Very few topics get avoided as thoroughly as this one. Women put up with itching, unusual discharge or a change in odour for weeks, treat themselves from the pharmacy on a guess, and hope it settles, all because it feels awkward to talk about.

It should not be awkward, and it is worth getting right. The vagina is a self cleaning, finely balanced part of the body, and most of the common problems are easy to identify and treat once you know what is normal.

Reassurance first. Some discharge every day is completely normal and healthy. It is your body keeping itself clean. What matters is a change from your own normal, in amount, colour, smell or comfort. That change is the signal, not the discharge itself.

What normal looks like

Vaginal discharge is fluid made by the vagina and cervix that keeps the area clean and moist. Normal discharge is usually clear or milky white, and it changes across the monthly cycle, becoming more stretchy and slippery around the middle of the cycle. It should not itch, burn or smell strongly.

The vagina keeps itself at a slightly acidic balance that holds unwanted germs in check. Anything that upsets that balance, including harsh soaps, douching, scented products and some antibiotics, can lead to the common problems below.

Thrush, the itchy one

Thrush is a yeast infection, very common and not something you have caught from anyone. It typically causes intense itching, soreness, and a thick white discharge often described as looking like cottage cheese, usually without a strong smell.

It is easily treated with antifungal medicine. It becomes more likely after antibiotics, in pregnancy, and in women with diabetes that is not well controlled. If thrush keeps coming back, that is worth a conversation, because the reason behind the pattern sometimes matters more than the infection itself.

Bacterial vaginosis, the smelly one

Bacterial vaginosis, or BV, happens when the natural balance of bacteria shifts. Its hallmark is a thin, greyish white discharge with a fishy smell that is often stronger after sex. It may cause little or no itching.

BV is not classed as a sexually transmitted infection, but it is linked to changes in the vaginal balance. It usually clears with a short course of the right antibiotic. Because thrush and BV are treated with different medicines, guessing wrong at the pharmacy is a common reason symptoms drag on, which is why a proper test helps.

Dryness and irritation

Vaginal dryness can cause itching, burning and discomfort during sex. It is very common around and after menopause, when natural lubrication falls, and it also follows some medicines and skin conditions. It responds well to treatment, from simple moisturisers and lubricants to prescribed options, so there is no need to endure it in silence.

Everyday irritation is often caused by the products meant to help. Scented soaps, wipes, bubble baths and douching all disturb the natural balance. Plain water on the outside is enough, and the inside of the vagina does not need washing at all.

A note on infections passed through sex

Some causes of discharge, pain or odour are sexually transmitted infections, which are covered in a separate article. The key point here is that several of them cause few or no symptoms, so if there is any chance you have been exposed, ask for testing rather than waiting for signs. Testing is straightforward and confidential, and our laboratory is on site.

Get urgent care if you have severe lower belly or pelvic pain, a high fever with vaginal symptoms, heavy vaginal bleeding, or discharge with pain during pregnancy. These need prompt assessment, and our Accident and Emergency department is open 24 hours.

When to see a doctor rather than self treat

It is reasonable to try a pharmacy treatment once for classic thrush. See a doctor if the symptoms do not clear, keep returning, or are not clearly thrush. Also see a doctor for a new discharge with a strong smell, any bleeding between periods or after sex, pain during sex or when passing urine, sores or blisters, or any symptom in pregnancy.

A consultation is quick and private. A doctor may take a simple swab, which is sent to the laboratory to identify exactly what is present, so you are treated for the right thing the first time.

What to do next

Vaginal symptoms are common, they are nothing to be ashamed of, and they are almost always treatable once the cause is clear. If something has changed from your normal and it is not settling, book a consultation. Getting the right diagnosis saves weeks of guesswork and discomfort, and it is a routine part of what we do.

Something not right down there? Get it checked at Newtown.

Consultation and laboratory testing are available under one roof at 55 Woodford Street, Port of Spain, so the cause of an infection or an ongoing symptom can be found and treated properly rather than guessed at. Book a consultation for a private, respectful assessment. Our Accident and Emergency department is open 24 hours for severe pelvic pain, heavy bleeding or fever.

Book your consultation Call 622-4945

This article is for general education only and is not a substitute for personal medical advice, diagnosis or treatment. Always consult a qualified healthcare provider about your own health. If you believe you have a medical emergency, call or visit our 24-hour Accident and Emergency department immediately.