Sexually Transmitted Infections (STIs): An Overview, Payment, and Coverage | KFF
Causes Of Heavy Vaginal Discharge
Some vaginal discharge is a sign of a healthy reproductive system. Heavy vaginal discharge can occur due to arousal, ovulation, infections, or fluctuations in hormones.
At certain points in the menstrual cycle, people can have more discharge than usual. This can also occur in people who are pregnant, about to begin their first period, or who are taking hormone medications.
Healthy discharge is clear, white, or off-white. Discharge that is an unusual color has a strong smell could signal an underlying condition.
This articles discusses why someone may have heavy vaginal discharge and what they can do about it.
One potential cause of wetness around the vagina is arousal. Sexual arousal causes glands near the vaginal opening, known as the Batholin glands, to produce fluid.
Together with the moisture already inside the vagina, this provides lubrication for sexual intercourse. People may mistake this for excessive discharge.
Arousal fluid is clear and watery with a slippery texture. Other signs of arousal in females include:
For those who have periods, ovulation marks the point at which the ovaries release an egg. It usually happens around 14 days before menstruation.
Estrogen increases in the time leading up to ovulation, and with it, so does discharge. The cervical fluid may become clear and slippery, similar to that of raw egg whites. After ovulation, discharge decreases. People may only have a small amount of discharge, or none at all.
Estrogen is also high a few months before the first period, and can be higher when taking estrogen medications, such as hormonal birth control or fertility drugs. People may experience more discharge in these situations, too.
People often have more vaginal discharge when they are pregnant. This can help protect the vagina and developing fetus from infections.
Towards the end of pregnancy, the amount of discharge may increase further. Before birth, the fluid may contain streaks of pink mucus. This is a sign that the body is preparing for labor.
If a person notices an increase in discharge and their period is late or does not come, they may benefit from taking a pregnancy test.
Vaginitis refers to inflammation of the vagina. This can occur due to irritation from tight clothing, scratchy fabrics, lubricants, or other personal care products. Alternatively, it could be due to an infection.
If the cause is an infection, a person with vaginitis may have thick vaginal discharge that may be white, gray, yellow, or green, with a strong unpleasant smell.
Other symptoms of vaginitis include:
Bacterial vaginosis (BV) is a condition that results from an overgrowth of bacteria in the vagina. This vaginal infection is the most common among females aged 15–44 years.
The exact cause of BV remains unclear. It usually occurs in people who have been sexually active, but it is not a sexually transmitted infection (STI). It may be a result of disturbance to the microbes that live in the vagina.
According to the Office on Women's Health, those who have BV may notice a milky or gray-colored vaginal discharge. Some also report a strong, fishy vaginal odor, especially after sexual intercourse.
BV can also cause:
Vaginal yeast infections result from an overgrowth of a fungus known as Candida albicans. Nearly 70% of females will have a yeast infection at some point in their lives.
The most common symptom of a vaginal yeast infection is an intense itching in the vagina and vulva. Vaginal yeast infections can also cause an odorless vaginal discharge that looks similar to cottage cheese.
Vaginal yeast infections are treatable at home using over-the-counter antifungal ointments. Symptoms should improve within a few days. However, severe infections can last longer and may require medical treatment.
Trichomoniasis is an STI that occurs due to a parasite. People can develop trichomoniasis after having sex with someone who carries it.
Although most people who have trichomoniasis do not experience symptoms, some may have an itching or burning sensation in the genital area.
Trichomoniasis infections can also cause excess vaginal discharge that has a foul or fishy odor and a white, yellow, or green color. It may also be thinner than usual.
Healthy vaginal discharge can vary in color and consistency. It can be thin and watery, or thick and cloudy. The color may be clear, white, or off-white.
Some may also have brown, red, or black vaginal discharge at the end of their menstrual periods if their vaginal discharge still contains blood from the uterus.
The amount of vaginal discharge that is usual can vary from person to person and changes throughout the menstrual cycle, as well as during puberty, pregnancy, or menopause.
It is not always necessary to see a doctor about excessive vaginal discharge. However, a person may want to consider seeing their doctor if their vaginal discharge changes in quantity, appearance, or smell.
Yellow, green, gray, or unpleasant-smelling vaginal discharge could indicate an infection. Other reasons to see a doctor include:
Treating excess vaginal discharge depends on the underlying cause.
People can reduce symptoms of vaginitis by avoiding the source of irritation. Keeping the vulva clean using water, and wiping from front to back when using the bathroom, may help to prevent recurring infections.
Doctors can treat infections, including trichomoniasis, using antibiotics or antifungals. Wearing barrier methods of contraception, such as condoms, can also reduce the chances of getting an STI.
Treatment for PCOS varies depending on the individual. A doctor may recommend a combination of lifestyle changes and medications to help people manage their symptoms and regulate their hormone levels.
Maintaining a healthy body weight and eating a varied diet low in added sugars may also help improve some symptoms of PCOS. Birth control pills that contain estrogen or progestin can help balance out excess levels of androgens.
Even healthy vaginal discharge can cause discomfort at times. Here are some tips for managing heavy vaginal discharge:
Below are the answers to common questions about discharge.
Is it normal to have white discharge everyday?White vaginal discharge is typical, and some people may have some every day. However, if the discharge is thick and clumpy, and a person experiences itchiness, this could be a sign of a yeast infection.
Why am I discharging so much and it smells?If a person suddenly has much more discharge than usual and it has a strong odor, this could be a sign of an infection. It is important to speak with a doctor for a diagnosis.
Why do I have so much watery discharge?Watery discharge can be typical. If it is clear and does not smell unpleasant, it may not be a sign anything is wrong. But if the discharge is grey, milky, and smells unpleasant, this could be BV.
Excess vaginal discharge can occur as a result of ovulation, arousal, or infections. Typical vaginal discharge ranges in color from clear to white of off-white.
The consistency of vaginal discharge also varies from thin and watery to thick and sticky. Generally, healthy vaginal discharge should be relatively odorless.
Doctors can treat most causes of heavy discharge. Depending on the cause and severity, people may see their symptoms improving within a few days to weeks.
What To Know About Gonorrhea
Gonorrhea is a common sexually transmitted infection (STI). Early signs of gonorrhea include a white, green or yellow discharge and pain on urination, but there may be no symptoms. Treatment typically involves antibiotics.
Treatment is essential and is usually effective if a person has an early diagnosis.
In 2019, there were 616,392 diagnoses of gonorrhea in the United States.
It is a notifiable disease, which means that a doctor needs to report all cases to the National Notifiable Diseases Surveillance System. This information enables health authorities to plan treatment and prevention strategies.
Gonorrhea is usually easy to treat, but any delays can result in serious and sometimes permanent complications. For example, pelvic inflammatory disease (PID) can develop when gonorrhea affects the uterus or fallopian tubes. This can lead to infertility.
Another complication is epididymitis, which is inflammation of the tube that carries sperm. This, too, can result in infertility.
Many people with gonorrhea have no symptoms. Those who do often experience a burning sensation during urination.
A person with a penis might also notice:
A person with a vagina might have increased vaginal discharge and bleeding between periods.
Rectal symptoms may also occur if a person has anal sex. These may include:
If gonorrhea results from oral sex, the infection can be located in the throat, but it may cause no symptoms.
Gonorrhea is a bacterial infection, and if semen or vaginal fluid that contains this bacteria enters the eye, the person may develop conjunctivitis, commonly called "pink eye."
A person might receive a diagnosis of gonorrhea if they see a doctor due to symptoms or suspected exposure to the bacteria.
The doctor will ask the person about their symptoms and medical history. They will also order a test, which might require a urine sample or a swab of the penis, cervix, urethra, anus, eyelid, or throat.
At-home tests are also available. A person using an at-home testing kit sends their sample to a lab and receives the results directly. If the result is positive, they need to see a doctor for treatment, and the doctor may wish to do another test to confirm the result.
It is crucial to use the kit exactly as instructed, or the result may not be accurate. Because the tests can vary in accuracy, it is better to see a healthcare professional, if possible.
If one person has a diagnosis of gonorrhea or another STI, any sexual partners should also receive testing.
Everyone with gonorrhea needs treatment to stop the infection from progressing. The treatment typically involves antibiotics.
It is important to receive treatment as soon as possible. Doctors may not be able to treat complications that the infection has already caused.
The Centers for Disease Control and Prevention (CDC) recommends a single dose of 500 milligrams of intramuscular ceftriaxone (Rocephin).
Doctors used to administer ceftriaxone plus a dose of azithromycin, but health authorities changed the guidelines in 2020. This is because the bacteria that cause gonorrhea, Neisseria gonorrhoeae, are becoming increasingly resistant to azithromycin.
There are certain situations in which a doctor might recommend a different treatment — for example, one that involves taking an oral antibiotic. In this case, it is crucial to take the full course of medication and avoid sharing it with anyone else.
Antibiotic resistance is making gonorrhea increasingly difficult to treat. If a person does not notice any improvement in their symptoms after several days, they should return to their doctor for guidance. Further testing can determine whether the treatment is working.
It is important to attend any follow-up appointments and avoid having sex until a healthcare professional says that it is safe to do so.
If gonorrhea occurs during pregnancy, it is essential to let the healthcare team know. The infection can pass to the baby during delivery, so the newborn may need antibiotics right away.
Some newborns develop conjunctivitis, and gonorrhea is one possible cause. The symptoms usually appear 2–4 days after birth and include red eyes, thick pus in the eyes, and swollen eyelids.
If any of these symptoms arise, seek medical attention immediately.
N. Gonorrhoeae bacteria are responsible for gonorrhea. They thrive in warm, moist environments, and the infection can develop in any of the body's mucous membranes, including those in the genitals, mouth, throat, eyes, and rectum.
Gonorrhea can pass from person to person through sexual contact that involves the penis, vagina, anus, or mouth. It can pass on without a male ejaculating. Gonorrhea can also transmit to a newborn during delivery.
Gonorrhea can cause various severe complications. For this reason, it is important to receive treatment as soon as possible.
For a person with a vagina, gonorrhea can lead to:
Other complications of the infection can occur during pregnancy and delivery. And without treatment, gonorrhea increases the risk of stillbirth.
If the infection transmits to a newborn, it can cause a joint infection, loss of vision, or bacteremia, a life threatening blood infection.
In a person with a penis, gonorrhea can lead to epididymitis, which can cause problems with fertility.
And in everyone, untreated gonorrhea can lead to infections in the joints that could require IV treatment.
The STI can also lead to disseminated gonococcal infection, which can be life threatening. Some signs and symptoms include:
In addition, people with gonorrhea have a higher risk of contracting or transmitting HIV. One reason is that either infection can cause open sores, which make it easier for viruses and bacteria to enter the body.
Ways to prevent gonorrhea include:
Male Infertility: Causes, Treatments And More
When it comes to infertility in both males and females, sometimes the cause is a mystery, a diagnosis officially known as unexplained infertility. But there are certain causes that can be identified— age, for example, can be a big factor in fertility not just in women, but men as well.
"Older men are often more infertile than younger men, because sperm count can change with age," says Zev Rosenwaks, M.D., director and Physician-in-Chief of The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell in New York. "The genetic makeup of the sperm can change as well, and something called DNA fragmentation can cause genetic abnormalities."
Certain genetic conditions can have an impact on male fertility, too, adds Dr. Douglas. "Genetic mutations that lead to medical conditions such as cystic fibrosis, Kallmann syndrome and Klinefelter syndrome, cryptorchidism, thyroid disease and varicoceles can impact sperm production, transportation of sperm through the testes and/or the quality of the sperm," she explains. "Y chromosome microdeletions [a genetic disorder caused by missing genes in the Y chromosome that are correlated with infertility], in particular, are one of the most common biological issues that cause impaired sperm production."
Erectile dysfunction or decreased libido can also contribute to male infertility, Dr. Douglas notes, because there are few (or no) opportunities for conception to occur.
Lifestyle factors play a role, too, such as weight, says Dr. Rosenwaks—when you're overweight, it can have an impact on hormones and sperm.
Meanwhile, "tobacco use can lower sperm counts and viability while increasing the percent of sperm with abnormal morphology [meaning they're misshapen or crooked]," adds Dr. Douglas. "Heavy cannabis use and alcohol consumption can also decrease sperm function. These have lingering effects, though they typically subside three to six months after the usage stops."
Additionally, she says, prolonged exposure to endocrine disrupting chemicals (EDCs), such as toxins, pesticides and plastic contaminants, can impact fertility hormones and disrupt sperm function.
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