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December 15, 2025
Background
Vaginal discharge is a normal and general occurrence in a vagina of female. It helps to clean and protect the vaginal area to remove dead cells and bacteria.
This process maintains a healthy balance of bacteria and an acidic pH level in the vagina to prevent infections.
Vaginal discharge varies in color, consistency, and quantity throughout the menstrual cycle. These variations are linked to hormonal changes.
Types of vaginal discharge as follows:
Clear and Watery
Clear and Stretchy
Normal
Abnormal
Discharge is seen clear and stretchy during ovulation phase, while it is thicker and slightly yellow in the luteal phase.
It is observed more due to high estrogen levels during ovulation, puberty, and pregnancy period.
Epidemiology
Gynaecological advice required in vaginal discharge cases and studies shows 10% to 25% women report abnormal discharge.
Sexual behaviour determines risk of STI, that impacts abnormal discharge from unprotected intercourse or multiple partners.
Disruption in vaginal bacteria causes bacterial vaginosis occurs in fishy odour and thin grey discharge.
Bacterial vaginosis affects 29% to 35% of women worldwide, while yeast infections affect 75% of women for minimum one time.
Anatomy
Pathophysiology
Cervix mucus consistency changes during menstrual cycle to protects from infections.
Vaginal walls secrete fluid to maintain moisture and acidic environment. Ovulation increases sticky mucus for easier sperm movement during conception.
Increase estrogen level in pregnancy causes more clear or milky vaginal discharge called as leukorrhea.
Yeast infections caused due to overgrown candida albicans fungus to give thick discharge.
Etiology
Genetics
Prognostic Factors
Hormonal issues from conditions including PCOS or menopause can affect outcomes treated with therapies and management.
Effect of irritant type on prognosis is significant and removes irritant lead to rapid symptom improvement.
The age of the individual can influence the prognosis. Individuals with strong immune systems generally have a better prognosis for infections.
Untreated STIs or repeat infections can cause pelvic inflammation to affect fertility and health.
Good hygiene and avoidance of irritants improve vaginal discharge prognosis.
Clinical History
Detailed information including presenting symptoms, menstrual history, sexual history and medical history of patient should be gathered.
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Acute symptoms are:
Strong odor, itching, discomfort, pelvic pain, dysuria
Chronic symptoms are:
fishy-smelling discharge, dryness, irritation, bleeding
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Dose of metronidazole and clindamycin should be taken orally two times daily for one week to treat bacterial vaginosis.
Metronidazole gel is applied intravaginally once daily for 5 days and use clindamycin cream at bedtime for a week.
Use of clotrimazole or miconazole topically in the form of vaginal cream or suppository for 3 to 7 days.
Use azithromycin and doxycycline through oral route two times daily for one week to treat chlamydia.
Normal discharge throughout the menstrual cycle does not require treatment.
Use estrogen therapy for vaginal dryness and atrophic vaginitis in menopause cases.
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
use-of-non-pharmacological-approach-for-vaginal-discharge
To clean the genital area patient should use mild soaps or cleansers.
Always dry the genital area after bath to prevent excess moisture which can promote yeast growth.
Cotton underwear should be preferred and avoid tight-fitting synthetic cloths panties.
Use of condoms during intercourse to reduce the risk of sexually transmitted infections that causes abnormal discharge.
Proper awareness about vaginal discharge should be provided and its related causes with management strategies.
Use of Antibiotics
Metronidazole:
It inhibits nucleic acid synthesis to disrupt DNA of organisms associated with bacterial vaginosis.
Azithromycin:
It binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA.
Use of antifungals
Clotrimazole:
It binds with phospholipids in the fungal cell membrane that causes leakage of essential intracellular elements.
Use of Antiprotozoals
It causes cytotoxicity that damage DNA to prevent further DNA synthesis.
Use of Hormonal Therapy
It is mainly responsible for the development and maintenance of the female reproductive system and sexual characteristics.
use-of-intervention-with-a-procedure-in-treating-vaginal-discharge
Interventions with procedures for vaginal discharge are considered when initial treatments with medications or lifestyle modifications are not sufficient.
It includes colposcopy, endometrial biopsy and hysteroscopy procedure.
use-of-phases-in-vaginal-discharge
In the initial assessment phase, evaluation of the patient associated symptoms including menstrual cycle, sexual history, and laboratory test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of antibiotics, antifungal, and antiprotozoal agents.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and therapies.
The regular follow-up visits with the gynecologist are scheduled to check the improvement of patients along with treatment response.
Medication
fluconazole/ornidazole/azithromycin
Take oral dose as per physician advised
oxyquinoline/sodium lauryl sulfate
Adult females
Indicated for Vaginal acidification
Insert half of the applicator with gel intravaginally thrice weekly during the 1st week after pessary insertion, followed by intravaginal application of gel using the applicator twice a week
Future Trends
Vaginal discharge is a normal and general occurrence in a vagina of female. It helps to clean and protect the vaginal area to remove dead cells and bacteria.
This process maintains a healthy balance of bacteria and an acidic pH level in the vagina to prevent infections.
Vaginal discharge varies in color, consistency, and quantity throughout the menstrual cycle. These variations are linked to hormonal changes.
Types of vaginal discharge as follows:
Clear and Watery
Clear and Stretchy
Normal
Abnormal
Discharge is seen clear and stretchy during ovulation phase, while it is thicker and slightly yellow in the luteal phase.
It is observed more due to high estrogen levels during ovulation, puberty, and pregnancy period.
Gynaecological advice required in vaginal discharge cases and studies shows 10% to 25% women report abnormal discharge.
Sexual behaviour determines risk of STI, that impacts abnormal discharge from unprotected intercourse or multiple partners.
Disruption in vaginal bacteria causes bacterial vaginosis occurs in fishy odour and thin grey discharge.
Bacterial vaginosis affects 29% to 35% of women worldwide, while yeast infections affect 75% of women for minimum one time.
Cervix mucus consistency changes during menstrual cycle to protects from infections.
Vaginal walls secrete fluid to maintain moisture and acidic environment. Ovulation increases sticky mucus for easier sperm movement during conception.
Increase estrogen level in pregnancy causes more clear or milky vaginal discharge called as leukorrhea.
Yeast infections caused due to overgrown candida albicans fungus to give thick discharge.
Hormonal issues from conditions including PCOS or menopause can affect outcomes treated with therapies and management.
Effect of irritant type on prognosis is significant and removes irritant lead to rapid symptom improvement.
The age of the individual can influence the prognosis. Individuals with strong immune systems generally have a better prognosis for infections.
Untreated STIs or repeat infections can cause pelvic inflammation to affect fertility and health.
Good hygiene and avoidance of irritants improve vaginal discharge prognosis.
Detailed information including presenting symptoms, menstrual history, sexual history and medical history of patient should be gathered.
Acute symptoms are:
Strong odor, itching, discomfort, pelvic pain, dysuria
Chronic symptoms are:
fishy-smelling discharge, dryness, irritation, bleeding
Dose of metronidazole and clindamycin should be taken orally two times daily for one week to treat bacterial vaginosis.
Metronidazole gel is applied intravaginally once daily for 5 days and use clindamycin cream at bedtime for a week.
Use of clotrimazole or miconazole topically in the form of vaginal cream or suppository for 3 to 7 days.
Use azithromycin and doxycycline through oral route two times daily for one week to treat chlamydia.
Normal discharge throughout the menstrual cycle does not require treatment.
Use estrogen therapy for vaginal dryness and atrophic vaginitis in menopause cases.
OB/GYN and Women\'s Health
To clean the genital area patient should use mild soaps or cleansers.
Always dry the genital area after bath to prevent excess moisture which can promote yeast growth.
Cotton underwear should be preferred and avoid tight-fitting synthetic cloths panties.
Use of condoms during intercourse to reduce the risk of sexually transmitted infections that causes abnormal discharge.
Proper awareness about vaginal discharge should be provided and its related causes with management strategies.
OB/GYN and Women\'s Health
Metronidazole:
It inhibits nucleic acid synthesis to disrupt DNA of organisms associated with bacterial vaginosis.
Azithromycin:
It binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA.
OB/GYN and Women\'s Health
Clotrimazole:
It binds with phospholipids in the fungal cell membrane that causes leakage of essential intracellular elements.
OB/GYN and Women\'s Health
It causes cytotoxicity that damage DNA to prevent further DNA synthesis.
OB/GYN and Women\'s Health
It is mainly responsible for the development and maintenance of the female reproductive system and sexual characteristics.
OB/GYN and Women\'s Health
Interventions with procedures for vaginal discharge are considered when initial treatments with medications or lifestyle modifications are not sufficient.
It includes colposcopy, endometrial biopsy and hysteroscopy procedure.
OB/GYN and Women\'s Health
In the initial assessment phase, evaluation of the patient associated symptoms including menstrual cycle, sexual history, and laboratory test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of antibiotics, antifungal, and antiprotozoal agents.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and therapies.
The regular follow-up visits with the gynecologist are scheduled to check the improvement of patients along with treatment response.
Vaginal discharge is a normal and general occurrence in a vagina of female. It helps to clean and protect the vaginal area to remove dead cells and bacteria.
This process maintains a healthy balance of bacteria and an acidic pH level in the vagina to prevent infections.
Vaginal discharge varies in color, consistency, and quantity throughout the menstrual cycle. These variations are linked to hormonal changes.
Types of vaginal discharge as follows:
Clear and Watery
Clear and Stretchy
Normal
Abnormal
Discharge is seen clear and stretchy during ovulation phase, while it is thicker and slightly yellow in the luteal phase.
It is observed more due to high estrogen levels during ovulation, puberty, and pregnancy period.
Gynaecological advice required in vaginal discharge cases and studies shows 10% to 25% women report abnormal discharge.
Sexual behaviour determines risk of STI, that impacts abnormal discharge from unprotected intercourse or multiple partners.
Disruption in vaginal bacteria causes bacterial vaginosis occurs in fishy odour and thin grey discharge.
Bacterial vaginosis affects 29% to 35% of women worldwide, while yeast infections affect 75% of women for minimum one time.
Cervix mucus consistency changes during menstrual cycle to protects from infections.
Vaginal walls secrete fluid to maintain moisture and acidic environment. Ovulation increases sticky mucus for easier sperm movement during conception.
Increase estrogen level in pregnancy causes more clear or milky vaginal discharge called as leukorrhea.
Yeast infections caused due to overgrown candida albicans fungus to give thick discharge.
Hormonal issues from conditions including PCOS or menopause can affect outcomes treated with therapies and management.
Effect of irritant type on prognosis is significant and removes irritant lead to rapid symptom improvement.
The age of the individual can influence the prognosis. Individuals with strong immune systems generally have a better prognosis for infections.
Untreated STIs or repeat infections can cause pelvic inflammation to affect fertility and health.
Good hygiene and avoidance of irritants improve vaginal discharge prognosis.
Detailed information including presenting symptoms, menstrual history, sexual history and medical history of patient should be gathered.
Acute symptoms are:
Strong odor, itching, discomfort, pelvic pain, dysuria
Chronic symptoms are:
fishy-smelling discharge, dryness, irritation, bleeding
Dose of metronidazole and clindamycin should be taken orally two times daily for one week to treat bacterial vaginosis.
Metronidazole gel is applied intravaginally once daily for 5 days and use clindamycin cream at bedtime for a week.
Use of clotrimazole or miconazole topically in the form of vaginal cream or suppository for 3 to 7 days.
Use azithromycin and doxycycline through oral route two times daily for one week to treat chlamydia.
Normal discharge throughout the menstrual cycle does not require treatment.
Use estrogen therapy for vaginal dryness and atrophic vaginitis in menopause cases.
OB/GYN and Women\'s Health
To clean the genital area patient should use mild soaps or cleansers.
Always dry the genital area after bath to prevent excess moisture which can promote yeast growth.
Cotton underwear should be preferred and avoid tight-fitting synthetic cloths panties.
Use of condoms during intercourse to reduce the risk of sexually transmitted infections that causes abnormal discharge.
Proper awareness about vaginal discharge should be provided and its related causes with management strategies.
OB/GYN and Women\'s Health
Metronidazole:
It inhibits nucleic acid synthesis to disrupt DNA of organisms associated with bacterial vaginosis.
Azithromycin:
It binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA.
OB/GYN and Women\'s Health
Clotrimazole:
It binds with phospholipids in the fungal cell membrane that causes leakage of essential intracellular elements.
OB/GYN and Women\'s Health
It causes cytotoxicity that damage DNA to prevent further DNA synthesis.
OB/GYN and Women\'s Health
It is mainly responsible for the development and maintenance of the female reproductive system and sexual characteristics.
OB/GYN and Women\'s Health
Interventions with procedures for vaginal discharge are considered when initial treatments with medications or lifestyle modifications are not sufficient.
It includes colposcopy, endometrial biopsy and hysteroscopy procedure.
OB/GYN and Women\'s Health
In the initial assessment phase, evaluation of the patient associated symptoms including menstrual cycle, sexual history, and laboratory test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of antibiotics, antifungal, and antiprotozoal agents.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and therapies.
The regular follow-up visits with the gynecologist are scheduled to check the improvement of patients along with treatment response.

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