M., Zgliczyńska, M., Rapisarda, A. M. C., Vecchio, G. M., Pino, A., Angelico, G., Knafel, A., Riemma, G., De Franciscis, P., & Cianci, S. (2021). The Role of Genital Tract Microbiome in Fertility: A Systematic Review. International journal of molecular sciences, 23(1), 180. https://doi.org/10.3390/ijms23010180
  5. Ravel, J., Moreno, I., & Simón, C. (2021). Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. American Journal of Obstetrics and Gynecology, 224(3), 251–257. https://doi.org/10.1016/j.ajog.2020.10.019
  6. Skafte-Holm, A., Humaidan, P., Bernabeu, A., Lledo, B., Jensen, J. S., & Haahr, T. (2021). The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis. Pathogens (Basel, Switzerland), 10(3), 295. https://doi.org/10.3390/pathogens10030295
  7. UpToDate. (n.d.). UpToDate. https://www.uptodate.com/contents/vaginal-discharge-in-adult-women-beyond-the-basics#:~:text=Vaginal%20discharge%20is%20made%20by,of%20lower%20levels%20of%20estrogen
  8. Martin Lopez J. E. (2015). Candidiasis (vulvovaginal). BMJ clinical evidence, 2015, 0815.
  9. Kairys, N. (2023, July 4). Bacterial vaginosis. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK459216/
  10. STD Facts – Trichomoniasis. (n.d.). https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm
  11. Donders, G., Bellen, G., Grincevičienė, Š., Ruban, K., & Vieira‐Baptista, P. (2017). Aerobic vaginitis: no longer a stranger. Research in Microbiology, 168(9–10), 845–858. https://doi.org/10.1016/j.resmic.2017.04.004
  12. Mohseni, M. (2023, August 8). Chlamydia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK537286/
  13. Springer, C. (2023, April 17). Gonorrhea. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK558903/
  14. Bleibel, B. (2023, July 3). Vaginal atrophy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559297/