Symptoms Covered in this Topic

• Vaginal symptoms include discharge, bleeding and pain.
• Vulva symptoms include itching, pain and pain when passing urine.
• Genital area skin symptoms include itching, pain, rash and swelling.

Vaginal Discharge: Normal versus Abnormal

• A clear or whitish discharge is normal. It may increase and contain more mucus around the middle of your menstrual cycle when you ovulate. This is normal.
• Two small glands (pea like structures) at the entrance to the vagina also produce clear mucus to help lubricate the vagina and keep the lining healthy.
• Yellow or green vaginal discharge can mean an infection.
• A bad-smelling discharge is also not normal.
• An abnormal discharge can also cause a genital rash.

Causes of Abnormal Vaginal Discharge and/or Itching

• Sexually Transmitted Infections (STI) can be passed from either the female or male partner. They may also cause pain with passing urine, pelvic pain, and bleeding.
  • Gonorrhea
  • Trichomonas
  • Genital Herpes
  • See the STI Exposure care guide for more information.
• Vaginitis often causes vaginal discharge and itching. It can be caused by an irritation or an infection, such as:
  • Yeast infection
  • Candidiasis
  • Trichomonas
  • Bacterial vaginosis (white-gray discharge, fishy odor).
• Vaginal Foreign Objects (such as a forgotten tampon) can cause an infection and discharge.
• Cervical Polyps are small fleshy growths which may cause vaginal discharge and/or vaginal bleeding and spotting.
• Cervical or Uterine Cancer can cause discharge, but there are often other symptoms, such as pain and vaginal bleeding.
• Bartholin's Cyst or Abscess. The Bartholin's glands produce clear mucus which helps keep the vagina healthy. If the gland gets blocked, it can swell and become a cyst. You may feel this as a small lump at the entrance of the vagina. The cyst may burst and cause vaginal discharge. The cyst can also become infected, causing severe pain and sometimes pus.

Causes of Abnormal Vaginal Bleeding (also see Vaginal Bleeding care guide)

• Hormone Changes
• Cervical Polyps
• Cervical Cancer
• Uterine Cancer
• Sexually Transmitted Infections (STIs)
• Fibroids
• Endometriosis
• Peri-menopausal Bleeding
• Post-menopausal Bleeding (serious)

Other Health Problems that Cause Vaginal Symptoms

• Dyspareunia (pain during sex)
• Vulvar Cancer
• Vulvar Pain

When to Call for Vaginal Symptoms

Care Advice

Vaginal Discharge

What You Should Know about Normal Vaginal Discharge:

• A small amount of vaginal discharge is normal. It begins at puberty.
• The discharge is clear or whitish, thin and a small amount. It may vary throughout the menstrual cycle.
• It has a cleansing purpose and is very normal.

Call Your Doctor If:

• Discharge becomes yellow, green or thick
• Discharge is bad-smelling
• It causes pain, itching or a rash
• You think you need to be seen

Mild Skin Rash or Itching of Genital Area - Treatment

What You Should Know about Genital Rashes or Itching:

• Rashes can be caused by skin irritants that were on the hands. The hand may touch the genital area when passing urine.
• Examples of irritants are plants (such as an evergreen) or chemicals (such as bug repellents). Fiberglass or pet saliva or even food can also be irritants.
• Itching can also be due to pubic lice.
• Most small rashes can be treated at home.
• Here is some care advice that should help.

Clean the Area:

• Wash the area once with soap to remove any irritants. It may be easier to do so in the bath or shower.

Steroid Cream for Itching:

• For itchy rashes, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
• Do this 2 times per day for a few days.

Lice Treatment:

• Insecticide creams and lotions are available from a drug store to treat pubic lice.
• Ask your doctor or a pharmacist if you are not sure what to use.
• Recent close contacts or sex partners should also be treated.
• Follow the advice on the package on how to use the cream or lotion. Treatment is usually left on the skin for 12 to 24 hours before washing off. An additional treatment is usually applied after 7 days.

What to Expect:

• Small rashes from irritants should go away in 2 days with treatment.

Prevention of Rashes:

• Wash your hands before touching your genital area.

Call Your Doctor If:

• Rash spreads or gets worse
• Rash lasts more than 3 days
• Fever occurs
• You think you need to be seen
• Your symptoms get worse

STI Prevention

How to Prevent Sexually Transmitted Infections (STIs):

• Most STIs are spread by exchange of body fluids (semen, vaginal fluids or blood). This can occur during oral, anal, or vaginal sex.
• They can also occur from direct contact with any sores during sex.
• Condoms are the only trusted way to prevent most STIs during sex.

Abstinence and Other "Safe" Sexual Activities:

• Abstaining from sex is the only 100% effective means of not getting STIs. This means not having sex (vaginal, oral or anal).
• Actions which are believed safe (and don't often spread STIs) are holding hands and hugging. Touching and kissing (if no sores on lips or in mouth) are also safe.

Use of Condoms:

• Condoms are the only trusted way to prevent most STIs during sex.
• Putting on a condom: (1) Hold the condom at the tip to squeeze out the air. (2) Roll the condom all the way down the erect penis. Don't try to put a condom on a soft penis.
• Taking off a condom: (1) After sex, hold onto the condom while the penis is being pulled out. This will keep the condom from coming off before the penis is out. (2) The penis should be pulled out while still erect, so that sperm (semen) doesn't leak out of the condom.
• Buy latex rubber or plastic condoms. Never use condoms made from animal skins. They can leak.
• If you use a lubricant during sex, make sure it is water-based (like K-Y Liquid). Do not use petroleum jelly, vegetable oil or baby oil. These can cause a condom to break.
• For more facts about condoms, see website Condom Effectiveness.

Actions that Don't Prevent STIs:

• Douching (rinsing out the vagina with water or other fluids) does not prevent STIs. Neither does taking a shower after sex.
• Withdrawal (when a man pulls his penis out before he ejaculates or 'comes') is not a way to prevent STIs or pregnancy.
• Having a STI once does not prevent you from getting it again. You can also get different STIs.
• Using other forms of birth control won't prevent you from getting an STI. If you are using an IUD, birth control pills, implant or shot, you still need to protect yourself with condoms.

Call Your Doctor If:

• You have any symptoms that you think might be an STI.
• You have sex without a condom or the condom breaks during sex. Reason: emergency contraception pills (if available) can prevent pregnancy if taken within 72 hours.
• You miss your period and might be pregnant.
• You have other questions or concerns

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.




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