Every Body: What's Considered Normal Vaginal Discharge?
Dr. Marnie Luck ND is a Toronto-based naturopathic doctor and educator who helps people live happier, healthier and more connected lives. Her practice has a focus in reproductive and vaginal health. Her claim to fame is her ability to resolve chronic yeast and BV (bacterial vaginosis) infections where other approaches haven’t worked. She believes knowledge and health are intrinsically linked and aims to empower people to learn more about their bodies. You can learn more about Marnie here or follow her on Instagram at @marnieluck.
What is vaginal discharge? Why does it happen?
The vagina is like a self-cleaning oven- the discharge you notice is the sloughing off of cells, bacteria and fluid— all of which are a healthy part of the vaginal ecosystem. In essence, discharge is a sign that the vagina is continually recalibrating— regenerating epithelial (vaginal lining) cells, healthy bacteria and fluid. The vagina needs its lubricated mucosal layer (where the healthy bacteria and vaginal immune system live) and inevitably you’ll see evidence of this via vaginal discharge.
A moist vagina is a healthy vagina— where there is moistness, there will be discharge. Estrogen is the key driver of a moist and healthy vagina - and thus, a vagina that produces healthy discharge.
When estrogen levels rise starting in puberty, the cells in the vagina produce more glycogen— a fuel used by the cells and the healthy bacteria in the vagina. Lactobacilli species love glycogen, and the vagina loves having a robust amount of lactobacilli bacteria present. Glycogen and lactobacilli are responsible for maintaining the optimal pH of the vagina. When the vagina has a healthy mucosal barrier, acidic pH and abundant lactobacilli (with its anti-inflammatory and anti-microbial properties), it is well equipped to defend itself against invading or opportunistic bacteria and yeast.
What’s considered “normal" discharge?
There is a variation of “normal” amongst people with vaginas. Normal discharge can be clear, white, off-white, yellow-ish, slippery, sticky, wet - and are all considered normal. It is also very normal for vaginal discharge to have an odour. That being said, even in the presence of “normal” discharge, there can be an infection or dysbiosis (imbalance of good and bad bacteria). For example, you can have a yeast infection and not have discharge, but experience itchiness and irritation. Some sexually transmitted infections may not alter vaginal discharge, so it’s a good idea to routinely get tested for STIs if you are sexually active and/or have a new sex partner.
In terms of quantity, it depends. “Normal” can vary from a lot to a little. Noticing discharge on your underwear is very normal.
Why does my discharge discolor my underwear?
One of the main reasons discharge can discolor underwear is because of its acidic pH. If you can remember from high school science class, the lower the pH, the more acidic something is. The vagina is happiest at a pH of around 4 (for reference: water has a pH of 7, blood has a pH of 7.35-7.45, stomach acid has a pH of 1-2). Vaginal discharge, which includes the by-products of the healthy bacteria like lactic acid, can oxidize when outside the vagina (ie. on underwear).
That’s why vaginal discharge may stain white underwear a yellow-ish color and may seemingly “bleach” black underwear. You have 2 options if you’re worried about your underwear staining: 1. Embrace it— know that it’s normal and don't worry about it. 2. Rinse/soak/wash your underwear after use to reduce the amount of time the discharge remains on the fabric before laundry day.
Why do I sometimes have more discharge than usual?
Quantity and consistency of discharge depends on a variety of factors. If you are not on hormonal contraception (like the birth control bill), your hormones will fluctuate throughout the month. Leading up to ovulation, estrogen levels rise and stimulate the production of cervical mucus which plays an important role in conception. This may last for several days, and will increase the amount of vaginal discharge you have.
There are some factors that may affect the vaginal mucosal ecosystem and subsequently influence the quantity of discharge. Factors like sexual activity, menstruation, medications (like antibiotics), spending time in baths/pools/hot tubs, use of products/soaps vaginally and high sugar diets can influence the vaginal microbiome and alter its pH.
When should I talk to a professional about it?
First and foremost, get to know your normal. You may start to notice a cyclical pattern to your discharge and how certain factors influence quantity and quality.
If you notice that there is a significant difference in the smell, color, or quantity of discharge it is a good idea to speak to a healthcare practitioner (medical doctor, naturopathic doctor, midwife, nurse practitioner). These practitioners will be able to do a swab to confirm if the discharge is because of an offending pathogen (bacteria or yeast).
If you are sexually active, it is a good rule of thumb to have an STI screening done routinely.
If you feel you need to change your underwear throughout the day or use a panty liner/absorbent underwear because of higher qualities of discharge, this can be normal, or it can be a sign there may be an underlying issue. If you are concerned about this, a vaginal swab and testing vaginal pH can identify if the discharge is normal or if treatment is required.
When in doubt, it never hurts to get a professional opinion. However, hopefully the information above gives you a better idea of what’s normal!