What The Doctor Does
Doctors first ask the woman questions about her symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the discharge and the tests that may need to be done .
Doctors ask about the discharge:
What it looks and smells like
When it occurs in relation to menstrual periods and sexual intercourse
Whether other symptoms are present
Doctors also ask about other symptoms, such as abdominal or pelvic pain, pain during urination or sexual intercourse, itching, fever, and chills.
Other questions include whether women use hygiene sprays or other products that may irritate the genital area and whether women have any conditions that can increase the risk of having a vaginal discharge .
The physical examination focuses on the pelvic examination.
Rashes, itching, or other symptoms, depending on the disorder
A doctor’s examination
* Features include symptoms and results of the doctor’s examination. Features mentioned are typical but not always present.
CT = computed tomography MRI = magnetic resonance imaging.
Ovulation Pain Or Midcycle Spotting
Mittelschmerz is a German word that translates as “middle pain.” It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.
Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.
This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.
Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.
Diagnosis is made through patient history.
Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.
Top Symptoms: abdominal pain , last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain
Symptoms that always occur with ovulation pain or midcycle spotting: last period approximately 2 weeks ago
Why You Shouldnt Ignore Postmenopausal Bleeding
A woman is considered to be in menopause after 12 consecutive months without a period. You may experience irregular bleeding leading up to menopause, a stage known as perimenopause. But once youre in menopause, all vaginal bleeding should stop.There are benign causes of postmenopausal bleeding. For 10 percent of women, however, the cause is endometrial cancer.Early diagnosis offers the best chance to beat endometrial cancer. I urge women to treat postmenopausal bleeding as cancer until proven to be something else. I dont say this to scare people, but a healthy amount of worry in this situation is warranted.
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What Does Normal Vaginal Discharge Look Like
During most times of the month, vaginal discharge is clear or white and watery or slightly sticky. , the discharge may be thicker and more like mucous. These are all normal conditions. Many women also experience bloody-brown or brown vaginal discharge at the end of their periods or right after their menstrual cycle ends. This, too, is normal.
Systemic Absorption Of Vaginal Hormonal Preparations
An important concern about treatment safety relates to the extent of systemic absorption of vaginal estrogens. The conclusion from several studies comparing different doses of estradiol vaginal tablets, or different vaginal estrogen preparations is that systemic absorption occurs, but to a limited extent. Labrie et al showed that levels of estradiol increased on average from a baseline level of 3 pg/mL to 17 pg/mL on day 7 of treatment for both estradiol vaginal tablets and conjugated estrogen cream . Nilsson and Heimer showed that, although plasma estradiol concentration diminished by the 14th day of daily treatment with 10 or 25 g of vaginal estradiol, it was still statistically significantly higher than pretreatment levels. Some evidence shows that estradiol levels diminish over time when vaginal estrogens are used consistently.,
Although vaginal estrogens applied as a cream, vaginal tablets, or a low-dose vaginal ring are systemically absorbed, the rise in serum estrogen levels appears to remain well below premenopausal levels. Nonetheless, this may be of concern to women with a history of breast or other hormonally sensitive cancers
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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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What Does Menopause Discharge Look Like
Before menopause, its normal for women to experience up to one teaspoon of white or clear, odorless discharge each day. Its also totally normal for this amount to vary from one woman to another. At different points of a womans menstrual cycle, shell produce different amounts of discharge with consistencies ranging from thin and milky to thick and mucus-like.5This type of normal discharge typically tapers off during and after menopause as estrogen levels in the body fall. For some women, it may all but disappear completely.
Abnormal discharge can happen throughout a womans life, but when it occurs during menopause, its more likely to be the result of irritation, inflammation, or infection caused by drier, thinner vaginal tissues.6 According to Dr. Rebecca Levy-Gantt, this type of infectious discharge may appear yellow or green in color or be associated with odor, itching or discomfort.
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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.
Early Signs Of Pregnancy
- Pink spotting just before you expect your period. This is called implantation bleeding and may be mistaken for the start of your period.
- Frequent urge to pee
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Postmenopausal Bleeding Is Never Normal
Whether its light spotting or a heavier flow, vaginal bleeding after menopause can signal potential health problems.
It should always be brought up with your provider, said Gina M. Mantia-Smaldone, MD, a gynecologic oncologist at Fox Chase Cancer Center. And the sooner, the better. Rather than waiting for your next planned checkup, give your gynecologist a call quickly to schedule an evaluation.
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When To Seek Help
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
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Your Age Affects Your Risk
The longer youve been in menopause, the less likely you are to experience postmenopausal bleeding. Women are significantly more likely to have bleeding in the first year of menopause compared to later on, research shows.
But women whove been postmenopausal for a while still need to pay attention to any bleedingendometrial cancer most commonly affects women in their mid-60s.
What Questions Should I Ask My Healthcare Provider
- 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.
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Whats Considered Unusual Or Not Normal Vaginal Discharge
Now, what is not normal? If we’re looking at colour, then we’re looking at maybe a mucus that’s tinged with green, or grey, or a very yellowy thick colour, or even a browny colour.
The consistency does tend to change, so it would be maybe sort of sticky, it may be very thick. You might find that it sticks to your underwear a lot more than the normal mucus do. Volume-wise, it normally tends to be continuous, so you would end up producing a lot of mucus sort of consistently, rather than being different at different times of the month.
The smell would tend to be very different, too. And I know, you know, women talk about a sort of fishy smell, it could be a metallic smell. It would be a strong smell and probably quite unpleasant even to ourselves.
And another way of telling is sometimes women will say that if something not quite right is going on mucus-wise, that they can smell it themselves even when they’ve got their clothes on, and that can sometimes be a little bit of a clue that something isn’t quite right.
What Is The Role Of The Ovulation Discharge
Cervical mucus changes around ovulation to provide the sperm cells a swim-friendly environment to swim in as they head toward your fallopian tubes, searching for the egg that they need to fertilize.
Ovulation discharge also plays the role of sperm protector, as it helps the sperm remain healthy during the journey.
That is why it is so useful to be able to identify the ovulation discharge once it appears, especially if you are actively trying to conceive and get pregnant.
When you see ovulation discharge, you will know right away that you are about to ovulate or already ovulating, and you will be able to recognize that you need to start working on getting pregnant.
Tracking your fertile cervical mucus is, called cervical mucus method, and it is one of the methods used for tracking ovulation, as well as family planning, among other methods.
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Does It Matter How Far After Menopause You Are Say Six Months Post
Dr. Jessie: It doesnt. Post-menopausal bleeding can be an indicator for abnormal cells in the uterine lining at any point after menopause. While there are probably more benign conditions that can cause some vaginal bleeding the closer you are to menopause , if you have gone a full year without a period, you need to get in to see your doctor.
Chlamydia And Vaginal Discharge
Any woman who is sexually active can get a chlamydial infection. Youâre especially at risk if your age falls between 20 and 24.
Chlamydia is one sneakyâbut commonâSTD because it rarely comes with any obvious symptoms .
Thatâs not the only thing that makes chlamydia an insidious STD, either: left untreated, a chlamydial infection can seriously hurt a womanâs reproductive systemâwhich can result in infertilityâor cause an ectopic pregnancy . Chlamydia in women can also result in pelvic inflammatory diseaseâleading to chronic pelvic pain.
The good news is that, once detected, chlamydia can be effectively treated. So, because chlamydia presents a real danger to a womanâs healthâand because it is a curable bacterial infectionâthe CDC recommends that women under 25 get an annual screening for chlamydia.
Chlamydia infections do occasionally present with symptomsâlike mucus- and pus-containing cervical discharges, which can come out as an abnormal vaginal discharge in some women. So, what does a chlamydia discharge look like? A chlamydia discharge is often yellow in color and has a strong odor. A symptom that frequently co-occurs with this discharge is painful urination that often has a burning sensation in the genital area.
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Use Only Unscented Soap
Perfumed soaps and sprays can upset the pH balance of the vagina, as can douching. To clean your vagina, you should only use warm water and a gentle, unscented soap on the outside, or vulva. You should never put soaps, sprays, or douching products inside the vagina itself since this can lead to infections.
What Does Egg White Discharge Look Like
Pregnant people tend to experience changes in their vaginal discharge as well, which is a result of hormonal changes in the body.
The changes in color and consistency occur because vaginal discharge, or mucus which is a mixture of secretions from the cervix, vaginal squamous epithelial cells, and secretions from sebaceous, sweat, and Bartholins glands has a complex mix of viscoelastic properties. These properties experience structural changes throughout the cycle.
So, what does it mean when you have egg white vaginal discharge? It could suggest a few different things:
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Does Discharge Change During The Menstrual Cycle
Vaginal discharge changes throughout your menstrual cycle. Everyone will experience different amounts of discharge.
In the first week after your period, a discharge is not usually present. If there is some discharge, it will probably be quite thick.
In the middle of your cycle, discharge is normally thin and clear. It may look slightly yellow or brownish if it has been in your underwear for a length of time.
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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What Is Vaginal Atrophy
Vaginal atrophy is a condition where the lining of the vagina gets drier and thinner. This results in itching, burning and pain during sex, among other symptoms. The condition also includes urinary tract problems such as urinary tract infections and frequent urination. Vaginal refers to the vagina while atrophy means a wasting away or diminution. Recently, the term vaginal atrophy has been replaced with the newer term, genitourinary syndrome of menopause . This new term helps describe not just the vaginal, but also the urinary symptoms that can be accompanied by the effects of low estrogen.
Vaginal atrophy most often occurs during menopause, the change of life. This happens because of a decrease in the hormone estrogen. It can occur in younger women, as well, when their estrogen levels are affected.
Hormones are produced, stored and secreted by the endocrine system, a network of glands and organs. Women need the hormone estrogen for good health, especially during the child-bearing years. When menopause happens around age 50, the ovaries produce fewer hormones and the woman stops having a monthly period. There are many uncomfortable symptoms for women during that time, and that includes vaginal dryness and other symptoms that might indicate vaginal atrophy.