Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection.
Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven’t been diligent about your personal hygiene.
None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition.
Types of Vaginal discharge and infections
The vagina serves as a passageway between the outside of the body and the inner reproductive organs. The pH balance of the vagina is acidic, which discourages infections from occurring. This acidic environment is created by normally-occurring bacteria. A healthy vagina produces secretions to cleanse and regulate itself, similar to how saliva cleanses and regulates the environment of the mouth. These vaginal secretions are normal vaginal discharge. Any interference with the delicate balance of vaginal secretions sets up an environment conducive to infection.
Normal Vaginal Discharge– All women have some vaginal discharge. Normal discharge may appear clear, cloudy white, and/or yellowish when dry on clothing. It may also contain white flecks and at times may be thin and stringy. Changes in normal discharge can occur for many reasons, including menstrual cycle, emotional stressors, nutritional status, pregnancy, usage of medications – including birth control pills, and sexual arousal.
Effects of the Menstrual Cycle – The menstrual cycle affects the vaginal environment. You may notice increased wetness and clear discharge around mid-cycle. The pH balance of the vagina fluctuates during the cycle and is the least acidic on the days just prior to and during menstruation. Infections, therefore, are most common at this time.
Signs of Abnormal Discharge – Any changes in color or amount of discharge may be a sign of a vaginal infection. Vaginal infections are very common; most women will experience some form of a vaginal infection in their lifetime. If you experience any of the symptoms below, this may be a sign of vaginal infection:
Discharge accompanied by itching, rash or soreness
Persistent, increased discharge
Burning on skin during urination
White, clumpy discharge (somewhat like cottage cheese)
Grey/white or yellow/green discharge with a foul odor
Causes of Vaginal itching and discharge
Glands in the cervix and the walls of the vagina normally produce a clear mucus. This is very common among women of childbearing age.
These secretions may turn white or yellow when exposed to the air.
The amount of mucus produced varies during the menstrual cycle as hormone levels in the body change.
The following factors can increase the amount of normal vaginal discharge:
Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle)
Different types of infections may cause itching or a discharge in the vagina. These include:
Infections spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis.
Vaginal yeast infection, caused by a fungus.
Normal bacteria that live in the vagina that overgrow, causing a gray discharge and fishy odor. This is called bacterial vaginosis (BV). BV is not often spread through sexual contact.
Other causes of vaginal discharge and itching may be:
Menopause and low estrogen levels, which may lead to vaginal dryness and other symptoms (Atrophic vaginitis).
Forgotten tampon or foreign body, which may cause a foul odor.
Chemicals found in detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies or creams, which may irritate the vagina or the skin around the vagina
Less common causes include:
Cancer of the cervix or vagina
Skin conditions, such as desquamative vaginitis and lichen planus
Signs and Symptoms of Vaginal Discharge
Vaginal discharge may range in color from clear to gray, yellow, greenish, or milky-white and may have an unpleasant smell. The symptoms and character of vaginal discharge depend upon the specific condition that is the cause of the discharge.
Bacterial vaginosis: Not all women with bacterial vaginosis will have symptoms, but bacterial vaginosis typically produces a discharge that is thin and grayish-white in color. It is usually accompanied by a foul, fishy smell.
Trichomonas: Trichomonas infection produces a frothy, yellow-green vaginal discharge with a strong odor. Associated symptoms can include discomfort during intercourse and urination, as well as irritation and itching of the female genital area.
Gonorrhea: Gonorrhea may be not produce symptoms in up to half of infected women, but it can also cause burning with urination or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area.
Chlamydia: Like gonorrhea, Chlamydia infection may not produce symptoms in many women. Others may experience increased vaginal discharge as well as the symptoms of a urinary tract infection if the urethra is involved.
Vaginal yeast infection: A vaginal yeast infection is usually associated with a thick, white vaginal discharge that may have the texture of cottage cheese. The discharge is generally odorless. Other symptoms can include burning, soreness, and pain during urination or sexual intercourse.
How do I know if my discharge is unhealthy?
Any sudden change to your discharge may indicate a vaginal infection. You should be aware of how your discharge naturally varies throughout your cycle and what isn’t normal, but obvious warning signs of infection are:
a change in colour or consistency
a sudden bad smell
an unusually large amount of discharge
another symptom alongside the discharge, such as itching outside your vagina or pain in your pelvis or tummy
unexpected bleeding from the vagina
If you’re not sure whether your discharge is normal and are worried about it, see your GP or nurse. Read about sexual health for general information and advice.
How is abnormal discharge treated?
How you are treated will depend on what’s causing the problem. For example, yeast infections are usually treated with antifungal medications inserted into the vagina in cream or gel form. Bacterial vaginosis is treated with antibiotic pills or creams. Trichomoniasis is usually treated with the drug metronidazole (Flagyl) or tinidazole(Tindamax).
Here are some tips for preventing vaginal infections that can lead to abnormal discharge:
Keep the vagina clean by washing regularly with a gentle, mild soap and warm water.
Never use scented soaps and feminine products or douche. Also avoid feminine sprays and bubble baths.
After going to the bathroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection.
Wear 100% cotton underpants, and avoid overly tight clothing.
Home Care Treatments
Keep your genital area clean and dry when you have vaginitis.
Avoid soap and just rinse with water to clean yourself.
Soak in a warm, not hot, bath may help your symptoms. Dry thoroughly afterward.
Avoid douching. Many women feel cleaner when they douche, but it may actually worsen symptoms because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.
Other tips are:
Avoid using hygiene sprays, fragrances, or powders in the genital area.
Use pads and not tampons while you have an infection.
If you have diabetes, keep your blood sugar levels in good control.
Allow more air to reach your genital area. You can do this by:
Wearing loose-fitting clothes and not wearing panty hose
Wearing cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Cotton increases air flow and decreases moisture buildup.
Not wearing underwear at night when you sleep.
Girls and women should also:
Know how to properly clean their genital area while bathing or showering.
Wipe properly after using the toilet always from front to back.
Wash thoroughly before and after using the bathroom.
Always practice safe sex, and use condoms to avoid catching or spreading infections.
Vaginal bleeding after sex is common and can happen when you’re not menstruating or don’t expect to be menstruating. Although it’s often called “vaginal” bleeding, the term refers to bleeding from the vagina as well as bleeding from other parts of your genital and urinary systems.
Vaginal bleeding after sex occurs most often in younger, premenopausal women and doesn’t necessarily mean that you need to see a doctor. But vaginal bleeding after sex in older, postmenopausal women is less common and warrants a visit to your doctor to find out what’s causing it.
Causes of bleeding after sex
Bleeding after sex can be a sign of a health condition:
an infection, such as pelvic inflammatory disease (PID), or a sexually transmitted infection (STI), such as chlamydia
vaginal dryness (atrophic vaginitis) caused by reduced vaginal secretions after the menopause
damage to the vagina, such as tears caused by childbirth, or by dryness or friction during sex
cervical or endometrial polyps (benign or non-cancerous growths in the womb or the lining of the cervix)
cervical ectropion (also known as cervical erosion), where there is an inflamed area on the surface of the cervix
In rare instances, bleeding after sex can be a sign of cervical or vaginal cancer.
Symptoms of bleeding after sex
Bleeding after sex may occur with other symptoms depending on the underlying disease, disorder or condition. For example, bleeding after sex due to vaginal dryness may occur with other symptoms of menopause, such as mood swings and cessation of menstrual periods.
Symptoms that may occur along with bleeding after sex
Bleeding after sex may occur with other symptoms including:
Difficulty getting pregnant or infertility
Lower back pain
Nausea and vomiting
Painful bowel movements
Painful sexual intercourse
Pelvic or abdominal pain or cramps
Symptoms of menopause (cessation of menstrual periods, loss of sexual desire, vaginal dryness)
Unusual vaginal discharge
Symptoms that might indicate a serious or life-threatening condition
In some cases, bleeding after sex can be a sign of a serious or life-threatening condition, such as cervical cancer, a sexually transmitted disease (STD), or uterine cancer. Seek immediate medical care (call 911) if you have any of the following symptoms:
High fever (higher than 101 degrees)
Severe pelvic or abdominal pain
Severe or heavy vaginal bleeding
Vaginal bleeding during pregnancy
Tests and examinations
Depending on any other symptoms and your medical history, your GP may recommend some tests or examinations, such as:
a pregnancy test (depending on your age)
a pelvic examination (where the GP inserts two fingers into your vagina to feel for anything unusual)
looking at the cervix with an instrument called a speculum
If the problem is caused by vaginal dryness, they may recommend that you try using lubricating gels.
You may also be referred to a specialist, such as a gynaecologist or genitourinary specialist.
Cervical screening tests
It’s important that all women aged 25 to 64 get regular cervical screening tests to help prevent cervical cancer.
Healthy urine should be clear and straw-coloured, and shouldn’t be particularly smelly.
Some people find that their urine smells stronger and is darker first thing in the morning when it’s more concentrated, or generally when they’re dehydrated.
Also, certain food and drinks, including asparagus, beer, garlic and coffee, may temporarily give urine a stronger smell.
Certain medicines and vitamin and mineral supplements can also alter the odour of urine but never stop taking any medication without speaking to your GP first.
You may find the smell of your urine improves by drinking more fluids. Generally, make sure you drink enough fluid so you’re not thirsty for long periods, and steadily increase your fluid intake when exercising and during hot weather.
Causes of Urine Odor
Urine odor is related to the volume and concentration of a variety of substances excreted by the kidneys. Normally, urine that contains a lot of water has little to no odor. If your urine becomes highly concentrated a high level of waste products with little water urine odor may have a strong ammonia smell.
Many foods and medications, such as asparagus or certain vitamins, can affect the odor of urine. Sometimes, unusual urine odor may indicate a medical condition or disease, such as:
Cystitis (bladder inflammation)
Congenital heart disease in adults
Diabetic ketoacidosis (high levels of blood acids called ketones)
Gastrointestinal-bladder fistula (abnormal connection between the intestines and bladder)
Maple syrup urine disease (rare genetic disease that causes difficulty breaking down certain amino acids)
Metabolic disorder (a problem with the way your body converts the foods you eat into energy)
Type 2 diabetes (uncontrolled)
Urinary tract infection (UTI)
Urine Odor Symptoms & Signs
Normal urine is clear and has a straw-yellow color. While the odor of urine can vary somewhat, in most cases, it does not have a strong smell. With dehydration, the urine is more concentrated and may have a stronger ammonia scent than normal. Consumption of certain foods, such as asparagus (which can impart a characteristic odor to urine), and taking some medications may be causes for changes in the odor of urine. The presence of bacteria in the urine, such as with a urinary tract infection (UTI), can affect the appearance and smell of urine. When there is an infection in the urinary tract, the urine may take on a foul-smelling odor as well as appear cloudy or bloody. A burning sensation during urination may be a symptom of a UTI. The urine may also have an abnormally sweet odor in uncontrolled diabetes, and some rare genetic conditions can also cause the urine to have an abnormal or strange odor.
Sweet or fruity odour
Ketoacidosis (Diabetic, alcoholic, starvation)
Maple syrup urine disease (infants, rare)
Urine at room temperature for prolonged period (“alkaline fermentaion”)
E. coli infection
Contamination with feces
Suppurative diseases of the GU tract
Volatile organic acids most marked in “concentrated” urine specimens
Swimming pool odour
Urine Color Changes
Urine gets its yellow color from a pigment called urochrome. That color normally varies from pale yellow to deep amber, depending on the concentration of the urine. Darker urine is usually a sign that you’re not drinking enough fluid. “Your body needs a certain amount of fluid to function, so the body will hold on to fluid and the urine will become very strong and concentrated. When that happens, it will turn a darker color,” Griebling says.
The opposite is also true. If your urine is very pale, it means that you’re either drinking a lot of fluid, or you’re taking a diuretic a drug that forces the body to get rid of excess water.
Urine can turn a rainbow of colors, and an unusual hue isn’t necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, carrots can tint it orange, vitamins can give it a yellow hue, and an inherited disease called porphyria can shade it the color of port wine.
How Often Do You Need to Go?
How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you’re constantly feeling the urge to go and it’s not because you’re drinking extra fluid, causes can include:
Overactive bladder – involuntary contractions of the bladder muscle
Urinary tract infection
Interstitial cystitis – a condition that causes the bladder wall to become inflamed and irritated
Benign prostate enlargement -growth of the prostate that causes it to squeeze the urethra and block the normal flow of urine out of the body
Neurological diseases, including stroke and Parkinson’s disease
When to see a doctor
Most changes in urine odor are temporary and don’t indicate serious illness. But sometimes an unusual urine odor is associated with an underlying medical condition. If you’re concerned about the odor of your urine, talk to your doctor.
Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the last few inches of your large intestine.
Rectal bleeding may show up as blood in your stool, on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding can range in color from bright red to dark maroon to a dark, tarry color.
Rectal bleeding (blood in stool) facts
Rectal bleeding is the passage of blood through the anus.
The bleeding may result in bright red blood in the stool, maroon colored or black stool. The bleeding also may be occult (not visible with the human eye).
The common causes of rectal bleeding include anal fissure, hemorrhoids, diverticulosis, colon cancer and polyps, colonic polyp removal, angiodysplasias, colitis, proctitis, and Meckel’s diverticula. Rectal bleeding also may be seen with bleeding that is coming from the stomach, duodenum, or small intestine.
Rectal bleeding may not be painful; however, other symptoms that may accompany rectal bleeding are diarrhea, and abdominal cramps due to the blood in the stool.
Rectal bleeding is commonly evaluated and treated by gastroenterologists and colorectal or general surgeons. The origin of rectal bleeding is determined by history and physical examination, anoscopy, flexible sigmoidoscopy, colonoscopy, radionuclide scans, visceral angiograms, and blood tests.
Rectal bleeding is managed by correcting the low blood volume and anemia if present with blood transfusions, determining the site and cause of the bleeding, stopping the bleeding, and preventing rebleeding.
Rectal bleeding can be prevented if the cause of the bleeding can be found and definitively treated, for example, by removing the bleeding polyp or tumor. In addition, there it may be appropriate to search for additional abnormalities, for example, polyps or angiodysplasias that have not yet bled but may do so in the future. This may require either gastrointestinal endoscopy or surgery.
Rectal Bleeding Symptoms
Bright red blood coating the stool
Dark blood mixed with the stool
Black or tarry stool
Bright red blood in vomit
“Coffee-grounds” appearance of vomit
Other signs, which also need a doctor’s attention, include:
Fatigue, weakness, pale appearance
Anemia — your blood is low on iron-rich hemoglobin
The location of the bleeding may affect what you notice.
If it comes from the rectum or the lower colon, bright red blood will coat or mix with your stool. The stool may be mixed with darker blood if the bleeding is higher up in the colon or at the far end of the small intestine.
Rectal Bleeding Causes
Some of the most common causes of visible rectal bleeding in adults are outlined below. However, don’t try to diagnose yourself, and always see your GP for a proper diagnosis.
Click on the links for more information about these causes.
piles (haemorrhoids) – swollen blood vessels in and around the rectum. They can bleed when you have a bowel movement, which can leave streaks of bright-red blood in your stools and on the toilet paper. Piles may also cause itchiness around your anus. They often heal on their own.
anal fissure – a small tear in the skin of the anus, which can be painful as the skin is very sensitive. The blood is usually bright red and the bleeding soon stops. You may feel like you need to keep passing stools, even when your bowel is empty. It often heals on its own within a few weeks.
anal fistula – a small channel that develops between the end of the bowel, known as the anal canal or back passage, and the skin near the anus (the opening where waste leaves the body). They’re usually painful and can cause bleeding when you go to the toilet.
angiodysplasia – abnormal blood vessels in the gastrointestinal tract, which can cause bleeding. It’s more common in older people and can cause painless rectal bleeding.
gastroenteritis – a viral or bacterial infection of the stomach and bowel, which your immune system usually fights off after a few days. It can cause diarrhoea containing traces of blood and mucus, as well as vomiting and stomach cramps.
diverticula – small bulges in the lining of your lower bowel. These contain weakened blood vessels that can burst and cause sudden, painless bleeding (you may pass quite a lot of blood in your stools).
bowel cancer (colon or rectal cancer) – you should always get checked by your GP if you have rectal bleeding. The only symptom of bowel cancer may be rectal bleeding in the early stages, so don’t ignore it. Bowel cancer can be treated more easily if it’s diagnosed at an early stage.
Less common causes of rectal bleeding
Some of the more unusual causes of rectal bleeding include:
anticoagulant drugs – such as warfarin or aspirin, which are taken to reduce your chance of a blood clot but can sometimes cause internal bleeding.
inflammatory bowel disease – such as Crohn’s disease or ulcerative colitis. These long-term conditions cause the lining of the bowel to become inflamed. Crohn’s disease affects the gut higher up, whereas ulcerative colitis affects the large bowel and rectum further down. Both tend to cause bloody diarrhoea.
bowel polyps – small growths on the inner lining of the colon or rectum. These are common and often don’t cause symptoms, but may lead to a small amount of blood in your stool.
sexually transmitted infections (STIs) – any sexual activity involving the anal area can spread STIs, which may sometimes lead to rectal bleeding. Read more about the risks of anal sex.
Diagnosing Rectal Bleeding
Examine your anus visually
Feel for abnormalities within your rectum with a gloved, lubricated finger
Perform a colonoscopy
Recommend a flexible sigmoidoscopy
Use an anoscope, a short tube with a camera on its tip
How Rectal Bleeding is Treated?
Most cases can be treated. Your plan will depend on what’s causing the bleeding.
You may get an endoscopy. For instance, if your upper digestive tract is bleeding, your doctor may be able to control it by injecting chemicals directly into the problem area, using an endoscope to guide the needle. A doctor can also use heat to treat (or “cauterize”) an area that’s bleeding and surrounding tissue through the endoscope, or place a clip on a bleeding blood vessel.
Those techniques aren’t always enough. Sometimes you need surgery.
Once the bleeding is under control, you may need to take medicine to keep it from coming back.
Petechiae are pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechiae to appear red, brown or purple. Petechiae (puh-TEE-kee-ee) commonly appear in clusters and may look like a rash. Usually flat to the touch, petechiae don’t lose color when you press on them. Sometimes they appear on the inner surfaces of the mouth or the eyelids.
There are many conditions in which petechiae may be seen. These conditions range from very minor to very major. The common causes of petechiae include local injury and trauma, allergic reactions, autoimmune diseases, viral infections that impair blood coagulation (clotting), thrombocythemia (an abnormally low platelet level), certain medical treatments such as radiation and chemotherapy, idiopathic thrombocytopenic purpura (ITP), leukemia and other bone marrow malignancies that may lower the number of platelets, and sepsis (bloodstream infection). Petechiae are commonly seen right after birth in the newborn and after violent vomiting or coughing. Drugs such as the anticoagulants warfarin (Coumadin) or heparin, aspirin, and cortisone can also cause petechiae.
Symptoms of Petechiae
Well, symptoms depend on the underlying condition in addition to this petechial spots or rash. Infectious conditions are accompanied by fever, malaise, and flu-like symptoms. There are some other manifestations of the particular system involved by the infection.
The petechiae initially is red in colour. It appears in the form of individual blotches in the preliminary stages. With the passage of time, they coalescence together and then appear as a rash. The petechiae are flat spots that change their colour as the time passes.
It is a must that you see your health care practitioner promptly in case you or a family member develops petechia. It’s vital to establish the cause, given that some underlying setbacks can be potentially grave.
Special Characteristics of Petechiae
There are certain features specific to petechiae that help their earlier detection and differentiate them from other rashes and spots.
Tiny blood vessels (capillaries) link the smallest parts of your arteries to the smallest parts of your veins. Petechiae appear when capillaries bleed, leaking blood into the skin. A number of things can cause this bleeding, including:
Certain medical conditions
Specific types of injuries
Injuries and sunburn
Tiny petechiae of the face, neck and chest can be caused by prolonged straining during activities such as:
Petechiae may result from taking some types of medications, including:
Petechiae may be caused by any of a number of fungal, viral and bacterial infections, including:
Cytomegalovirus (CMV) infection
Hantavirus pulmonary syndrome
Rocky Mountain spotted fever
Sepsis an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced
Viral hemorrhagic fevers
Other medical conditions
Petechiae may also be caused by noninfectious medical conditions. Examples include:
Thrombocytopenia (low platelet count)
Scurvy (vitamin C deficiency)
Vitamin K deficiency
Size of Petechiae
The size of petechiae is not more than a 3mm. These are the tiny hemorrhagic spots. These are usually 0.5 to 1 mm in diameter. Larger form of petechiae measuring greater than 3 mm is termed as purpura.
Location of Petechiae
Petechiae can appear anywhere on our body but the particular area where it is commonly seen include the legs, face, ankles, back, thigh and shoulders.
Colour of the Petechiae
Usually the initial colour of the petechiae is red. It appears in the form of a rash. Then it turns to bluish or purplish. Ultimately, its colour turns to dark purple or blue.