Merck Manual

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Some Causes and Features of a Vaginal Discharge

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 Trichomonas Vaginitis (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

  • Radiation therapy

  • Pelvic surgery

  • Certain chemotherapy drugs

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 Psoriasis Psoriasis , lichen sclerosus Lichen Sclerosus 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.