Some Causes and Features of a Vaginal Discharge
Cause | Common Features* | Diagnostic Approach |
|---|---|---|
During childhood | ||
A foreign object (often toilet paper or a small object) in the vagina | A discharge, usually with a foul odor and often containing small amounts of blood | A doctor's examination, sometimes done after the girl is sedated or given a general anesthetic |
Infections such as
| Itching, redness, and swelling in the genital area Often pain during urination With streptococcal or staphylococcal infection, redness and swelling in the genital area | Examination under a microscope and analysis of a sample of the discharge to check for microorganisms that can cause vaginal infections |
Itching that worsens at night | Examination of the genital area and anus to check for pinworms | |
Irritation caused by urine or stool | Itching, redness, and a foul odor coming from the genital area Sometimes pain during urination No discharge | A doctor's examination |
Soreness in the genital area Sometimes discharge that has a foul odor or contains blood Often vague symptoms (such as fatigue or abdominal pain) or changes in behavior (such as starting to have temper tantrums or to withdraw) | A doctor's examination To check for sexually transmitted infections, examination under a microscope and analysis of a sample of the discharge | |
During the childbearing years | ||
A thin, white or gray cloudy discharge with a fishy odor Sometimes itching and irritation | Examination under a microscope and analysis of a sample of the discharge | |
Irritation, itching, redness, and swelling in the genital area A thick, white, clumpy discharge that resembles cottage cheese Sometimes worsening of symptoms after intercourse and before menstrual periods Sometimes recent use of antibiotics or a history of diabetes | Examination under a microscope and analysis of a sample of the discharge | |
Trichomoniasis (an infection caused by protozoa) | A usually profuse, yellow-green, frothy discharge with a fishy odor Itching, redness, swelling, and soreness in the genital area Sometimes pain during sexual intercourse and urination | Examination under a microscope and analysis of a sample of the discharge |
Aching pelvic pain that becomes increasingly severe and may be felt on one or both sides A discharge that sometimes has a foul odor and, as infection worsens, can become puslike and yellow-green Abnormal bleeding from the vagina Sometimes pain during sexual intercourse or urination, fever or chills, nausea, or vomiting | Tests to detect sexually transmitted infections using a sample of secretions taken from the cervix Sometimes ultrasonography of the pelvis | |
A foreign object (often a forgotten tampon) in the vagina | An often profuse discharge with an extremely foul odor Often redness in the genital area and pain during urination and sometimes pain during sexual intercourse | A doctor's examination |
After menopause | ||
Thinning of the lining of the vagina (atrophic vaginitis)† | A scant discharge Pain during sexual intercourse | Examination under a microscope and analysis of a sample of the discharge |
Irritation caused by urine or stool | General redness in the area around the genitals and anus Conditions that increase the risk of such irritation, such as being incontinent or bedbound | A doctor's examination |
At any age | ||
Chemical irritation (such as that due to soaps, bubble baths, hygiene sprays, or vaginal creams and ointments) | Redness, itching, swelling, and soreness in the genital area | A doctor's examination |
An abnormal opening (fistula) between the intestine and genital tract, which may result from
| A discharge with a foul odor Presence of stool in the vagina or in the vaginal discharge | A doctor's examination |
Inflammation due to
| Recent treatment of a disorder affecting the pelvis A scant white or yellow discharge Pain during sexual intercourse Sometimes itching, redness, burning pain, and mild bleeding | A doctor's examination Usually examination under a microscope and analysis of a sample of the discharge |
Skin disorders such as psoriasis, lichen sclerosus, and lichen planus (due to an autoimmune reaction, when the body attacks its own tissues) | Rashes, itching, or other symptoms, depending on the disorder | Usually a doctor's examination alone Sometime a biopsy |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Thinning of the lining of the vagina is a symptom of the genitourinary syndrome of menopause, which also includes vaginal dryness, pain during sexual intercourse, urinary urgency, and urinary tract infections. | ||
CT = computed tomography; MRI = magnetic resonance imaging. | ||