discharge

and Sabine Schrör, medical journalist

Hanna Rutkowski is a freelance writer for the medical team.

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Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne.As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

More about the experts All content is checked by medical journalists.

Discharge (med .: fluorine vaginalis, fluorine genitalis) starts shortly before puberty and accompanies women up to the menopause. How it is made is subject to hormonal fluctuations. It increases during ovulation and pregnancy. If the normal, transparent and odorless discharge changes in color, smell or texture, this can indicate a disease. Read everything you need to know about vaginal discharge here.

Brief overview

Forms: normal discharge ("white flow"; milky-white, odorless discharge from the vagina), pathological discharge (e.g. yellowish, grayish, brown or red discolored, crumbly, lumpy, thick, foul smelling).
Causes of altered discharge: including infections with bacteria (e.g. chlamydia infection, gonorrhea), viruses (e.g. genital herpes, HPV infection), protozoa (trichomonads) or fungi (e.g. vaginal fungus), hormone fluctuations, pregnancy, stress, excessive intimate hygiene, antibiotic therapy, Latex allergy, polyps, tumors, genital tuberculosis.
Tips for self-help: cure with lactic acid bacteria, proper intimate hygiene and wiping technique after defecation, avoidance of sugar in the case of an acute fungal infection, sex only with a condom.
When to the doctor Women should see a doctor if the normal discharge changes in color, smell and / or texture and if other symptoms occur (e.g. fever, itching, pain during sex). Discharge after menopause should also always be clarified. Men with discharge should always see a doctor.
What does the doctor? Collection of medical history, gynecological / urological examination, smear with laboratory examination, if a tumor is suspected, tissue removal (biopsy). Treatment depending on the cause (e.g. antibiotics for bacterial infection, antimycotics for fungal infection). In the case of venereal diseases: co-treatment of the partner.

Discharge: forms

Normal discharge (white flow)

Every woman knows the odorless, milky-white secretion (white flow) that flows out of the vagina every day. This discharge (called fluorine vaginalis or fluorine genitalis) appears for the first time a few years before puberty and accompanies women up to the menopause.

Depending on the phase of the cycle a woman is in, the consistency and quantity of the discharge changes. For example, many women notice that they are ovulating by an increased, almost liquid discharge caused by the female hormone estrogen. Shortly before and after menstruation, the vaginal fluorine is somewhat more viscous.

Discharge - important protective function

The discharge from the vagina has its purpose: it removes excess mucus and flaked cells from the uterus and vagina. At the same time, the fluorine vaginalis contains many lactic acid bacteria that create a slightly acidic vaginal environment and thus ward off intruders such as fungi, viruses and bacteria. The discharge also prevents sperm from entering the uterus if the uterus is not prepared for pregnancy due to the cycle.

Diseased discharge

If the discharge becomes noticeably discolored (e.g. yellowish or brownish), smells unpleasant, becomes crumbly, lumpy and / or viscous, this may indicate a disease of the vaginal area. These include, above all, vaginal infections caused by pathogens (such as bacteria, fungi), but also other diseases.

Sometimes, however, hormonal fluctuations, certain medications or psychological problems are also responsible for abnormal discharge.

If your discharge changes significantly, for example yellow, brown or noticeably thick and / or smells bad, you should always see your gynecologist to investigate the cause.

Discharge: causes

An altered discharge can have many different causes - some of them are pathological (such as infections), while others are not (e.g. normal hormone fluctuations over the course of the monthly cycle). Here are the main ones:

Bacterial infections

A thin, grayish, fishy-smelling discharge usually indicates inflammation of the vagina (colpitis, vaginitis). Usually this is from the bacterium Gardnerella vaginalis caused. Staphylococci and streptococci can also be the trigger, as well as the following pathogens common sexually transmitted diseases:

Chlamydia: A chlamydial infection - caused by the bacterium Chlamydia trachomatis - is one of the most common sexually transmitted diseases. In women, it often goes unnoticed. Only an increased, sometimes purulent-yellow discharge and pain when urinating can indicate this. If left untreated, chlamydial infection can make you sterile.

Gonococci (Neisseria gonorrhoeae): These bacteria cause the widespread sexually transmitted disease gonorrhea. This is often symptom-free, especially in women. But it can also cause symptoms such as a foul-smelling, yellowish discharge and a burning sensation when urinating. If left untreated, there is a risk of chronic complaints.

A fishy-smelling discharge can also indicate an imbalance in the vaginal environment, in which potentially pathogenic bacteria multiply while the proportion of "good" lactic acid bacteria decreases. Such bacterial vaginosis is often caused by sexual intercourse. Other risk factors include psychosocial stress and smoking.

Fungal infections

The acidic vaginal environment, for which lactic acid bacteria are responsible, usually prevents the yeast from growing Candida albicans can multiply here. However, if the lactic acid bacteria are reduced, for example by antibiotic therapy or a weakened immune system, vaginal fungus (vaginal mycosis) can spread. Typical signs are a lumpy, white discharge accompanied by a badly reddened mucous membrane, itching, and burning pain.

Trichomonads infection

One of the widespread sexually transmitted diseases is also an infection with trichomonads (trichomoniasis) - to be more precise Trichomonas vaginalis. The small, mobile parasites attack the urinary and genital tract (urogenital tract), especially in women. Symptoms of the infection are itching and foul-smelling yellow discharge.

Viral infections

Viruses can also infect the genital area and cause symptoms such as discharge there. The most important are:

Herpes simplex virus: The herpes simplex virus type 2 causes genital herpes. Signs of this are the typical blisters in the area of the vagina, labia and mucous membrane, reddened mucous membrane, itching, heavy discharge and fever.
Human papillomavirus (HPV): This virus causes so-called genital warts, which often go unnoticed. A reddish-brown discharge is typical of the infestation. Some subspecies of HPV cause cervical cancer. There is now a vaccination against it (HPV vaccination).

Other influencing factors

Hormonal fluctuations: Under the influence of the female sex hormone estrogen, the discharge becomes more fluid shortly before ovulation. He is tougher in the period before and after menstruation. This is completely normal.
Sexual arousal: Increased watery discharge during sexual arousal is also quite normal. It acts as a natural "lubricant" to facilitate penile penetration.
Stress: Changed or heavy discharge can be the result of psychosocial stress, because this can unbalance the composition of the natural vaginal flora. Signs of such bacterial vaginosis can be a "fishy" smelling discharge.
Foreign bodies in the vagina such as a forgotten tampon are an ideal breeding ground for bacteria. The result can be vaginal inflammation (colpitis).
Latex allergy: Some people are allergic to latex, for example to latex condoms. In affected women, contact with the mucous membrane with such condoms can cause vaginal burning, pain during sexual intercourse and altered discharge.
Tumors: Discharge that is irregular, sometimes bloody or watery or occurs after the menopause is alarming. Then benign tumors can be the reason, e.g. uterine polyps (red-brown discharge). Watery, strongly smelling or even bloody discharge can also indicate cancerous tumors of the genital organs.
Genital tuberculosis: Tuberculosis that spreads to the genital area is now very rare in Europe. It leads to sterility.
Antibiotic therapy: Some antibiotics destroy the healthy lactic acid bacteria in the vagina, making it easier for pathogens to settle and spread.
Other causes of a changed vaginal environment: Risk factors such as diabetes mellitus, hormonal contraceptives and excessive intimate hygiene can unbalance the acidic vaginal climate and thus promote infections in the genital area (with symptoms such as discharge).

Discharge in pregnancy

If excessive discharge occurs during pregnancy, many women are unsettled. However, there is usually no reason to do so, because increased discharge in pregnant women is normal. It is the same discharge that occurs every day in non-pregnant women: white flow.

But of course you can also get a vaginal infection with a correspondingly changed discharge during pregnancy, which poses a certain risk for the unborn child. Because some pathogens can cause premature births. During delivery there is also the risk that the baby will be infected with the pathogens.

You can find out more about this in the article Discharge in pregnancy.

Discharge in men

Men can also suffer from discharge. Then fluid comes out of the urine level, which is neither urine nor seminal fluid. This discharge indicates an inflammation of the urinary tract (urethritis). It is usually caused by an infection with pathogens that the man became infected with during sexual intercourse. If the bacteria are of the gonococcal type, doctors speak of gonorrheic (specific) urethritis. Much more often, however, other germs are the cause. Then there is a non-gonorrheic (unspecific) urethritis.

Non-gonorrhoeic urinary tract inflammation (urethritis non gonorrhoica, NGU)

Non-gonorrhoeic urethritis (NGU) is particularly common in men between the ages of 20 and 35. The triggering germs that those affected "catch" during sexual intercourse are mostly bacteria - above all Chlamydia trachomatis (Chlamydia) and Ureaplasma ureolyticum, sometimes streptococci.

Aside from bacteria, fungi and trichomonads, for example, can also cause non-gonorrheic urinary tract inflammation.

In around five percent of all infected people, the urinary tract infection is not associated with any symptoms. In the other cases it is often mild and is therefore usually not recognized immediately. Important signs are:

burning pain when urinating
Frequent need to urinate with only a few drops secreted
Burning or itching in the urethra
swollen lymph nodes in the groin
glassy discharge

Regardless of whether the non-gonorrheic urethritis causes symptoms or not, the infected are in any case very contagious to their sexual partners.

Gonorrhoeic inflammation of the urinary tract (urethritis gonorrhoica, GU)

Here the urinary tract infection is caused by an infection with gonococci. Popularly, the infection is also known as gonorrhea or gonorrhea. Typical signs of gonorrheal urethritis are:

Painful urination; a feeling of broken glass in the urethra
white or purulent discharge
Itching in the urethra

If the disease is left untreated, the symptoms will subside on their own after about eight weeks. The pathogens can rise into the epididymis via the urogenital tract and lead to infertility. The prostate can also be affected and become inflamed.

If you have a vaginal discharge as a man, you should definitely consult a doctor (family doctor / urologist) to treat the cause and prevent serious consequences such as later infertility.

Discharge: Tips on how to help yourself

These tips will help you to prevent infections with pathogens in the genital area or to support the medical treatment of such infections:

Lactic acid treatment: A disease or antibiotic treatment can significantly reduce the number of lactic acid bacteria in the vagina. Tampons with natural yoghurt or special lactic acid suppositories from the pharmacy bring the vaginal flora back into balance.
Proper intimate hygiene: Never wash the vagina yourself, especially not with harsh soaps or with vaginal douches. You should limit your intimate hygiene exclusively to the outer genital area and only use clear water and, if necessary, pH-neutral, gentle washing lotions.
Wipe properly after a bowel movement: Vaginal infections caused by intestinal bacteria can be avoided with the right wiping technique: Always wipe yourself from front to back after a bowel movement.
No sugar: In the case of vaginal thrush, it is often recommended to eat a low-sugar or sugar-free diet, because mushrooms love sugar. But there are also doctors who say that the sugar content in the diet has no influence on a yeast infection.
Safe sex: Only a condom can help prevent the transmission of sexually transmitted diseases. Use it especially if you are dealing with changing partners.
Panty liners instead of tampons: Especially if you suffer from frequent discharge, you should use panty liners instead of tampons.
Cotton underwear: In contrast to underwear made from synthetic fibers, cotton underwear does not hinder the exchange of air in the genital area. This means that bacteria and fungi in the external genital area cannot multiply so easily.

Discharge: when do you need to see a doctor?

An altered discharge in women can indicate an illness. Therefore, women should watch their discharge carefully: What color is the discharge? Is it thick or rather thin? Does it smell unpleasant? Most of the time, the changed discharge is due to an easily treatable vaginal infection. However, caution should be exercised with red-brown, bloody-lumpy discharge, especially if it occurs after the menopause. Because this discharge can be a symptom of cancer.

You should definitely see your gynecologist if:

the amount of discharge changes significantly.
the discharge changes color: yellow or brown discharge as well as green, white or purulent vaginal fluorine indicate diseases.
The texture of the vaginal secretion changes: Crumbly or lumpy discharge can also indicate illnesses.
The smell of the discharge changes: Discharge that smells particularly fishy can be a sign of infection.
Other symptoms in the genital area such as severe itching, redness and burning pain occur.
Symptoms when urinating such as frequent urination or pain when urinating are added.
whitish deposits are on the vaginal lining or the labia.
you experience unusual pain during intercourse.
other accompanying symptoms such as a general feeling of illness or fever.
the discharge occurs after menopause.

Discharge in men is always a reason for a visit to the urologist! The underlying disease - inflammation of the urinary tract (urethritis) - can be brought under control with antibiotics. Here, too, it is important that the partner is also treated in order to avoid re-infection.

Discharge: what does the doctor do?

The contact person for women with a changed vaginal secretion is the gynecologist. He will first ask you a few questions about the medical history (anamnesis). For example, he asks how long the changed discharge has existed and how exactly the nature, color and smell of the discharge have changed. This information can give the gynecologist an initial suspicion. If you are taking medication or have previous illnesses, you should also mention this in the anamnesis interview.

In the subsequent gynecological examination, the doctor can determine whether and how your vaginal lining has changed. For example, is it reddened or swollen? With a swab, pathogens such as bacteria, fungi or trichomonads can be detected directly under the microscope. The doctor can also easily determine the pH value in the vagina, which is normally around 4.5, with a test stick.

Certain pathogens such as chlamydia can only be detected in the laboratory. This usually takes a few days.

If there is no inflammation, it is important to rule out a tumor as the cause of the discharge. For this, too, a smear is taken and, if necessary, a small tissue sample (biopsy) is taken. A pathologist will then thoroughly examine this for any degenerate cells.

Discharge in men: examinations at the urologist

The urologist will also take a medical history first on a man with a discharge. He then examines the genital area for any abnormalities, for example redness and swelling in the area of the glans and foreskin. He also takes a secretion sample from the urethra. This is examined under the microscope and often analyzed more precisely in the laboratory. The results are usually enough to make the correct diagnosis.

Discharge: treatment

Therapy for the discharge depends on the cause. For example, if you have a yeast infection, the doctor will prescribe so-called antimycotics. The antifungal agents are available as vaginal suppositories or ointments. If a bacterial infection (such as the vagina or urinary tract) is causing the discharge, antibiotics are used. The same applies to an infection with trichomonads.

It is important with any infection-related discharge that your partner is also treated. This is the only way to prevent you and your partner from infecting each other again and again.

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