Vaginal Discharge

Vaginal discharge is normal and varies during your menstrual cycle. Before ovulation (the release of the egg), there is A LOT of mucous produced, up to 30X more than after ovulation. It is also more watery and elastic during that phase of your cycle. You may want to wear panty liners during that time.

The things to be worried about include if the discharge has a yellow or green color, is clumpy like cottage cheese, or has a bad odor. If worried, see a doctor.


Different Types of Discharge
Is this normal?
Different Types of Discharge

White: Thick, white discharge is common at the beginning and end of your cycle. Normal white discharge is not accompanied by itching. If itching is present, thick white discharge can indicate a yeast infection.

Clear and stretchy: This is "fertile" mucous and means you are ovulating.

Clear and watery: This occurs at different times of your cycle and can be particularly heavy after exercising.

Yellow or Green: May indicate an infection, especially if thick or clumpy like cottage cheese or has a foul odor.

Brown: May happen right after periods, and is just "cleaning out" your vagina. Old blood looks brown.

Spotting Blood/Brown Discharge: This may occur when you are ovulating/mid-cycle. Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a pregnancy test.

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Is this normal?
We receive many questions about vaginal discharge through our "Ask the Expert" section. Below physician assistant Steven Johnson, explains what is normal and when to see a health care provider.

One of the challenges to answering questions sent into a health care Web site is making sure that the person asking the question seeks the advice and care from her doctor when appropriate. There is often information NOT given that can really change the answer.

For instance:

How old are you (really)?
Are you on medications or do you take herbs or vitamins?

Do you have pain or itching?

Are you pregnant?

Do you have other health problems (like diabetes)?

An important question is sexual activity. Sometimes it isn't accurate to simply say yes or no. Symptoms can depend on the number of sexual partners, kind of sexual partners, birth control, birth control failure, kind of sex you are having and if abuse is involved. I think you can see, it can get pretty complicated to get all the information needed to give the best answer possible.

With that said, here is my best answer to the common question of vaginal discharge.

A normal vaginal discharge consists of about a teaspoon (4 ML) a day that is white or transparent, thick to thin, and odorless. This is formed by the normal bacteria and fluids the vaginal cells put off. The discharge can be more noticeable at different times of the month depending on ovulation, menstrual flow, sexual activity and birth control.

It is not uncommon for the normal discharge to be dark, brown or discolored a day or two following the menstrual period.

If you are having ANY of the symptoms below SEE YOUR HEALTH CARE PROVIDER.
Pain

Itching

Discomfort

Rash or sores alone or with a vaginal discharge



The female reproductive system consists of two ovaries, two fallopian tubes, the uterus, and the vagina. An ovary normally produces an egg (ovulation) about 11 to 17 days before the woman''s next menstrual period, or approximately once a month. The egg is released from the ovary into a fallopian tube and swept into the uterus by tiny hairlike cells (cilia) and muscle action.

Female Menstruation

Menstruation or a period is a major stage of puberty in girls; it's one of the many physical signs that a girl is turning into a woman. And like a lot of the other changes associated with puberty, menstruation can be confusing. Some girls can't wait to start their periods, whereas others may feel afraid or anxious. Many girls (and guys!) don't have a complete understanding of a woman's reproductive system or what actually happens during the menstrual cycle, making the process seem even more mysterious.

Puberty and Periods
When girls begin to go through puberty (usually starting between the ages of 8 and 13), their bodies and minds change in many ways. The hormones in their bodies stimulate new physical development, such as growth and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she usually gets her first menstrual period.

About 6 months or so before getting her first period, a girl might notice an increased amount of clear vaginal discharge. This discharge is common. There's no need for a girl to worry about discharge unless it has a strong odor or causes itchiness.

The start of periods is known as menarche. Menarche doesn't happen until all the parts of a girl's reproductive system have matured and are working together.

Baby girls are born with ovaries, fallopian tubes, and a uterus. The two ovaries are oval-shaped and sit on either side of the uterus (womb) in the lowest part of the abdomen called the pelvis. They contain thousands of eggs, or ova. The two fallopian tubes are long and thin. Each fallopian tube stretches from an ovary to the uterus, a pear-shaped organ that sits in the middle of the pelvis. The muscles in a female's uterus are powerful and are able to expand to allow the uterus to accommodate a growing fetus and then help push the baby out during labor.

As a girl matures and enters puberty, the pituitary gland releases hormones that stimulate the ovaries to produce other hormones called estrogen and progesterone. These hormones have many effects on a girl's body, including physical maturation, growth, and emotions.

About once a month, a tiny egg leaves one of the ovaries — a process called ovulation — and travels down one of the fallopian tubes toward the uterus. In the days before ovulation, the hormone estrogen stimulates the uterus to build up its lining with extra blood and tissue, making the walls of the uterus thick and cushioned. This happens to prepare the uterus for pregnancy: If the egg is fertilized by a sperm cell, it travels to the uterus and attaches to the cushiony wall of the uterus, where it slowly develops into a baby.

If the egg isn't fertilized, though — which is the case during most of a woman's monthly cycles — it doesn't attach to the wall of the uterus. When this happens, the uterus sheds the extra tissue lining. The blood, tissue, and unfertilized egg leave the uterus, going through the vagina on the way out of the body. This is a menstrual period. This cycle happens almost every month for several more decades (except, of course, when a female is pregnant) until a woman reaches menopause and no longer releases eggs from her ovaries.

How Often Does a Girl Get Her Period?
Just as some girls begin puberty earlier or later than others, the same applies to periods. Some girls may start menstruating as early as age 10, but others may not get their first period until they are 15 years old.

The amount of time between a girl's periods is called her menstrual cycle (the cycle is counted from the start of one period to the start of the next). Some girls will find that their menstrual cycle lasts 28 days, whereas others might have a 24-day cycle, a 30-day cycle, or even longer. Following menarche, menstrual cycles last 21–45 days. After a couple of years, cycles shorten to an adult length of 21–34 days.

Irregular periods are common in girls who are just beginning to menstruate. It may take the body a while to sort out all the changes going on, so a girl may have a 28-day cycle for 2 months, then miss a month, for example. Usually, after a year or two, the menstrual cycle will become more regular. Some women continue to have irregular periods into adulthood, though.

As a girl gets older and her periods settle down — or she gets more used to her own unique cycle — she will probably find that she can predict when her period will come. In the meantime, it's a good idea to keep track of your menstrual cycle with a calendar.

How Long and How Much?
The amount of time that a girl has her period also can vary. Some girls have periods that last just 2 or 3 days. Other girls may have periods that last 7 days or longer. The menstrual flow — meaning how much blood comes out of the vagina — can vary widely from girl to girl, too.

Some girls may be concerned that they're losing too much blood. It can be a shock to see all that blood, but it's unlikely that a girl will lose too much, unless she has a medical condition like von Willebrand disease. Though it may look like a lot, the average amount of blood is only about 2 tablespoons (30 milliliters) for an entire period. Most teens will change pads 3 to 6 times a day, with more frequent changes when their period is heaviest, usually at the start of the period.

Especially when menstrual periods are new, you may be worried about your blood flow or whether your period is normal in other ways. Talk to a doctor or nurse if:

your period lasts longer than a week
you have to change your pad very often (soaking more than one pad every 1–2 hours)
you go longer than 3 months between periods
you have bleeding in between periods
you have an unusual amount of pain before or during your period
your periods were regular then became irregular
Cramps, PMS, and Pimples
Some girls may notice physical or emotional changes around the time of their periods. Menstrual cramps are pretty common — in fact, more than half of all women who menstruate say they have cramps during the first few days of their periods. Doctors think that cramps are caused by prostaglandin, a chemical that causes the muscles of the uterus to contract.

Depending on the girl, menstrual cramps can be dull and achy or sharp and intense, and they can sometimes be felt in the back as well as the abdomen. These cramps often become less uncomfortable and sometimes even disappear completely as a girl gets older.

Many girls and women find that over-the-counter pain medications (like acetaminophen or ibuprofen) can relieve cramps, as can taking a warm bath or applying a warm heating pad to the lower abdomen. Exercising regularly throughout the monthly cycle may help lessen cramps, too. If these things don't help, ask your doctor for advice.

Some girls and women find that they feel sad or easily irritated during the few days or week before their periods. Others may get angry more quickly than normal or cry more than usual. Some girls crave certain foods. These types of emotional changes may be the result of premenstrual syndrome (PMS).

PMS is related to changes in the body's hormones. As hormone levels rise and fall during a woman's menstrual cycle, they can affect the way she feels, both emotionally and physically. Some girls, in addition to feeling more intense emotions than they usually do, notice physical changes along with their periods — some feel bloated or puffy because of water retention, others notice swollen and sore breasts, and some get headaches.

PMS usually goes away soon after a period begins, but it can come back month after month. Eating right, getting enough sleep, and exercising may help relieve some of the symptoms of PMS. Talk to your doctor if you are concerned about your premenstrual symptoms.

It's also not uncommon for girls to have an acne flare-up during certain times of their cycle; again, this is due to hormones. Fortunately, the pimples associated with periods tend to become less of a problem as girls get older.

Pads, Tampons, and Liners
Once you begin menstruating, you'll need to use something to absorb the blood. Most girls use a pad or a tampon. But some use menstrual cups, which a girl inserts into her vagina to catch and hold the blood (instead of absorbing it, like a tampon).

There are so many products out there that it may take some experimenting before you find the one that works best for you. Some girls use only pads (particularly when they first start menstruating), some use only tampons, and some switch around — tampons during the day and pads at night, for example.

Girls who worry about leakage from a tampon often use a pantiliner, too, and some girls use liners alone on very light days of their periods.

Periods shouldn't get in the way of exercising, having fun, and enjoying life. Girls who are very active, particularly those who enjoy swimming, often find that tampons are the best option during sports.

If you have questions about pads, tampons, or coping with periods, ask a parent, health teacher, school nurse, or older sister.