Dear Dr Mitchell,
I am 17 years old and I have some questions about my vaginal discharge because I'm not sure what is normal. Every week it changes and the smell changes as well, but it's nothing that smells too bad. I have never visited a gynaecologist and my mother doesn't live in Jamaica so I can't sit down to talk to her. How do I know if my discharge is normal? I am not sexually active.
A normal vaginal discharge is usually white in colour and has no odour. In the first part of the menstrual cycle, immediately after the flow has finished, the vaginal discharge tends to be white and watery and scant in amount. Around the time of ovulation (middle of the cycle) the discharge tends to look more like egg white (clear in colour) and is somewhat stretchy in nature. After ovulation the discharge thickens considerably and increases in volume. The discharge is not associated with any odour.
A thick, curdy vaginal discharge that itches is usually due to a yeast infection. There is usually no odour associated with this. This can cause itching on the inside and outside of the vagina. A greyish white, watery discharge with a fishy odour is usually due to bacterial vaginosis. This causes itching in a lot of cases and sometimes can be confused with a yeast infection. The treatment is completely different and so it is extremely important for the correct diagnosis to be made, so that the appropriate treatment can be given.
A yellow or greenish-coloured fishy vaginal discharge that itches is usually due to trichomonas infection. This is sexually transmitted.
Gonorrhoea and chlamydia infection are both sexually transmitted infections that can be associated with a vaginal discharge that sometimes looks like pus. These are serious infections that can damage your Fallopian tubes and cause difficulty in becoming pregnant. Once there is a sexually transmitted infection then screening for other sexually transmitted infections such as syphillis and human immunodeficiency virus (HIV) should be done.
You mentioned that you have never been sexually active so the mostly likely cause of your problem is bacterial vaginosis. This can be recurrent if you douche, use scented body wash, scented panty shields or tampons. The habit of inserting foreign body in the vagina will disturb the normal organisms in the vagina and change the acidity of the vagina, thus allowing for overgrowth of abnormal bacteria.
Bacterial vaginosis can be treated by taking Metronidazole tablets by mouth or using it in gel or tablet form in the vagina. You should discuss this with a grown family member and arrange to see a gynaecologist or your family doctor for a proper check-up to determine the underlying cause of the abnormal vaginal discharge so that the appropriate treatment can be prescribed.
You should also ask your doctor about getting the vaccine to prevent the human papillomavirus infection and cervical cancer. The usual age of vaccination starts at age 10 and extends up to age 65. The best time to be vaccinated is before the onset of sexual activity.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.