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Discharge: causes, function and tips

by Josephine Andrews
Published: Last Updated on 459 views

Discharge (med.: Fluor vaginalis, Fluor genitalis) begins shortly before puberty and accompanies women until menopause. Its composition is subject to hormonal fluctuations. It increases during ovulation and pregnancy. If the normal, transparent and odorless discharge changes in colour, smell or texture, this can indicate a disease. Read everything you need to know about vaginal discharge here.

brief overview

  • Forms: normal discharge (“white discharge”; milky-white, odorless discharge from the vagina), pathological discharge (e.g. yellowish, greyish, brown or red discolored, crumbly, lumpy, viscous, foul smelling).
  • Causes of altered discharge: e.g. infections with bacteria (e.g. chlamydia infection, gonorrhea), viruses (e.g. genital herpes, HPV infection), protozoa (trichomonas) or fungi (e.g. vaginal thrush), hormone fluctuations, pregnancy, stress, excessive intimate hygiene, antibiotic therapy, Latex allergy, polyps, tumors, genital tuberculosis.
  • Tips for self-help: Treatment with lactic acid bacteria, correct intimate hygiene and wiping technique after defecation, avoiding sugar in the case of an acute fungal infection, sex only with a condom.
  • When to the doctor? Women should see a doctor if the normal discharge changes in colour, smell and/or texture and other symptoms may occur (e.g. fever, itching, pain during sex ). Discharge after menopause should always be clarified. Men with discharge should always see a doctor.
  • What does the doctor? Collection of the medical history, gynecological / urological examination, smear with laboratory examination, tissue removal ( biopsy ) if a tumor is suspected. Treatment depends on the cause (e.g. antibiotics for bacterial infection, antifungal drugs for fungal infection). In the case of sexually transmitted diseases: co-treatment of the partner.

Discharge: forms

Normal discharge (white flow)

Every woman knows the odorless, milky-white secretion (white flow) that flows out of the vagina every day. This discharge (called fluor vaginalis or fluor genitalis) first appears a few years before puberty and accompanies women until menopause.

Depending on which cycle phase a woman is in, the consistency and quantity of the discharge changes. For example, many women notice when they are ovulating from increased, almost liquid discharge caused by the female hormone estrogen. Shortly before and after menstruation, the fluor vaginalis is somewhat more viscous.

Discharge – important protective function

The discharge from the vagina has a purpose: it frees the uterus and vagina from excess mucus and shed cells. At the same time, the Fluor vaginalis contains many lactic acid bacteria, which create a slightly acidic vaginal environment and thus ward off invaders such as fungi, viruses and bacteria. The discharge also prevents sperm from entering the uterus when it is not cyclically prepared for pregnancy.

Diseased discharge

If the discharge becomes noticeably discolored (e.g. yellowish or brownish), smells bad, becomes crumbly, lumpy and/or viscous, this can indicate a disorder of the vaginal area. These include, above all, vaginal infections caused by pathogens (such as bacteria, fungi), but also other diseases.

Sometimes, however, hormonal fluctuations, certain medications or psychological problems are also responsible for noticeable discharge.

If your discharge changes significantly, for example turns yellow, brown or noticeably thick and/or smells bad, you should always consult your gynecologist to find out the cause.

Discharge: causes

Altered discharge can have many different causes – some of which are pathological (such as infections) and others are not (eg, normal hormonal fluctuations over the course of the menstrual cycle). Here are the main ones:

Bacterial Infections

A thin, greyish, fishy-smelling discharge usually indicates an inflammation of the vagina (colpitis, vaginitis). This is usually caused by the bacterium Gardnerella vaginalis . Staphylococci and streptococci can also be the trigger, as can the following pathogens of common sexually transmitted diseases:

  • Chlamydia: A chlamydia infection – caused by the bacterium Chlamydia trachomatis – is one of the most common sexually transmitted diseases. In women, it often goes unnoticed. Only increased, sometimes purulent-yellow discharge and pain when urinating can indicate this. Left untreated, chlamydia infection can cause infertility.
  • Gonococci (Neisseria gonorrhoeae) : These bacteria trigger the widespread venereal disease gonorrhea. Especially in women, this is often asymptomatic. However, it can also cause symptoms such as a foul-smelling, yellowish discharge and burning when urinating. If left untreated, there is a risk of chronic symptoms.

A fishy-smelling discharge can also indicate an imbalance in the vaginal environment, in which potentially disease-causing bacteria multiply while the proportion of “good” lactic acid bacteria decreases. Such bacterial vaginosis is often caused by sexual intercourse. Other risk factors include psychosocial stress and smoking.

fungal infections

The acidic vaginal environment, for which lactic acid bacteria are primarily responsible, normally prevents the yeast fungus Candida albicans from being able to multiply here. However, if the lactic acid bacteria are reduced, for example by antibiotic therapy or a weakened immune system, a vaginal fungus (vaginal mycosis) can spread. Typical signs are a lumpy, white discharge, which is accompanied by a very reddened mucous membrane, itching and burning pain .

Trichomonal infection

One of the widespread venereal diseases is an infection with trichomonas (trichomoniasis) – more precisely with Trichomonas vaginalis . The small, mobile parasites affect the urinary and genital tracts (urogenital tract), particularly in women. Itching and foul-smelling yellow discharge are among the symptoms of the infection.

viral infections

Viruses can also infect the genital area and cause symptoms such as discharge there. The most important include:

  • Herpes simplex virus : Herpes simplex virus type 2 causes genital herpes. Signs of this are the typical blisters in the area of ​​the vagina, labia and mucous membrane, a reddened mucous membrane, itching, heavy discharge and fever .
  • Human papillomavirus (HPV): This virus causes so-called genital warts that often go unnoticed. A reddish-brown discharge is typical of the infestation. Some subtypes of HPV cause cervical cancer . There is now a vaccination against it (HPV vaccination).

Other influencing factors

  • Hormonal fluctuations: Under the influence of the female sex hormone estrogen, the discharge becomes more liquid shortly before ovulation. In the period before and after menstruation, it is tougher. This is completely normal.
  • Sexual arousal: Increased watery discharge during sexual arousal is also quite normal. It acts as a natural “lubricant” to facilitate penis penetration .
  • Stress: Changed or heavy vaginal discharge can be the result of psychosocial stress because it can unbalance the composition of the natural vaginal flora. Signs of such bacterial vaginosis may include a “fishy” smelling discharge.
  • Foreign objects in the vagina, such as a forgotten tampon, provide an ideal breeding ground for bacteria. The result can be a vaginal inflammation (colpitis).
  • Latex allergy: Some people are allergic to latex, such as latex condoms. In affected women, mucosal contact with such condoms can cause vaginal burning, pain during sexual intercourse and altered discharge.
  • Tumors: Discharge that is irregularly heavy, sometimes bloody or watery, or that occurs after the menopause is alarming. Then benign tumors can be the reason, eg uterine polyps (red-brown discharge). Watery, strong-smelling or even bloody discharge can also indicate cancerous tumors of the genitals.
  • Genital tuberculosis: Tuberculosis that spreads to the genital area is now very rare in Europe. It leads to infertility.
  • Antibiotic therapy: Some antibiotics destroy the healthy lactic acid bacteria in the vagina, making it easier for pathogens to establish and spread.
  • Other causes of a changed vaginal environment: Risk factors such as diabetes mellitus, hormonal contraceptives and excessive intimate hygiene can throw the acidic vaginal climate out of balance and thus promote infections in the genital area (with symptoms such as discharge).

discharge in pregnancy

If heavy discharge occurs during pregnancy, many women are unsettled. However, there is usually no reason for this, because increased discharge in pregnant women is normal. This is the same discharge that non-pregnant women experience every day: white discharge.

But of course you can also get a vaginal infection during pregnancy with a correspondingly changed discharge, which poses a certain risk for the unborn child. Because some pathogens can cause premature births. During delivery there is also a risk that the baby will become infected with the pathogens.

You can find out more about this topic in the article Discharge during pregnancy .

discharge in men

Men can also suffer from discharge. Fluid that is neither urine nor semen then leaks out of the urethra. This discharge indicates an inflammation of the urinary tract (urethritis). It is most often caused by infection with pathogens that the man contracted during sexual intercourse. If these are bacteria of the gonococci type, doctors speak of gonorrheic (specific) urethritis . Much more often, however, other germs are the cause. Then there is a non-gonococcal (non-specific) urethritis .

Non-gonococcal urinary tract inflammation (urethritis non gonorrhoica, NGU )

Men between the ages of 20 and 35 in particular are infected with non-gonococcal urethritis (NGU). The triggering germs that those affected “catch” during sexual intercourse are mostly bacteria – especially Chlamydia trachomatis (chlamydia) and Ureaplasma ureolyticum , sometimes also streptococci.

Aside from bacteria, fungi and trichomoniasis, for example, can also cause non-gonococcal urinary tract infections.

In about five percent of all infected people, the urinary tract infection is not accompanied by any symptoms. In the other cases, it is often mild and is therefore usually not recognized immediately. Important signs are:

  • burning pain when urinating
  • frequent urge to urinate, passing only a few drops
  • Burning or itching in the urethra
  • swollen lymph nodes in the groin
  • glassy discharge

Regardless of whether non-gonococcal urethritis causes symptoms or not, those infected are highly contagious to their sexual partners.

Gonorrheic urinary tract inflammation (Urethritis gonorrhoica, GU)

Here, the urinary tract infection is caused by an infection with gonococci. The infection is popularly known as clap or gonorrhea. Typical signs of gonorrheal urethritis are:

  • pain when urinating; feeling like there are splinters of glass in the urethra
  • white or purulent discharge
  • itching in the urethra

If the disease is not treated, the symptoms subside on their own after about eight weeks. However, the pathogens can ascend via the urogenital tract into the epididymis and lead to infertility. The prostate can also be affected and become inflamed.

If you, as a man, have discharge, you should definitely consult a doctor (family doctor/urologist) to have the cause treated and to prevent serious consequences such as subsequent infertility.

Discharge: Tips for self-help

These tips will help you to prevent infections with pathogens in the genital area or to support the medical treatment of such infections:

  • Lactic acid cure : An illness or antibiotic treatment can significantly reduce the number of lactic acid bacteria in the vagina. Tampons with natural yoghurt or special lactic acid suppositories from the pharmacy bring the vaginal flora back into balance.
  • Proper intimate hygiene : Never wash the vagina yourself, especially not with harsh soaps or vaginal douches. You should limit your intimate hygiene to the outer intimate area and only use clear water and, if necessary, pH-neutral, gentle washing lotions.
  • Proper wiping after a bowel movement : Vaginal infections caused by intestinal bacteria can be avoided with the right wiping technique: Always wipe from front to back after a bowel movement.
  • No Sugar : If you have a vaginal thrush, it’s often recommended to eat a low-sugar or no-sugar diet because mushrooms love sugar. But there are also medical professionals who say that the amount of sugar in the diet has no influence on a vaginal thrush infection.
  • Safer sex : Only the condom helps against the transmission of sexually transmitted diseases. Use it above all if you deal with changing partners.
  • Panty liners instead of tampons : You should use panty liners instead of tampons, especially if you frequently suffer from discharge.
  • Cotton underwear : Unlike underwear made from synthetic fibres, cotton underwear does not impede the exchange of air in the genital area. This means that bacteria and fungi cannot multiply so easily in the external genital area.

Discharge: when do you need to see a doctor?

Changed discharge in women can indicate a disease. Therefore, women should keep a close eye on their discharge: What color is the discharge? Is it thick or rather thin? Does it smell uncomfortable? The altered discharge is usually based on an easily treatable vaginal infection. However, you should be careful with red-brown, bloody-clumpy discharge, especially if it occurs after menopause. Because this discharge can be a symptom of cancer.

You should definitely see your gynecologist if:

  • the amount of discharge changes significantly.
  • the discharge changes color : Yellow or brown discharge and green, white or purulent vaginal fluoride indicate diseases.
  • the nature of the vaginal secretion changes: crumbly or lumpy discharge can also indicate illnesses.
  • The smell of the discharge changes: Discharge that smells particularly fishy can be a sign of an infection.
  • further complaints in the genital area such as severe itching, redness and burning pain occur.
  • Complaints when urinating such as frequent urge to urinate or pain when urinating.
  • there are whitish deposits on the vaginal mucosa or the labia.
  • experience unusual pain during intercourse .
  • other accompanying symptoms such as a general feeling of illness or fever.
  • the discharge occurs after menopause .

Discharge in men is always a reason for a visit to the urologist! The underlying disease – the inflammation of the urinary tract (urethritis) – can be easily controlled with antibiotics. It is also important here that the partner is also treated in order to avoid re-infection.

Discharge: what does the doctor do?

The contact person for women with altered vaginal secretions is the gynaecologist. He will first ask you a few questions about your medical history (anamnesis). For example, he inquires how long the changed discharge has existed and how exactly the texture, color and smell of the discharge have changed. This information can provide the gynecologist with a first suspicion. If you are taking medication or suffer from previous illnesses, you should also mention this in the anamnesis interview.

In the subsequent gynecological examination , the doctor can see whether and how your vaginal mucosa has changed. For example, is it red or swollen? With a smear , pathogens such as bacteria, fungi or trichomonads can be detected directly under the microscope. The doctor can also easily determine the pH value in the vagina, which is normally around 4.5, with a test stick.

Certain pathogens such as chlamydia can only be detected in the laboratory. This usually takes a few days.

If there is no inflammation, it is important to rule out a tumor as the cause of the discharge. For this, too, a smear is taken and, if necessary, a small tissue sample (biopsy) is taken. This is then thoroughly examined by a pathologist for degenerated cells.

Discharge in men: examinations by the urologist

The urologist will also first take the medical history of a man with a discharge. He then examines the genital area for any abnormalities, such as redness and swelling in the area of ​​the glans and foreskin . He also takes a secretion sample from the urethra. This is examined under the microscope and often analyzed more precisely in the laboratory. The results are usually sufficient to make the correct diagnosis.

Discharge: treatment

Treatment for discharge depends on the cause. For example, the doctor prescribes so-called antimycotics for a vaginal yeast infection. The antifungal agents are available as vaginal suppositories or ointments. If a bacterial infection (e.g. of the vagina or urinary tract) is the cause of the discharge, it is treated with antibiotics. The same applies to an infection with trichomonads.

It is important for every infection-related discharge that your partner is also treated. This is the only way to prevent you and your partner from reinfecting each other again and again.

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