White discharge that is thick and odorless is normal and happens due to expected hormonal changes caused by the menstrual cycle. It helps to keep the vagina lubricated and can range from transparent and thin (like egg whites) or thicker and white (like milk).
However, when white discharge has a particular smell and a different consistency than usual, it could be a sign of a vaginal infection, like candidiasis or an alteration in the normal vaginal flora, such as bacterial vaginosis. In these cases, the discharge occurs with other symptoms such as burning and itchiness in the vagina. If this happens we recommend you visit a gynecologist as soon as possible, so that you can get a recommendation on the best treatment.
Not all discharge is a sign of illness, as small quantities of white or clear discharge that is fluid-like and odorless is a normal finding.
If you have white discharge that is similar to cottage cheese along with other symptoms, such as itchiness, redness and burning, it may be caused by:
1. Yeast infection
A vaginal yeast infection, also known as candidiasis, is a very common infection that occurs when Candida fungus overgrows in the vaginal lining. In addition to white discharge, this type of infection can also lead to itchiness in the genital area, burning with urination, pain during sexual intercourse and redness in the area. Learn more about the causes and symptoms of yeast infections.
How to treat: Yeast infections are treated with antifungals, which can be taken orally, applied topically or inserted vaginally. The treatment can last from 3 to 7 days and should be under the supervision of a gynecologist. Read more about how yeast infections are treated.
2. Bacterial vaginosis
Bacterial vaginosis (BV) is characterized by an overgrowth of the Gardnerella vaginalis bacteria that is normally found in the vagina. Bacterial vaginosis can cause white, gray or yellow discharge, an unpleasant odor that is similar to rotten fish, itchiness and burning sensation in the genital area. Read more about the symptoms of bacterial vaginosis and what causes it.
How to treat: You are advised to see your doctor for a gynecological exam to confirm if BV is present. BV is usually treated with oral or topical antibiotics, like metronidazole, as prescribed by the doctor. During treatment, you are advised to use a condom during sexual intercourse and to keep the vaginal area clean and dry.
3. Vaginal discharge before menstruation
It is normal for women to have thick, white discharge just before menstruation, as this is part of the menstrual cycle. This discharge is odorless, and does not occur with any other symptom. Its function is to prevent the sperm from reaching the egg and fertilizing it. It also serves to protect the woman’s body and promote lubrication.
However, if you have yellow, brown or pink discharge before you menstruate, as well as other symptoms, you should see your doctor for assessment. See what discharge before your period can mean and why it happens.
How to treat: Given this is a normal finding that fluctuates with the menstrual cycle and does not cause any symptoms, no treatment or interventions are necessary.
Colpitis is characterized by inflammation of the vagina and the cervix that can occur due to bacteria, fungus or other protozoans. It can cause white, milky discharge that can also be frothy, foul-smelling. Upon examination, the cervix can present with swelling and red spots.
How to treat: You are advised to see a doctor or gynecologist to order testing to confirm colpitis. Testing can include a KOH test (which looks for fungus), a vaginal pH testing or a colposcopy. Once diagnosis is confirmed and the infectious agent is identified, appropriate treatment with topical or oral medication is usually prescribed.
5. Cytolytic vaginosis
Cytolytic vaginosis (CV) is characterized by the increased presence of Lactobacillus bacteria in the vagina. This bacteria is normally found in low levels in the vagina, but imbalances in levels can occur due to fluctuating vaginal pH or due to use of vaginal lubricants or tampons. Discharge associated with CV is usually white and sticky with a homogenous appearance.
How to treat: You should see your doctor for assessment and diagnosis. Treatment is usually aimed at normalizing Lactobacillus levels, which can be done with bicarbonate sodium douches or vaginal suppositories.
Cytolytic vaginosis that occurs with other symptoms like pain when urinating, pain during intercourse, genital redness and itching, the imbalances in bacteria may be related to an infection, which requires treatment with more specific medication.
Trichomoniasis is a sexually-transmitted infection caused by the Trichomonas sp. parasite that can affect both men and women. Although most people are usually asymptomatic, many experience a white, fluid discharge, pain with urinating, and genital redness.
How to treat: If you notice symptoms of trichomoniasis, it is important to see your doctor for diagnosis and treatment. Treatment usually involves the use of tinidazole or secnidazole as prescribed by your doctor. You should avoid any sexual activity while treating, and advise sexual partners to seek treatment.
During pregnancy, it is normal see small amounts of white discharge. It occurs due to expected hormonal changes and is not a sign of infection or illness. Learn more about discharge during pregnancy.
How to treat: Given it is a normal finding, treatment is not necessary. Pregnancies should be monitored by an obstetrician to ensure maternal and fetal health.
How to prevent vaginal discharge
Copious discharge may be a sign of a vaginal infection. To prevent infections and greater production of discharge, you should consider the following:
- Avoid wearing underwear that is damp or wet;
- Do not wear underwear made of synthetic materials, opting for cotton instead;
- Wear light, loose-fitting clothes and avoid very tight jeans and shorts;
- Avoid sweet foods and food that are high in carbohydrates, as they weaken your immune system;
- Do not douche the vagina, and opt to wash your external vagina with warm water and mild soap;
- Sleep without underwear
- After passing stool, always clean yourself from front to back to prevent feces from going into the vagina.
In addition, perfumed wipes or toilet paper can also be harmful to the vagina and increase the risk of developing an infection.