A question that comes up almost every day when I’m in clinic is this, “Do I have a yeast infection?” I’m serious when I say that this is THE question on all women’s minds. This question arises because of vaginal discharge. When I answer, I find myself having to go to the very source…to the beginning of what is normal and abnormal. I want to go to this place with you so that we can explore vaginal discharge together.
The quick and dirty answer is that not all vaginal discharge is bad. Yes, you can have vaginal discharge without having anything wrong at all. It can be normal discharge. Just like you take a shower or bath to cleanse your skin, your vagina naturally does the work of cleaning away bacteria that should not be there by producing vaginal discharge. That’s why douching is not needed. Your body has it covered.
But what if the vaginal discharge isn’t normal? This happens too. Many times when this occurs there are other symptoms with it like itching, irritation, or even a foul smell. That’s when we do tests to see what is going on. Your medical provider can take a sample and check the vaginal discharge on the microscope or send it to the lab to see if certain things are growing. We mainly check for bacterial vaginosis (which may or may not be an STD-usually occurs with bacterial overgrowth), yeast infections (a bacterial overgrowth that is usually caused by a hormone change or after you take an antibiotic), and trichomonas (an STD). Also, this a great time to check for STDs in general. Trust me, I have been surprised when vaginal discharge is the clue to finding a patient has Chlamydia/Gonorrhea. So I test for it all. Every time.
So what if you get tested for vaginal discharge, you have NO SYMPTOMS, and the test comes back positive for one of the infections? This definitely happens. It happens A LOT. I call this “if you seek, you shall find”. You may be asking, Dr. Amber, what do you mean?
Well, it’s as simple as this. As creepy as it sounds, just like any part of our body, bacteria is living there. We can take a sample of our skin every single day and find that something is growing there even if there isn’t an infection. The vagina is the same way. We can sample, sample, sample, and sample again trying to find an infection. I guarantee that the more we do it…the more we will find the same thing growing. Usually patients come back positive for BV or yeast. It makes sense…because it is bacteria that is there normally, but the symptoms arise when there is overgrowth (aka bacteria take over). At that time, I tell patients that if they really have symptoms we treat them with medication. If not, we need to do some serious re-evaluation. Why? Because if I prescribe a medication to someone with no symptoms and likely no infection…well I am introducing them to a medication that they don't need that may have side effects. If the test comes back positive for one of the STDs, you better believe I’m treating. No question about that!
Honestly, as much as this question comes up. I love to answer it. It helps me talk about how our body works. We don’t take time to talk about this much. Whether it is talking to a female or male patient, it’s a relief to many to know that VAGINAL DISCHARGE CAN BE NORMAL.