Warning: this blog will use the words “vaginal discharge” in a seemingly excessive amount, but the synonym is leukorrhea, so… vaginal discharge on repeat.
First of all, let’s establish this:
Vaginal discharge is normal and healthy, and an indication of the health of the vulva, vaginal canal, and cervix.
Where does it come from?
Vaginal discharge is produced by the cervix, under influence of hormones, especially estrogen. Cervical discharge impacts the movement of sperm through the cervix, either by being friendly or hostile (hostile discharge, that’s right, and it’s normal). It also supports lubrication of the vaginal canal, although your body has a few extra glands to support lubrication with sexual arousal.
Vaginal discharge changes throughout a menstrual cycle due to the fluctuations in estrogen and progesterone.
What is it made of?
Vaginal discharge is made up of mucous and bacteria.
The main bacteria in the vaginal canal are a number of Lactobacillus species, which produce lactic acid, allowing for a more acidic environment in the vaginal canal. The average pH of reproductive-aged women is 4.0- 4.5, and 4.7 in post-menopausal women.
An acidic vaginal pH protects the vagina from overgrowth of bacterial that normally lives quietly and in relative harmony with the Lactobacillus species. When the bacteria in the vaginal canal is altered, and Lactobacillus growth is diminished, the vaginal discharge changes, resulting in advantageous growth of yeast and other bacteria.
The vaginal canal has a wide variety of bacteria and yeast growing in it – most are normal, but we want the majority to be Lactobacillus species.
What should it look like?
A healthy vaginal discharge will be clear to white to yellowish and mucousy, usually without a significant odour.
The average reproductive-aged woman produces between 1-4mL of vaginal discharge in 24 hours.
When does it change?
Both the follicular phase and luteal phase of your menstrual cycle results in thicker white-yellow discharge, which is normal, and is hostile to sperm movement through the cervix.
Vaginal discharge changes around ovulation, as estrogen levels increase, resulting in a transparent, uncooked egg-white consistency, which is friendly to sperm, allowing it to pass through the cervix easily.
Vaginal discharge changes after menopause and during pregnancy, varying in amount and consistency.
Bacterial vaginosis (BV) is common, due to a variety of anaerobic bacteria existing in the vaginal canal, causing a malodourous (fishy-smelling) discharge that is thin, white, greyish, or green, and may be accompanied by vaginal itching, or a burning sensation with urination.
Vaginal candidiasis (yeast infections) result in a discharge that is thick and white, and in more severe cases a cottage-cheese like consistency, accompanied by vulvovaginal itching and painful urination. As with BV this is most commonly due to a change in vaginal flora. Yeast is naturally occurring in the mouth, gut, and vagina, and is kept at bay due to healthy bacteria.
- STIs – Trichomoniasis (causing a greenish-yellow, sometimes foamy discharge), or Chlamydia (sometimes resulting in yellow abnormal smelling discharge)
- Diet – nutrient-poor diets high in refined sugars can alter the expression of bacteria in your vaginal canal
- Stress – high stress can decrease the amount of Lactobacillus bacteria in the vaginal canal
- Semen – temporarily increases the pH of the vaginal canal, and without adequate Lactobacilllus bacteria, can allow for other bacteria and yeast to flourish
- Menstrual blood – also increases the pH of the vaginal canal, as it is an alkaline/basic substance
- Oral contraceptive pills and IUDs – alter the expression of bacteria in the vaginal canal
- Antibiotics – suppress or decrease the healthy expression of Lactobacillus species in the vaginal canal
- Internal lubricants,Spermicides – these can easily throw off the balance of bacteria
- Douches – bad idea – the vagina is self-cleaning and there is no need for douches
When should you seek treatment and evaluation from your Western medical doctor?
If you notice:
- Burning of the vulva or vagina, or a burning sensation when peeing
- Smelly discharge that is different from your usual cyclical discharges (e.g. fishy odour)
- Green, foamy, or clumpy white discharge
- Bloody discharge not related to your menses
- Lower abdominal pain
- Fever accompanying any of the above symptoms
How can a Naturopathic Doctor help?
Naturopathic doctors can help educate you on what’s happening with your discharge and vaginal bacteria. Dietary and lifestyle adjustments are sometimes all it takes.
If you experience recurring yeast infections or BV, we will discuss biofilms and the sneaky ways these bacteria and yeast thrive and hide until conditions are perfect for them, and best of all, we can help decrease biofilm.
There are a myriad of botanicals and nutrients that have antimicrobial and antifungal activity, as well as helpful probiotics that are targeted for vaginal health. These treatments are chosen specifically for you and your symptoms.
If hormones are part of the issue, we can help determine what’s imbalanced and offer a variety of ways to bring your body back into balance (psst… it’s root cause stuff usually).
Vaginal discharge. It’s normal. It’s healthy. Get to know it.
Perimenopause is an opportunity to ensure healthy ageing and support your body for the long-term. If you think you might be experiencing symptoms related to perimenopause, talk to your naturopathic doctor.
Hi, I’m Dr. Jenny Schmidt. My practice focuses on family health and wellness, healthy aging for men and women and optimizing fertility & hormone function. I work with you, within realistic and sustainable parameters, to find the root cause of dysfunction in your body and address it. I am available as well for HeartMath, which you can read about here.