This is such a good question! I am often surprised how many of my patients were not taught about their natural monthly hormonal fluctuations and the changes in vaginal discharge that coincide with these fluctuations.
Learning about and monitoring your vaginal discharge is an amazing way to get in touch with your body and your hormone cycling—and gain control of your sexual and gynecological health. Because many women find it difficult to discuss this topic, even with their doctors, I want to address common concerns and questions about vaginal discharge.
What Is Vaginal Discharge?
Vaginal discharge consists of fluids and mucus produced by cells in the vagina and cervix.
This discharge, which is usually clear or whitish, helps keep your vagina lubricated and prevents infection by clearing out unwanted bacteria and dead skin cells. It also maintains proper pH balance, which is important for vaginal health.
The main role of cervical mucus is to help the flow of sperm by providing nourishment and aiding mobility towards the egg during your fertile days around ovulation—or hinder its movement on non-fertile days.
Most premenopausal women average about one-half to one teaspoon of vaginal discharge every day, although this varies from one woman to another. The amount of fluid, as well as the color and consistency, changes during different phases of the menstrual cycle and times of life. For example, discharge increases during sexual arousal, pregnancy, and breastfeeding and decreases after menopause.
Why Should You Monitor Your Vaginal Discharge?
Knowing what your discharge should look like at each stage of your cycle can help you determine the best time to have intercourse to increase the likelihood of getting pregnant—and when to avoid intercourse if you are not wanting to get pregnant.
Monitoring your vaginal discharge can also give you clues that you may not be ovulating or that your hormones or vaginal flora are out of balance, and you may benefit from getting help from your healthcare provider.
Keeping track of your cycles, hormones, and fertility is particularly important for women who are trying to conceive or avoid conception, but it is empowering for women of all ages and stages of life.
How Do You Monitor Vaginal Discharge?
There are three ways to monitor your vaginal discharge.
- On your underwear: When you sit down to use the toilet, take a look.
- On your toilet paper: After urinating and wiping, check your toilet paper. For example, around the time of ovulation you may notice a faster or slippery wipe, sometimes referred to as “egg white” vaginal discharge.
- On your finger: Insert a clean forefinger into your vagina to feel the discharge, then rub it between your forefinger and thumb and note the color and consistency. During ovulation you can usually stretch the cervical mucus between your two fingers quite a distance before it separates.
What Are the Normal Types of Vaginal Discharge?
There are several types of vaginal discharge and most are related to menstrual cycles:
- Menstrual blood is the shedding of the endometrial lining, the inner lining of the uterus that builds up every month. It can range from brown to fresh red blood and may contain small dark clots. (If clots are large, speak to your healthcare provider.) Darker brown discharge and/or spotting can occur at the beginning or end of your period.
- Cervical fluid changes in response to estrogen levels. As estrogen levels increase, so does vaginal discharge.
- There is a dry phase one to three days after your period ends, when estrogen is at its lowest. You can still feel natural vaginal dampness, but the moisture will dissipate from your fingers within seconds, like the moisture on the inside of your cheek.
- Cervical fluid becomes progressively wetter as the estrogen level increases, peaking right before ovulation, around day 14 of a 28-day cycle. It may start off as opaque, white, and creamy, but progress to being clear, sticky, stretchy, and slippery, with an egg white consistency that stays moist for minutes or longer. Some women also notice pink or light red spotting during ovulation.
- The cervical fluid then becomes drier until your period or menstrual blood flows again.
- Arousal discharge is different from cervical mucus. After arousal or intercourse, vaginal discharge is clear, watery, and thin.
- Menopause, with its steep decline in estrogen, results in a diminishing of cervical discharge. In addition, the pH balance and moisture that help keep the vaginal cells plump and lubricated also decrease, leading to vaginal atrophy and a greater susceptibility to irritation.
What Isn’t Normal?
As you can see, there is a lot of variation in vaginal discharge, and the changes I have described are perfectly normal. However, you also need to be aware of changes that are abnormal. You should contact your healthcare provider if you have:
- Large clots during your periods.
- Long bouts of blood in your vaginal discharge before your period.
- Spotting at other times throughout your period.
- Spotting after menopause (12 months or longer without a menstrual period). Visit your primary care provider ASAP.
- Thick, white, “cheesy” discharge (signs of a yeast infection).
- White, gray, or yellow discharge with a fishy smell (signs of bacterial vaginosis).
- Yellow, greenish, frothy discharge with a foul odor (signs of trichomoniasis, a sexually transmitted disease).
- Itching, burning, swelling, redness, an unpleasant odor, or unusual discharge of any color are signs of the above or other infections or disorders and should be treated at once.
To Learn More
Learning about and monitoring your vaginal discharge is empowering! It’s a great way to track your menstrual cycles, increase your control of your fertility, detect hormone imbalances, and stay on top of gynecological health.
Taking Charge of Your Fertility by Toni Weschler is an excellent book that I recommend to all my patients who want to learn more. In my opinion, every young woman should read this book as a rite of passage when she starts her period to help her understand her cycles and get in touch with and trust her body—something all women should strive for.
