Vaginal Discharge: Types, Colours and When to Worry

Normal vaginal discharge is clear or white, with no bad smell, and it changes through your cycle: clearer and stretchy when you ovulate, thicker after. See a doctor if it changes colour, smells bad, itches or burns, or comes with pelvic pain or bleeding. The most common causes are thrush and bacterial vaginosis. This guide is by Dr. Pedro Yelamo Vera, an English-speaking GP licensed in Spain (Colegiado No. 484814280) who sees patients by video in English and Spanish.

What does normal vaginal discharge look like?

It is a fluid or mucus that keeps the vagina clean and moist and helps protect it from infection. Normal discharge is clear or white with no strong smell. It can be thick, sticky, slippery or watery.

The amount varies. It is often heavier in pregnancy, when you are sexually aroused and with some types of birth control. Around ovulation it is clearer, wetter and stretchy, like raw egg white. In Spain discharge is called flujo vaginal.

What does the colour of discharge mean?

• Thick, white and lumpy, like cottage cheese, with itching: most likely thrush (a yeast infection).
• Thin, white or grey with a fishy smell that is worse after sex: bacterial vaginosis.
• Green, yellow or frothy: may be trichomoniasis, a sexually transmitted infection.
• With pelvic pain or bleeding between periods: may be chlamydia or gonorrhoea.
• Brown or pink: often old blood at the start or end of a period. If it happens at other times, see a doctor.
• With blisters or sores: may be genital herpes.

Colour is a clue, but it is not enough for a diagnosis. Several infections look alike, and you can have more than one at once.

Why do I have more discharge than usual?

It can be normal around ovulation, in pregnancy, on the pill or when you are aroused. If it also itches, smells or looks different, there is usually an infection.

What is thrush?

It is a very common yeast infection. It causes itching, burning, redness and a thick white discharge with no bad smell. It is more likely after antibiotics, in pregnancy or with poorly controlled diabetes. Pharmacies sell treatments such as Canesten (clotrimazole). If it is your first time, you are pregnant or it keeps coming back, see a doctor. Read about vaginal thrush.

What is bacterial vaginosis?

It is an imbalance of the normal bacteria in the vagina. It does not usually itch, but it gives a thin discharge with a fishy smell. It is not a sexually transmitted infection, though it is more common with a new partner. It needs prescription treatment. Read more about bacterial vaginosis.

What if it could be a sexually transmitted infection?

Get tested if you had sex without a condom with a new partner, your discharge changes, or you bleed after sex or have pelvic pain. Chlamydia often has no symptoms and can affect fertility. Read about chlamydia.

Why does my vulva hurt?

Pain or soreness in the vulva can come from an infection, irritation from soaps or pads, dryness (for example in the menopause or while breastfeeding) or a cyst. A painful lump on one side of the vaginal opening may be a Bartholin's cyst.

If the pain lasts more than three months with no clear cause, it is called vulvodynia. You may feel it when touched, when sitting or during sex. It can be treated and is worth getting checked, even if tests come back normal.

How do I look after the area?

• Wash only the outside, with warm water and a mild, unscented soap.
• Do not douche, and avoid scented sprays or wipes.
• Wear cotton underwear and avoid very tight clothes.
• Use condoms with new partners.
• Do not use pharmacy treatments again and again without a diagnosis.

What do I ask for at a Spanish pharmacy?

For thrush you can say creo que tengo candidiasis. The pharmacist may suggest a cream or a vaginal tablet (óvulo). For a fishy smell, see a doctor: bacterial vaginosis needs a prescription.

When to see a doctor

• Your discharge changes colour, smell or texture, or there is much more than usual.
• Itching, burning or pain in the vulva or vagina.
• Bleeding between periods, after sex or after the menopause.
• Pain when you pee, or pain low in your tummy.
• You are pregnant and notice a change in discharge.
• Symptoms come back after treatment.

When to go to A&E or call 112

• Pregnant with a gush of fluid or bleeding: go to A&E (urgencias).
• Strong pelvic pain with a fever: go to A&E the same day.
• Very strong pain with dizziness or fainting, or a high fever with a rash and feeling very ill while using tampons: call 112.

Frequently asked questions about vaginal discharge

Getting a medical assessment

If you are in Spain and notice changes in your discharge, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about clotrimazole creams. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.