Chapter 4 – The Vagina and Vulva

Vaginal discharge

Normal vaginal discharge is a mixture of the transudate fluid across the vaginal mucosa and the mucus secretions from the endocervical glands. Clinicians are frequently asked about vaginal discharge by concerned patients, however it may often by physiological and not represent pathology. A variation in oestrogen and progesterone levels during the menstrual cycle alters the quantity and type of cervical mucus (and resultant vaginal discharge) in the following ways:

The increase in oestrogen prior to ovulation changes cervical mucus from thick and sticky (non-fertile) to clearer, wetter, stretchy and slippery (fertile). Fertile mucus facilitates the passage of sperm through the cervix to the uterus. After ovulation, with the production of progesterone, the mucus becomes thick and sticky again and hostile to sperm, so sperm are unable to swim through the mucus.

Consider the possibility of abnormal vaginal discharge if there is complaint of an increase in the amount of vaginal discharge, a change in the consistency or colour, and/or the presence of an offensive odour. There may or may not be associated symptoms such as itching, soreness, dysuria and dyspareunia.

... Buy now

Causes of vaginal discharge

Buy now

History taking

Buy now

Examination and investigation

Buy now

Comparative features of vaginal discharge

Buy now