The main points

  • If normal discharge becomes smelly, yellowish or greyish in colour or thick, white and lumpy in appearance, you may have an infection. Itching, abnormal bleeding, sores or pain in the genital area can also be a sign of infection.
  • Not all abnormal vaginal discharges are sexually transmitted.
  • Different infections need different treatments.

What is it?

Most women experience an inoffensive, whitish or clear vaginal discharge throughout their cycle. The amount varies from woman to woman. This is completely normal. If this normal discharge becomes smelly, yellowish or greyish in colour or thick, white and lumpy in appearance, you may have an infection. Itching, abnormal bleeding, sores or pain in the genital area can also be a sign of infection.

What causes an abnormal vaginal discharge?

Not all abnormal vaginal discharges are sexually transmitted.

Thrush or candida infection is caused by an overgrowth of the small amount of fungus normally present in the vagina.

People with diabetes, pregnant women and those taking courses of antibiotics also have an increased risk of thrush.

Bacterial vaginosis (BV) is caused by an imbalance of the normal bacteria that live in the vagina. It usually only happens in women who have sex but it is uncertain whether it is passed on through sex.

Sexually transmissible infections (STIs) such as chlamydia, gonorrhoea, mycoplasma and trichomoniasis can also cause discharge.

What are the symptoms?

Thrush

  • discomfort and itching around the vagina
  • a burning sensation and pain when passing urine and during sex
  • thick, white, lumpy discharge
  • redness and swelling of the vagina
  • small breaks in the skin around the vagina.

Bacterial Vaginosis

  • an unpleasant vaginal odour
  • an abnormal, thin greyish discharge
  • itching around the vagina.

Trichomoniasis

  • irritating discharge
  • redness and swelling of the vagina
  • a yellowish-green, frothy discharge.

Chlamydia, mycoplasma and gonorrhoea

  • discharge may increase, change colour or become blood stained
  • most women with these infections don’t notice a change in discharge or any other symptoms
  • there may be associated pelvic pain, pain with sex, bleeding in between periods or bleeding after sex.

What tests will I need?

Your doctor or nurse will take a swab of the discharge for further testing. You may be offered treatment before the test results are confirmed, if your symptoms suggest a specific infection.

How is it treated?

Different infections need different treatments.

Thrush is a fungal infection and is usually treated with anti-fungal creams or pessaries inserted into the vagina. Oral medication (fluconazole) is also available. You may also be advised to wear cotton underwear and not stay in damp gym clothes or wet swimwear.

BV, chlamydia and gonorrhoea are treated with antibiotics.

Should my partner/s be treated?

If you have thrush, your partner/s don’t usually need treatment. Male partners may get redness and irritation after sex and may need treatment if this persists.

If you have BV, male partner/s don’t need treatment, but female partner/s should be tested and treated.

If you have chlamydia, mycoplasma, trichomoniasis or gonorrhoea your partner/s should be treated.

When can I have sex again?

With thrush and BV, you only need to avoid sex if it is uncomfortable or unpleasant because of vaginal treatments.

Many of these treatments are oil-based and will damage rubber, so condoms can’t be used effectively with them. If you rely on condoms for safe sex or contraception, insert the vaginal treatments after having sex.

If you are treated for an STI, your doctor or nurse will tell you when you can have sex again. For chlamydia and gonorrhoea, you need to abstain for one week after treatment.

What will happen if it’s not treated?

Thrush is not a dangerous infection and some mild cases may settle without treatment. BV only needs to be treated if you have uncomfortable symptoms or if you are about to have a procedure such as insertion of an IUD or an abortion. There may be potential complications, however, for pregnant women. Discuss this with your doctor if you are pregnant or planning a pregnancy. Trichomoniasis, gonorrhoea or chlamydia should be treated effectively to avoid complications and passing the infection on to your sexual partner/s.

Will it come back?

Thrush and BV tend to recur in some women. Talk to your doctor or nurse if this happens, as you may need further testing and treatment.

Trichomoniasis, gonorrhoea or chlamydia will not recur unless treatment fails or you are reinfected.

How can I avoid it?

Excessive washing will not help the symptoms of a vaginal discharge. Wash your genital area with water no more than once a day. A small amount of soap or pH balanced cleanser may be used. Use water-based lubricant if you feel dry during sex.

Sexually transmissible infections can be avoided by:

  • always practising safe sex
  • using condoms on sex toys. Put a fresh condom on the toy before you start using it, and whenever you switch who’s using it.

Women who take hormonal contraception or use condoms every time they have sex are less likely to get BV.

The risk of thrush can be decreased in diabetics with good blood sugar control.

This health information is general information only. If you have any concerns about your sexual health, please see a doctor or visit one of our clinics.

Where to get more information, support or advice

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Last updated: 5 June 2016

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