Dr Sherene Kalloo

Vagi­nal health is a top­ic many women feel hes­i­tant to dis­cuss open­ly, yet it is one of the most im­por­tant as­pects of over­all well-be­ing. As a gy­nae­col­o­gist, I of­ten see pa­tients who de­lay seek­ing care be­cause they are un­sure whether what they are ex­pe­ri­enc­ing is “nor­mal.” Un­der­stand­ing the ba­sics of vagi­nal health em­pow­ers women to recog­nise when every­thing is func­tion­ing as it should—and when it is time to seek med­ical ad­vice.

First­ly, it is im­por­tant to un­der­stand that vagi­nal dis­charge can be com­plete­ly nor­mal. The vagi­na is a self-clean­ing or­gan. It nat­u­ral­ly pro­duces dis­charge to main­tain a healthy bal­ance of or­gan­isms and to keep tis­sues lu­bri­cat­ed. In most women, a nor­mal dis­charge is white or clear, may vary slight­ly in con­sis­ten­cy dur­ing the men­stru­al cy­cle, and has no strong or un­pleas­ant odour. Around ovu­la­tion, the dis­charge may be­come clear­er and more stretchy. Be­fore or af­ter men­stru­a­tion, it may ap­pear thick­er. These vari­a­tions are in­flu­enced by hor­mon­al changes and are usu­al­ly not a cause for con­cern.

Mild mois­ture is al­so nor­mal. The vagi­nal en­vi­ron­ment is de­signed to main­tain a slight­ly acidic pH, which pro­tects against harm­ful bac­te­ria. Oc­ca­sion­al­ly, some women may ex­pe­ri­ence very mild ir­ri­ta­tion, par­tic­u­lar­ly around their men­stru­al cy­cle, dur­ing preg­nan­cy, or when us­ing new hy­giene prod­ucts. If this ir­ri­ta­tion is brief and re­solves on its own, it is of­ten harm­less.

How­ev­er, there are cer­tain changes that should nev­er be ig­nored. Ab­nor­mal vagi­nal dis­charge of­ten dif­fers in colour, odour, con­sis­ten­cy, or quan­ti­ty. Yel­low, green, or grey dis­charge can sig­nal in­fec­tion. A strong, fishy, or foul odour is an­oth­er warn­ing sign. Per­sis­tent itch­ing, burn­ing, red­ness, swelling, or pain dur­ing uri­na­tion or sex­u­al in­ter­course are symp­toms that war­rant med­ical eval­u­a­tion.

Sev­er­al com­mon con­di­tions can cause these ab­nor­mal symp­toms. Bac­te­r­i­al vagi­nosis (BV) oc­curs when there is an im­bal­ance in the nat­ur­al bac­te­ria with­in the vagi­na. It is of­ten as­so­ci­at­ed with a grey­ish dis­charge and a no­tice­able fishy odour. Yeast in­fec­tions, on the oth­er hand, are caused by an over­growth of Can­di­da fun­gus and typ­i­cal­ly present with thick, white, “cot­tage cheese-like” dis­charge ac­com­pa­nied by in­tense itch­ing and ir­ri­ta­tion. Some­times swelling may be ob­served.

Sex­u­al­ly trans­mit­ted in­fec­tions (STIs), such as chlamy­dia, gon­or­rhea, or tri­chomo­ni­a­sis, can al­so pro­duce ab­nor­mal dis­charge, odour, and dis­com­fort. Im­por­tant­ly, some STIs may cause on­ly mild symp­toms—or none at all—es­pe­cial­ly in the ear­ly stages. This is why rou­tine screen­ing is es­sen­tial for sex­u­al­ly ac­tive women, even in the ab­sence of symp­toms. In par­tic­u­lar, chlamy­dia which may have no symp­toms in up to 70 per cent of af­fect­ed in­di­vid­u­als.

It is al­so worth not­ing that not all vagi­nal dis­com­fort is due to in­fec­tion. Al­ler­gic re­ac­tions to scent­ed soaps, vagi­nal douch­es (which are def­i­nite­ly not rec­om­mend­ed), sprays, tight syn­thet­ic un­der­wear, or even cer­tain san­i­tary prod­ucts can dis­rupt the nat­ur­al bal­ance of the vagi­na. In fact, ex­ces­sive wash­ing can do more harm than good. The vagi­na does not re­quire in­ter­nal cleans­ing; warm wa­ter and mild, un­scent­ed soap for the ex­ter­nal gen­i­tal area are suf­fi­cient and high­ly rec­om­mend­ed.

When should you see a doc­tor? Any sud­den or per­sis­tent change in dis­charge, odour, itch­ing, burn­ing, or pain should prompt a con­sul­ta­tion. Ear­ly di­ag­no­sis al­lows for sim­ple and ef­fec­tive treat­ment in most cas­es. Left un­treat­ed, some in­fec­tions, cer­tain STIs and bac­te­ria can as­cend in­to the up­per re­pro­duc­tive tract and lead to pelvic in­flam­ma­to­ry dis­ease (PID), which in­creas­es the risk of chron­ic pelvic pain, ec­topic preg­nan­cy, and in­fer­til­i­ty.

The key mes­sage is this: healthy vagi­nal dis­charge is nor­mal and varies through­out a woman’s life. But no­tice­able, per­sis­tent changes are your body’s way of sig­nalling that some­thing may be wrong. There is no need for em­bar­rass­ment. Open con­ver­sa­tions and time­ly med­ical care are es­sen­tial parts of pro­tect­ing your re­pro­duc­tive health.

By pay­ing at­ten­tion to your body and seek­ing care when need­ed, you take an im­por­tant step to­ward pre­serv­ing not on­ly vagi­nal health but your over­all well-be­ing.

Dr Sherene Kalloo

MDW, MBBS, DGO, DM, FACOG

spe­cial­ist ob­ste­tri­cian & gy­nae­col­o­gist