Vaginal discharge refers to the fluid that is expelled from the vagina, typically characterized by a watery or slightly thick consistency. It may also possess a mild odor. While some women may notice this discharge on a daily basis, others may experience it less frequently. In many cases, the presence of this fluid can be a sign of vaginal health and hygiene. Consequently, it is common for women to feel concerned when experiencing heavy discharge and to question its causes and whether it is considered normal. Is it an indication of pregnancy, a typical aspect of the menstrual cycle, or a potential infection that requires medical attention? Continue reading to have all your questions addressed.

What is vaginal discharge?

This fluid is generated by the glands located in the cervix and vagina, serving to cleanse and safeguard the vaginal ecosystem. According to obstetrician and gynecologist Dr. Sadhna Singhal Vishnoi, it consists of mucus, bacteria, vaginal secretions, and discarded cells that the body naturally eliminates.

The discharge from your vagina plays a crucial role in maintaining vaginal health by:

• Keeping your vagina clean: It flushes out bacteria and dead cells, which can prevent infections.
• Maintaining vaginal potential of hydrogen (pH) balance: The vagina has a slightly acidic pH, which is around 3.8 and 4.5. "Maintaining it can help prevent harmful bacteria from growing," says the expert.
• Lubrication: It keeps the vaginal walls moist, which helps prevent dryness and discomfort.
• Supporting fertility: During ovulation, discharge becomes slippery and stretchy, helping sperm reach the egg.

Vaginal discharge, which is usually white in colour or clear, varies with the changes in hormone levels, as per research published in Singapore Medical Journal in 2020. "The amount varies, but up to one teaspoon of vaginal discharge in a day is considered normal," says the expert.

What are the causes of an increased vaginal discharge?

An increase in vaginal discharge may be due to the following reasons:

1. Ovulation

Around the middle of your menstrual cycle (days between 10 and 14) estrogen levels peak, and leads to an increase in vaginal discharge. "This makes the cervix produce more cervical mucus, which becomes clear, slippery, and stretchy," says the expert. This helps the sperm move easily and increase the chances of pregnancy.

2. Pregnancy

While expecting, estrogen and progesterone levels increase, leading to an increase in vaginal discharge. "This thin, milky white fluid with no odour helps prevent infections and maintains a healthy environment for the baby," says the expert.

3. Sexual arousal

When you are sexually aroused, the Bartholin’s glands, located near the vaginal opening, produce a clear, watery fluid. This lubricant helps reduce friction while having sex. "The cervix also releases mucus, increasing vaginal discharge," says Dr Vishnoi.

4. Birth control

Oral contraceptives, hormonal intrauterine device, or hormone replacement therapy can cause an increase in vaginal discharge. During a 2022 study, published in Contraception, participants experienced increased amounts of discharge in the first few months after starting birth control. "This happens due to fluctuating estrogen and progesterone levels," says the expert.

5. Vaginal yeast infection

A vaginal yeast infection occurs when Candida albicans, which is a type of fungus, overgrows in the vagina. "It often happens after using antibiotics, eating a lot of sugar, stress, pregnancy, or diabetes. These are some of the factors that can disrupt the natural vaginal pH, and lead to thick, white heavy discharge," says the expert

6. Bacterial vaginosis

It is caused by an imbalance in vaginal bacteria, where the harmful ones outgrow the good bacteria or lactobacilli. "You can experience thin, grey or white discharge with a strong fishy smell," says Dr Vishnoi. Bacterial vaginosis is the most common cause of abnormal vaginal discharge, including heavy discharge, as per research published in the International Journal of Reproduction, Contraception, Obstetrics and Gynecology in 2021.

7. Sexually transmitted infections

Sexually transmitted infections like gonorrhea, chlamydia, or trichomoniasis can cause an increase in vaginal discharge due to inflammation and infection. "These infections spread through unprotected sex, and can lead to a discharge in yellow or green colour with a strong odour," says the expert.

8. Menopause

During menopause, estrogen levels often fluctuate. "Vaginal dryness is common among women in their mid-40s and 50s. Some women can also experience an increase in vaginal discharge, which is thin and watery, due to hormonal shifts," says the expert.

How to treat an increase in vaginal discharge?

Treatment depends on the cause of heavy vaginal discharge:

1. Yeast infection

If your discharge is thick, white, cottage cheese-like fluid, and you feel itchy down there, it can be due to a yeast infection. "Antifungal medications and probiotics can help to restore vaginal flora, and get rid of the infection," says the expert.

2. Bacterial vaginosis

Greyish-white heavy discharge with a strong fishy odour and a little bit of itching are signs of bacterial vaginosis. "Antibiotics like metronidazole or clindamycin, in oral or vaginal gel form, may help," says the expert. Also, avoid vaginal douching, as it disturbs vaginal flora.

3. Sexually transmitted infections

Apart from an increase in vaginal discharge, it leads to greenish-yellow frothy fluid with foul odour and intense itching. "Antibiotics like metronidazole and tinidazole may be prescribed by your doctor to treat trichomoniasis," says Dr Vishnoi. In case of chlamydia, you may experience white or yellowish discharge with an unpleasant smell. As for gonorrhea, the fluid is usually thin and green or yellow in colour. "Antibiotics like azithromycin or doxycycline may be given for chlamydia, and ceftriaxone for gonorrhea," says the expert.

4. Hormonal imbalances

If you experience an increase in vaginal discharge during pregnancy, ovulation or menopause, it may be due to the fluctuations in estrogen and progesterone levels. "In case of too much estrogen, diet changes like eating more fibre-rich foods, and managing stress may help balance hormone levels naturally," says the expert.

An increase in vaginal discharge may be due to different reasons, including pregnancy. If it's an infection, you may be given medicine. Sometimes, even making small changes in your diet can help.

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