Vaginal Discharge

WHEN TO SEE YOUR DOCTOR

* Your discharge is accompanied by severe itching.

* Your discharge is cheesy, yellow or greenish.

* Your discharge has a strong fishy or yeasty odor.

What Your Symptom Is Telling You

A small amount of discharge is just the normal moisture your vagina produces to keep you comfortable. Even a heavy discharge, caused by cervical mucus production, is normal in some women and harmless, says Eva Arkin, M.D., chief of gynecology at Scottish Rite Hospital and obstetrician and gynecologist with Atlanta Women's Specialists.

But what if your discharge doesn't feel normal? What if it is accompanied by itching? You probably have a vaginal infection, and that's a true cause for concern.

One of the most common vaginal infections is Candida albicans or Monilia, commonly known as a yeast infection. The classic discharge of a yeast infection has a sort of cottage-cheesy texture and is associated with intense itching. Sometimes a yeast infection results from taking a course of antibiotics for another infection in your body.

Bacterial infections (some of which are sexually transmitted) are caused by organisms like gardnerella, chlamydia or gonorrhea and are usually associated with a yellowish discharge that often has a fishy odor. In addition to discharge and itching, you may also feel burning sensations.

A watery, frothy, greenish yellow discharge may be a symptom of trichomoniasis, an infection that's often passed back and forth between partners. Although 35 years ago it was the most common vaginal infection, these days it's relatively rare.

Symptom Relief

Wondering if you should play detective with your own discharge? Most doctors say no. Discharges can be deceptive, and you may even have a combination of two types of infection, each of which will need appropriate medication. Your doctor will take a sample of the discharge and examine it under the microscope for a specific diagnosis.

For a look at medical treatments and home remedies for the vaginal infections that cause most itchy discharge, see Vaginal Itching on page 587. And to keep that discharge from returning, here are a few basic reminders.

Don't douche. Douching can actually be a dangerous way to deal with vaginal discharge, says David Eschenbach, M.D., professor and chief of the Division of Gynecology at the University of Washington School of Medicine in Seattle. Douching can drive infectious material or the douche preservatives up through the cervix into the uterus or change the bacteria in the vagina and cause pelvic inflammatory disease (PID), he says.

Let your powder take a powder. Though it may feel good, using talcum powder or cornstarch to dry up a discharge is also ill advised, Dr. Eschenbach says. Over time, the tiny particles move from the vagina into the uterus and end up near the ovaries. Eventually, these deposits may be a factor in the development of ovarian cancer.

Count on condoms. It's difficult for doctors to pinpoint the cause of most bacterial vaginal infections, but one obvious possibility is frequent sex with multiple partners. Using condoms consistently can prevent the transmission of many of these infections, says Patti Jayne Ross, M.D., an associate professor in the Department of Obstetrics and Gynecology at the University of Texas Medical School at Houston. But you should refrain from even protected intercourse until your infection clears up.