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What Causes White Discharge After Menopause

When To Seek Help

Menopause and discharge: what’s normal and what isnt

Vaginal discharge is one of the most common reasons women see a gynecologist, amounting to about 10 million office visits per year. Clear, watery discharge, however, is rarely a sign of a problem.

There are several conditions, including infections and STIs, that can cause abnormal discharge. Discharge may be a sign of a problem if there are noticeable changes in color, odor, consistency, or amount.

If youre concerned about your vaginal discharge, you should make an appointment with your primary care doctor, gynecologist, or OB-GYN. If you dont already have an OB-GYN, our Healthline FindCare tool can help you connect to physicians in your area. You can also seek treatment at a sexual health clinic, such as Planned Parenthood.

See your doctor if you have any of these signs of abnormal discharge:

  • yellow, gray, or green color
  • white and chunky discharge, like cottage cheese
  • a strong, fishy, or sour odor

Breast Cancer And Vva

Currently, more than 2 million women in the United States have a history of breast cancer. In breast cancer survivors, the estimated prevalence of vaginal atrophy, by symptom report, ranges from 23% to 61%. Prescribing even very low-dose localized estrogen treatments for these patients can cause concern because of the potential for systemic absorption.

Concern about the provision of any form of estrogen, either systemic or local, to breast cancer survivors contributes to the high incidence of VVA in women with breast cancer. Discontinuation of HT may trigger the onset of VVA symptoms.

Many surgical, endocrine, and chemotherapeutic treatments for breast cancer can cause or exacerbate VVA.,- Tamoxifen acts as an estrogen antagonist or agonist depending on the target organ and menopausal status. In premenopausal women, tamoxifen may cause VVA by acting as an estrogen antagonist and blocking the naturally high levels of endogenous estrogen. In postmenopausal women, however, it acts as an estrogen agonist on the urogenital tract.

Raloxifene does not appear to have an effect on the urogenital area in either premenopausal or postmenopausal women. Davies et al found no significant differences in incidence of VVA when comparing databases of postmenopausal women treated with raloxifene vs placebo.

Treatments For Red And Swollen Lower Legs

If you typically experience clear vaginal discharge, then the treatment may likely be to “wait and see” rather than “rush to the doctor.” As discussed, clear vaginal discharge is typically a normal byproduct of the female body and does not need treatment. The more urgent concern is not when normal discharge is clear and consistent, but when it begins to change, as this may be a sign of infection or other health issues.

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Is It Normal To Have A Period After Menopause

After menopause you will no longer be able to get pregnant and you will no longer get a period. If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem. Low hormone levels.

There Are Several Potential Causes But Some Are More Serious Than Others

Vaginal Discharge After Menopause

In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy , vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancera malignancy of the uterine lining, but only in a small number of cases. A 2018 study by the National Cancer Institute found that only about 9 percent of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.

Still, we want the option to intervene early if it is cancer, since treating it sooner leads to better outcomes, Mantia-Smaldone said.

If endometrial cancer is found early, a woman has a 95 percent chance of surviving the cancer for at least 5 years.

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When Should I Worry About My Vaginal Discharge

Clear, watery discharge with a mild odor is the normal kind of discharge. However, we have also learned that your discharge changes throughout pregnancy or your hormonal cycle.

Worry about vaginal discharge if it suddenly changes or if it is not consistent with your normal cycle. It may appear clumpy, and of a color different than usual, like green, yellow, brownish, or gray. Abnormal discharge also usually comes with a foul smell. Moreover, you may experience itchiness in your genital area, as well as swelling and pain when urinating.

Does Egg White Cervical Mucus Mean Ovulation

If you are a woman of childbearing age, the most common reason for egg white cervical mucus is ovulation. However, many women experience egg white cervical mucus in the days leading up to ovulation, and even for one to two days after its completion.

For this reason, egg white cervical mucus alone is not a reliable predictor of ovulation. The best way to predict your date of ovulation with the greatest accuracy is to use a digital hormone tracker like Mira to get your exact fertility hormone concentrations.

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What Causes Abnormal Discharge

Any change in the vagina’s balance of normal bacteria can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:

When Should I See My Healthcare Provider For Vaginal Atrophy

What is Vaginal Discharge? Causes, Symptoms & Treatment | Dr. Sumana Dutta (Bengali)

Even if youre not menopausal, be sure to report any symptoms of dryness, pain, burning/itching, urinary problems, UTIs, unusual spotting or bleeding or discharge to your healthcare provider. If weeks go by and the over-the-counter medications youre using for dryness dont work, you should see your healthcare provider then. If you see unusual discharge or bleeding, thats also a reason to see your healthcare provider. Also, always see your healthcare provider for any symptoms that negatively impact your daily life.

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Systemic Estrogen Agents And Vva

Systemic estrogen therapy, in the form of patches, oral agents, or a higher-dose vaginal ring, is sometimes used for VVA, especially when the patient also has hot flashes. However, 10% to 20% of women may have residual VVA symptoms even while taking systemic estrogen. These women will require administration of local vaginal estrogens alone or along with systemic therapy for relief of VVA symptoms.

Two studies have shown that oral hormone therapy may worsen symptoms of urinary incontinence. The Heart and Estrogen-Progestin Replacement Study found a higher risk of both urge and stress incontinence in the hormone-treated group vs the placebo group throughout the treatment period.

It has been suggested that urge incontinence worsened with HT because progesterone was a component. However,in the Women’s Health Initiative, 3 treatment groups were evaluated for urge incontinence . Women given conjugated estrogens alone were at increased risk of developing urge incontinence compared with those receiving placebo , whereas the women given combination conjugated estrogens with progesterone were not . Thus, whether oral HT adversely affects urge urinary incontinence remains unclear.

Creamy White Discharge: What Does It Mean

    Vaginal discharge has various characteristics including odor, volume, color, and accompanying symptoms. Depending on these characteristics, each type of discharge can mean something different.

    Vaginal discharge can be completely normal, or it can be a symptom of certain health conditions such as a yeast or bacterial infection.

    Creamy white discharge is one of the most common types of vaginal discharge, and most women will experience it at some point in their lives. This type of discharge can have many causes, some completely normal and others suggesting potential health issues.

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    Complementary And Alternative Medicine

    Complementary and alternative medicine products have been extensively studied in the treatment of hot flashes, but less information is available on their use in VVA. One study found that Vitamin E and phytoestrogen applied locally as a gel improved the symptoms of VVA. An evaluation of VVA was undertaken in a cross-sectional study of 60 women, half of whom had taken 1,25-dihydroxyvitamin D orally for at least 1 year and half of whom had not. The prevalence of vaginal atrophy was significantly higher in the group who did not use vitamin D, as measured by VMI and symptoms.

    In a separate study, soy supplementation for the treatment of VVA was investigated. Phytoestrogens such as soy bind to ERs in the vagina and bladder. A randomized controlled trial evaluating dietary supplementation with 12 to 20 mg/d of soy showed no improvement in VMI.

    Currently, well-established effective complementary and alternative medicine treatments for VVA are lacking.

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    White Creamy Discharge During Pregnancy

    Abnormal vaginal discharge etiopathogenesis

    Most people experience an increase in vaginal discharge during pregnancy. As long as this white creamy discharge has a mild smell or no smell and doesnt cause itching, the increased volume is perfectly normal.

    This creamy white discharge is known as leukorrhea. Rising hormone levels during early pregnancy increase your bodys production of fluid and discharge. This keeps your uterus safe from bacteria that could harm the growing fetus.

    If youre pregnant and notice discharge with an unpleasant odor or itchiness, make sure to see your health care provider. Vaginal infections during pregnancy can lead to complications like preterm birth and neonatal infections.

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    What Percentage Of Postmenopausal Bleeding Is Cancer

    Most cases of postmenopausal bleeding can be attributed to conditions that are not usually serious and can be treated easily.Bleeding, for instance, might be the result of polyps or genitourinary syndrome of menopause , both of which are non-cancerous.However, 10 per cent of postmenopausal bleeding cases may be symptomatic of endometrial or cervical cancer, so it is vitally important to get it checked by a doctor.5 Research suggests that around 90 per cent of women with endometrial cancer experience vaginal bleeding .By assessing bleeding, medical professionals have a greater window to catch cancer early, when it is most treatable.

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    How Are These Symptoms Related To My Breast Cancer Treatment

    • Chemotherapy: women can develop vulvar and vaginal burning due to inflammation. These are similar to the changes that occur in the lining of the mouth and gastrointestinal tract.
    • Tamoxifen: the effects of this medication are variable some pre-menopausal women note dryness due to the effect of tamoxifen blocking oestrogen in the lining of the vagina while others experience more vaginal discharge. In post-menopausal women, who already have lower levels of oestrogen, the change may be less marked.
    • Aromatase inhibitors , letrozole , or exemestane ): studies have shown more vaginal symptoms with aromatase inhibitor-only treatment than with tamoxifen-only treatment.
    • Raloxifene: this drug originally approved for treatment of osteoporosis, has been approved for breast cancer risk reduction since 2007. In post-menopausal women it has not been associated with adverse vaginal symptoms and does not affect sexual function. There is no good evidence about raloxifene’s effects in pre-menopausal women.

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    Creamy White Discharge With Odor

    Thick white discharge will normally have a mild odor or no odor at all. If your vaginal discharge has a foul odor, it could be a sign of a vaginal infection.

    Bacterial vaginosis is a condition characterized by a pH shift in the vaginal flora that makes it less acidic, causing vaginal discharge. The discharge produced by BV is often yellow or gray. This discharge often has a fishy smell that becomes more noticeable after sex.

    Yeast infections are common, affecting three out of four women at some point in their life. Yeast infections are caused by a fungus called candida, which is a normal part vaginal flora. However, candida can cause unpleasant symptoms when it grows excessively.

    Youre more likely to have a yeast infection if you take oral contraceptives or antibiotics, or have diabetes or an immune deficiency. Yeast infections cause white creamy discharge that is clotted and looks similar to cottage cheese. Symptoms of a yeast infection can also include:

    • Vaginal itching or burning

    Will I Need Surgery

    Menopause & You: Bleeding After Menopause

    Surgery for nipple discharge is sometimes warranted. This is usually reserved for cases where a significant abnormality, such as a papilloma or breast cancer is suspected. Surgery is usually also needed for bloodstained nipple discharge even if the tests show no abnormality. In this case, it is done to explore the ducts under the nipple to rule out significant abnormalities not seen on tests. Surgery may also be performed as a procedure to cure annoying discharge caused by conditions such as duct ectasia.

    Version 4 WSP 214 April 2021

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    Causes Of Postmenopausal Bleeding

    There can be several causes of postmenopausal bleeding.

    The most common causes are:

    • inflammation and thinning of the vaginal lining or womb lining caused by lower oestrogen levels
    • cervical or womb polyps growths that are usually non-cancerous
    • a thickened womb lining this can be caused by hormone replacement therapy , high levels of oestrogen or being overweight, and can lead to womb cancer

    Less commonly, postmenopausal bleeding is caused by cancer, such as ovarian and womb cancer.

    How Is Vaginal Atrophy Treated

    You and your healthcare provider will work closely together to come up with a treatment plan for vaginal atrophy. Theyll help you decide which plan is most effective based on your symptoms and the severity of them. Estrogen therapy is considered to be the most effective.

    Some treatments are meant to treat the symptoms of atrophy. Others address the loss of estrogen, specifically, which will also act to relieve symptoms.

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    Vaginal Or Endometrial Atrophy

    As hormone levels decrease during menopause, the vaginal lining or the uterine cells may become thinner. This thinning is called vaginal atrophy or endometrial atrophy.

    Vaginal atrophy often causes the vagina to become drier, less flexible, and more susceptible to inflammation or infection than before menopause. Vaginal atrophy may lead to:

    • brown spotting
    • redness
    • bleeding after sex

    The vagina may feel continuously uncomfortable, so a woman with these symptoms should speak to a doctor. A doctor may recommend hormone replacement therapy, as well as the use of water-soluble lubricants during sexual activity.

    What Questions Should I Ask My Healthcare Provider

    Is Vaginal Discharge Normal After Menopause
    • What over-the-counter options do you recommend for me?
    • What prescriptions do you recommend for me?
    • Is my condition temporary?
    • Are there other ways to treat my condition?
    • Are there any risks of treatment?
    • How long will it be before the treatments work?
    • Do I have another condition on top of the vaginal atrophy?
    • What else can I do to stop the vaginal atrophy from worsening?
    • What can my partner do to help?

    A note from Cleveland Clinic

    Vaginal atrophy is serious for menopausal women. It affects your quality of life with discomfort, frequent bathroom trips, frequent UTIs, burning, pain with sex and more. Fortunately, there are many treatments and your healthcare provider can help you find the best option for your symptoms.

    Seek treatment. Dont be afraid to have the conversation with your healthcare provider and with your partner. Always follow your healthcare providers instructions and do what you can to prevent vaginal atrophy from getting worse!

    Last reviewed by a Cleveland Clinic medical professional on 10/27/2020.

    References

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    What Causes White Vaginal Discharge

    Vaginal discharge is important for the reproductive system. Thick white vaginal discharge is often called infertile cervical mucus. This type of mucus is seen between ovulation and the beginning of your period. As long as the discharge is not accompanied by symptoms like pain, redness, or itching, it is absolutely normal.

    Possible causes for white discharge before your period include:

    • Normal reproductive system functioning
    • Birth control Birth control alters your hormone levels, which can lead to increased white discharge. This white discharge is a normal side effect of hormonal birth control.
    • Pregnancy Discharge from pregnancy is usually thicker and creamier than normal.

    Different types of vaginal discharge are categorized based on their color and consistency. Some vaginal discharge is normal. Others that are chunky, foul smelling, or green/yellow may indicate an underlying condition that needs attention and immediate treatment.

    All healthy vaginas and vulvas have a normal scent. A funky smell or bad odor could indicate an infection or medical condition that needs attention and treatment.

    • The symptoms of bacterial vaginosis include unpleasant-smelling discharge and a burning sensation when you pee.
    • Vaginitis due to a yeast infection can cause thick white discharge without any smell.
    • Vaginal discharge with an unpleasant odor is also caused by sexually transmitted infections like gonorrhea, chlamydia, and trichomoniasis.

    Not Sure What To Do Next

    If you are still concerned about your vaginal discharge, why not use healthdirects online Symptom Checker to get advice on when to seek medical attention.

    The Symptom Checker guides you to the next appropriate healthcare steps, whether its self care, talking to a health professional, going to a hospital or calling triple zero .

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    Research And Statistics: Who Gets Vaginal Discharge

    All women have normal vaginal discharge, and vaginal discharge can occur at all times of a woman’s life, starting in childhood.

    During childhood, common causes include:

    • Poor hygiene that causes infection due to bacteria from the digestive tract
    • Chemicals in bubble baths or soaps
    • A foreign object in the vagina

    Reasons for vaginal discharge that occurs in women during other times of life are listed in the Causes and Risk Factors section above.

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    It Might Be Worth Seeing A Specialist

    Vaginal Discharge During Menopause

    Your gynecologist should be able to perform your initial evaluation. But, if he or she suspects that your bleeding might be related to cancer, its important to see a gynecologic oncologist, Mantia-Smaldone said.

    Endometrial cancer is usually treated with surgery that includes a hysterectomy, which may be followed by radiation and/or chemotherapy. Because gynecologic oncologists deal with female reproductive cancers every day, they have more experience operating on cancers, staging them correctly, and determining the best course of therapy. And that can add up to a more successful treatment outcome.

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