Vaginal discharge: When to worry

It is that time of the year again when the weather is hot; we’re all sweating and trying to keep up with our water intake. For our practice, it’s that time when we get a lot of girls and women calling to ask about vaginal discharge. We get so many queries that we decided to debunk some of the myths out there about vaginal secretions; and let you know when to worry or not to worry. Sit back and have a good read.

1. Are all secretions bad?

Definitely not! The female reproductive system is like a well-run organization. Everything is time-oriented (well, most of the time). The female reproductive system is well controlled against intruders, like sperms, and repeatedly fends them off. If the balance is thrown off, it revolts resulting in smells, discharges and pain. At the helm of this control is two hormones, oestrogen and progesterone, that control the environment, as well as follicular stimulating and luteinizing hormones that control the cycles.

At different times of your cycle you will notice discharge from clear to white, with a thick mucus plug around the cervix, to other times when there is a thin plug and watery discharge; this is perfectly normal. It is just the hormone cycle – no need to see a doctor

1. Do you douche or wear a lot of synthetic fibres?

If you ask me why we don’t see a lot of grannies coming in complaining of discharge – it’s simple, they wear granny pants (comfy cotton well-fitting pants), and they tend not to practise chemical douching. Whereas young women have a tendency to literally sterilize their vaginas with all sorts of funny stuff in the market and wear very tight underwear with poor absorbing capabilities.

Solution? Wear natural fibre undergarments and avoid tight fits unless absolutely necessary; give yourself a break once in a while; feel free especially while indoors or sleeping. DO NOT DOUCHE! The body has natural bacteria that keeps the pH at a conducive level that discourages growth of other harmful bacteria and fungi. If you really want to douche, you could use a prescription drug like lactacyd, not endorsing it, but at least it supplements lactobacillus (friendly bacteria) growth in the vagina.

You should really worry when.                                                                                                                                                    

a. You have a discharge a couple of days after a sexual encounter.

This type of discharge could be a sexually transmitted infection (STI), usually chlamydia and gonorrhoea. Get checked quickly along with your partner(s). Remember an STI in a woman can be silent and can cause infertility, so be careful out there.

b. You have foul smelly coloured discharge

Natural discharge usually doesn’t have a bad odour. Pathological (abnormal) discharge usually has a funny fish-like or stale-bread smell. As soon as you notice this, see your local doctor as soon as possible.

More often than not, it’s a yeast infection. It comes as thick cottage cheese-like discharge and has a stale smell. Most women who have had this will pick it up easily and can even self-manage it. If you’re not sure, seek professional help.

For most women who drag their partner(s) to our practice and accuse them of infidelity, please don’t embarrass the poor guys; a yeast infection is not a STI and can’t be transmitted sexually.

If you get recurrent yeast infections (more than four episodes in a year) we need to make a culture of the discharge and check your immune status, especially for diabetes, a common red flag for women at risk of diabetes.

c. You have bloody discharge

If you’re not on your periods and you get bloody discharge, don’t assume all is well. You need urgent assessment to rule out benign things, like tears after sex and possible cancers; elderly women are especially vulnerable.

To sum up:

Daily discharge with no foul smell, no blood and no pelvic/abdominal pain -probably nothing to worry about. But discharge after intercourse, bloody discharge and/or pelvic/abdominal pain -probably serious; see a doctor.

Next week – Contraceptives; how to choose the best one for you!

House Call Daktari are a medical concierge service that aims to provide patients with personalised, attentive, quality medical care in a one on one patient setting.