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Friday, December 19, 2014

Dr. Pegs Prescription

‘I can’t help it if I have a heavy flow and a wide-set vagina’

Q: Is it normal to have discharge from the vagina? If so, how much and what color?

A: Imagine your mouth without saliva, your nose without mucus, or your eyes without tears. You get the idea. Our bodies produce a variety of secretions and substances, all of which have a function. Vaginal fluid, also called discharge, is normal; all women have it. Vaginal discharge is made of mucus and fluid from the cervix and vagina, along with normal bacteria and cells that are shed from the inner lining of the vagina. The function of this female secretion is partly for self-cleansing, partly lubrication, and partly protection from infection.

The pH of the vagina is about 4. Just in case you have forgotten chemistry 101, anything less than pH 7 is an acid. In this case, acidity is created and maintained by the friendly neighborhood bacteria, and helps keep harmful bacteria at bay. Normal vaginal discharge has a mild or neutral odor. By the way, semen has a pH in the basic range, up around 8.2.

A woman’s discharge will change throughout the month, because hormones affect genital tissues. During the menstrual period, discharge is composed mostly of blood. This is actually the lining of the uterus that builds up every month in preparation for nourishing a pregnancy. If no pregnancy occurs, the body sheds the lining. Menstrual fluid ranges from red to brown. After her period, a woman’s discharge tends to be light yellow or white in color and slightly sticky.

In the middle of the menstrual cycle, about 14 days before her next period starts, one of the woman’s ovaries releases an egg. At this time, called ovulation, a woman is fertile. This means it is possible for her to get pregnant. Our bodies are wired for reproduction, and the feminine secretions reflect this. When ovulation approaches, the cervical mucus becomes slippery and clear, about the consistency of raw egg white, through which sperm can easily slide. Some women track their fertility by carefully observing their vaginal fluids and planning sex accordingly.

After ovulation, the discharge becomes thicker and white again, but when a woman gets sexually excited she will temporarily produce the clear slippery fluid. Some women release fluid from glands next to the urethra during orgasm.

Most women produce 1-4 ml of vaginal secretion every 24 hours.

More than the usual amount could signal an infection. Other signs of infection might be a change in the normal color of your discharge, a change in odor, itching or tenderness of the skin, painful urination, painful sex or bleeding after sex. Yeast infections are quite common, and usually cause itching and a heavy white discharge. A yeast infection is not sexually transmitted: It can be caused by taking antibiotics, wearing sweaty spandex and stress, among other things.

Another common vaginal infection is called bacterial vaginosis.

This one causes a bubbly white discharge with a fishy odor.

Sexually transmitted diseases such as chlamydia and gonorrhea can also cause an abnormal discharge. Women taking oral contraceptives will have a discharge that is different from what it was off the pill, either lighter or heavier, and of course lacking the ovulation phase because women on the pill do not ovulate.

Some women clean out their vaginas with commercial solutions. This is called douching. Douching upsets the natural chemical and biological balance of the vagina and can cause infections, irritation and even a heavier discharge and is generally not recommended by doctors.

Here’s the bottom line: vaginal discharge is normal. Get to know your own body, including your normal secretions. If there is a change, or if you have questions, come see our women’s health providers at Student Health and Counseling. Call (505) 277-3136 for an appointment.

Peggy Spencer is a student-health physician. She is also the co-author of the book “50 ways to leave your 40s.” Email your questions directly to her at pspencer@unm.edu. All questions will be considered anonymous, and all questioners will remain anonymous.