Thousands of women around the world visit their gynecologists annually, complaining of vaginal discharge. Let’s take a look at what’s considered normal discharge in a health vaginal environment. Like the rest of the body, the vagina, contains a variety of bacteria and other micro-organisms that assist in maintaining it’s environment or natural flora. Lactobacillus, commonly referred to as the ‘good’ bacteria, plays an important role in this maintenance. A vaginal PH 4.5 or less, creates the ideal environment for Lactobacillus to flourish. Another component of vaginal health is the naturally occurring discharge. This discharge ranges from clear and sticky to white and thick. It is often called leucorrhea (leukorrhea). The changes in composition of discharge are related to the hormonal changes that a women experiences on a monthly bases. However, normal vaginal discharge does not itch, look clumpy like cottage cheese nor have a foul odor. These types of changes are often the first signs of an infection. Seek immediate medical advice.
The most common cause of abnormal vaginal discharge is bacterial vaginosis (BV). The prevalence in African-American women exceeds 50%. This type of discharge looks like skim-milk yet smells like rotten fish. Although it is NOT a sexually transmitted infection, the exact cause of BV is not well understood. Science has shown that it results from changes in the delicate balance of vaginal flora. With BV, the PH of the vagina becomes more basic, and the composition of micro-organisms subsequently changes. The presence of Lactobacillus decreases and species like Gardnerella Vaginalis predominate. The characteristic odor of BV is a direct result of the amines metabolized during this process.
It is advisable to seek professional help with diagnosing abnormal vaginal discharge. Not only will the provider evaluate the discharge but they may also perform any necessary testing. BV is usually accompanied by other infections. Ultimately the provider will write any required prescription medications. Treatment is not currently sold in the pharmacy “over the counter”.
So BV, no big deal, right? – Wrong! There are consequences associated with BV especially when it’s chronic. BV has been associated with pre-term delivery or low birth weight. It has also been linked to pelvic inflammatory disease and inflammation of the tubes. Some studies have even show that it may increase the chances of getting HIV! Therefore, prevention is key to avoiding repeated infections and keeping the vagina healthy. Some people laugh at the notion that the vagina cleans itself. Well it literally does via good bacteria like Lactobacillus as discussed earlier. In attempting to keep the vagina clean, many women purchase a variety of feminine products (ex. douches, wipes, powders, sprays). Unfortunately many of these products disturb vaginal flora by either washing away the healthy bacteria or changing the vaginal PH. Sperm is something else that contributes to altering the vaginal PH. The best vaginal wash before or after sex is plain old water. Just allow nature to take it’s course.
Bacterial vaginosis is an aggravating, annoying but often avoidable infection. Although it is not transmitted sexually, it is important to seek medical care. Don’t try diagnosing this on your own. There is no reason to feel embarrassed. Numerous women report this problem at some point in their lives. So get treated and avoid reinfection if possible.
When you take care of your vagina, your vagina will take care of you,
Dr. Lisa McLeod