It can be scary to look down in your underwear and see something you aren’t expecting. An unexpected or unfamiliar discharge can turn even the most level-headed of us into frantic Googlers.
A common cause for genital concern in females is white discharge, or leukorrhea. Leukorrhea has a variety of causes. Most are totally normal and benign, while a few are potentially related to an infection.
In this guide we’ll go over all the potential causes for vaginal white discharge in your underwear, what to do if you think you do have an infection, and wrap up with how to avoid future infection if you are infection-prone.
White Discharge: Usually Normal
Vaginal secretions help keep the vagina lubricated and cleansed. Normal discharge ranges from clear to milky white and from watery to jellylike to fairly thick and even sticky. Also, your vaginal discharge may emit a variety of smells, from sweet to salty to musky. Most of this very normal discharge variation can be chalked up to changes in hormone levels throughout your menstrual cycle. So, your white discharge is probably perfectly normal.
What Normal White Discharge Can Mean
There is a panoply of completely benign things that white vaginal discharge (leukorrhea) in your panties could mean.
Normal: You’re Ovulating
During the middle of your menstrual cycle, during ovulation, you will release an increased level of slippery, wet mucous with a consistency like egg whites. While this discharge is usually clear when wet, it may form crusty white or yellowish stains in your underwear when it dries.
Normal: Your Period Is About to Start
Discharge generally becomes much thicker, whiter, and stickier in the several days immediately before your period begins. This is due to changing hormone levels and increased production of mucous from the cervix. So a thick white discharge could just mean your period is about to start.
Normal: You’re Stressed
Stress affects your hormone levels, which can cause changes in vaginal mucous production. This in turn can cause a discharge that is a little different in color, texture, or quantity than usual, including white discharge in your underwear.
Normal: You’ve Changed Your Diet
The pH of the vagina is slightly acidic, which helps to prevent infection. However, the foods that you eat can affect the pH of the vagina, leading to slight changes in color, consistency, or even smell of vaginal discharge. So, if you’ve recently changed the foods that you eat, you could notice discharge that’s whiter, thicker, thinner, etc.
If the vagina loses too much of its acidity and becomes too basic, you will be at increased risk of infection, but a slight change in discharge due to a changed diet isn’t anything to be worried about on its own.
Normal: You’re Aroused or Were Recently Sexually Active
Arousal causes an increase in vaginal secretions. Normally these secretions are fairly watery, so you may notice increased moisture that is typically clear but could dry to a whitish or yellowish color. However, orgasm causes the vagina to secrete a thick, white discharge.
Additionally, if you have recently engaged in unprotected penis-in-vagina intercourse, it might actually be semen you’re seeing. A certain quantity of semen is typically discharged from the vagina sometime in the 24 hours following sexual intercourse. It will generally be slippery and white.
Normal: You’re Pregnant
Increased quantities of thick, milky white discharge is one of the earliest signs of pregnancy. These increased quantities of thick discharge often continue throughout the pregnancy. This is caused by elevated estrogen levels and helps keep the vagina infection-free.
Normal: You’re Taking Hormonal Birth Control
Because hormonal birth control affects your hormone levels, it can also affect your discharge. So if you have recently started or changed your hormonal birth control, a change in discharge color, consistency, or quantity could be a side effect.
So that’s a LOT of normal reasons you could have white discharge.
But there are a few reasons white discharge is abnormal and suggestive of a health problem. Let’s cover them.
4 Signs Your Discharge May Indicate a Health Issue
There are a few signs associated with white vaginal discharge that indicate that you may have an infection of some kind:
- Unusual Texture—your white discharge is chunky like cottage cheese, extremely thick like cream cheese, or frothy like foam or soap bubbles.
- Odor—you have unusually smelly discharge; particularly a fishy or rotten smell.
- Itching, burning, discomfort—if you are experiencing any kind of itching, burning, or discomfort in your vulva (with or without urination) in tandem with your discharge, it’s likely you have an infection.
- Color—if you have a discharge that is yellowish, greenish, or gray when wet, this could indicate an issue.
If you’ve had normal white discharge before, you have a way to compare your current discharge. If it seems out of the ordinary, trust your instinct – pay attention to it rather than letting it go.
Read on for some common conditions associated with leukorrhea, how to identify them, and what to do if you have them.
Common Vaginal Infections Associated With Discharge and What to Do About Them
Here’s an overview of common infections/conditions that may cause abnormal white or whitish discharge, how you might contract them, and what to do if you think you have one.
Again, don’t freak out by reading these – we just want to be complete and let you know everything that might be happening, within reason. As we described above, most white discharge is pretty normal. You’ll be the best judge – if you feel like something is unusual, then err on the safe side and check with a doctor.
A small amount of yeast organisms normally live in the vagina. Yeast is a fungus whose numbers are held in check via a delicate balance between bacteria and other normally-occurring vaginal microorganisms. When this balance is disrupted, it can lead to an overgrowth of yeast in the vagina, which causes a yeast infection.
Yeast infection discharge is, in general, fairly distinctive. Yeast infections cause “cottage-cheese discharge”—white (maybe with a grayish cast) and clumpy.
Yeast infection symptoms include:
- Severe itching
- Painful urination
- Painful intercourse
- Red skin around the vulva
Common risk factors for yeast infections include antibiotic use, which kills the regulating bacteria; stress, pregnancy, and use of oral birth control, which affect hormone balance; vaginal douching, which upsets the vagina’s pH; and a depressed immune system.
Diagnosis and Treatment
Yeast infections can be diagnosed by a pelvic exam and a swab of tissues at the doctor’s office; however, they can also be treated with over the counter antifungal creams or vaginal suppositories. Note that some of the ingredients in OTC yeast infection treatments can compromise the latex in condoms or diaphragms, so use an alternate form of birth control if you have sex while doing the treatment course.
However, if you aren’t totally sure it’s a yeast infection, you’re pregnant, or you’ve had recurring yeast infections, go see a doctor to get a confirmed diagnosis. They will be better able to identify the exact issue and offer the safest, best treatment.
Similar to a yeast infection, bacterial vaginosis is caused by an overgrowth of some of the microorganisms that normally reside in the vagina – this time from bacteria, not yeast.
Bacterial Vaginosis (BV) causes a thin, watery discharge that is white or gray and smells very fishy; the odor may be stronger after sex. How thin is thin and how fishy is fishy? Again, you have to compare it to your usual discharge to tell if it’s unusual.
The discharge is generally the main symptom, although in rare cases burning during urination or itching may occur. About half of infections are asymptomatic.
Risk factors include new or multiple sex partners, smoking, having an IUD, vaginal douching, and recent antibiotic use. It is not considered an STI, but women can pass it to other female sex partners.
Diagnosis and Treatment
If you think you have BV, you need to go to the doctor to be treated. BV is diagnosed through pelvic exam, a test of vaginal secretions, and a test of vaginal pH. It is treated through antibiotics, delivered orally in pill form or topically via a cream. Antibiotics are effective, although many women will contract BV again after treatment.
Infection with BV may increase the risk of contracting PID (pelvic inflammatory disease) in the future. Current infection with BV also increases the likelihood of contracting any STIs that one is exposed to while infected. BV may also cause pregnancy complications.
Trich is a sexually-transmitted infection caused by the parasite Trichomonas vaginalis.
Trichomoniasis (or Trich) causes a thin, frothy, smelly discharge with a foul or fishy odor. The discharge may be clear, white, yellow, gray, or green.
Many people with Trich (70%) have no symptoms. For those who are symptomatic, symptoms usually develop within 5 to 28 days, and if the infection is untreated, symptoms can come and go. Common symptoms (in addition to the discharge) include:
- Burning or itching in the vulva area
- Genital redness
- Frequent urge to urinate
- Painful urination
As Trich is an STI, risk factors include multiple sexual partners and unprotected sex; however, it can also sometimes be transmitted in non-sexual contexts where the organism can thrive in a warm, moist environment, like an improperly maintained hot tub. Previous Trich infections are also a risk factor for future infection.
Diagnosis and Treatment
Trich is diagnosed by a physical exam and swab test at the doctor’s office. It can be treated through a complete course of antibiotics. If you have suspect you may have Trich, go to a doctor (a walk-in primary care clinic is fine if you can’t get in with your gynecologist or primary care provider fast enough). Once you have been diagnosed and treated, you may want to get re-tested in three months to make sure the infection hasn’t recurred.
Complications of Trich include pregnancy complications (if infected while pregnant) and increased risk of HIV transmission (if HIV positive) and infection (if HIV negative).
Gonorrhea is a bacterial STI, and one of the most common STIs in general.
Gonorrhea can cause increased quantities of a greenish-yellow or whitish discharge. There may be blood in the discharge.
Many women have no symptoms, or mild symptoms that they mistake for another infection, like a yeast infection. For those who are symptomatic, symptoms normally develop between two and fourteen days following exposure. Possible symptoms include:
- Burning urination
- Increased urge to urinate
- Abdominal pain
- Pain or swelling in the vulva
Risk factors for gonorrhea include multiple sex partners and engaging in unprotected sex acts.
Diagnosis and Treatment
Gonorrhea can be diagnosed by a medical professional through a urine test or by taking a swab of the infected area. Gonorrhea often co-occurs with chlamydia, so if you are diagnosed with gonorrhea, you will probably also be treated for chlamydia (because the treatment is actually less expensive than the testing!)
Gonorrhea is treated with antibiotics—often a single dose. Sex partners should also be treated to avoid reinfection, and those with gonorrhea should avoid sexual contact for a week after treatment is completed. If you are diagnosed with gonorrhea, take your complete course of medication as directed and be sure to abstain from sex for the recommended time period.
Gonorrhea is sometimes confused for a yeast infection in people who have it. If you try to self-treat for a yeast infection and it’s actually gonorrhea, the infection will ultimately be harder for a doctor to diagnose and treat. This is why if there’s even a chance your infection might be gonorrhea (or any other thing that’s not a yeast infection), you should go to the doctor.
If a gonorrhea infection spreads to the uterus, fallopian tubes, and/or ovaries, it can lead to pelvic inflammatory disease (or PID). This may cause fever and vomiting in addition to the other symptoms of gonorrhea. While PID is treatable with antibiotics, it may leave scarring or damage to the reproductive organs that can affect future fertility. This is why going to the doctor ASAP if you suspect gonorrhea is critical.
Chlamydia is another common STI.
Chlamydia can cause increased quantities of yellowish discharge or milky-white vaginal discharge, frequently smelly.
Like gonorrhea, chlamydia is often asymptomatic. Symptoms normally develop 7-21 days after exposure if they do develop, and they can include:
- abdominal or back pain
- pain with sex or urination
- increased urge to urinate
- spotting between periods
- blood in urine
Risk factors for chlamydia involve multiple sex partners and unprotected sexual behavior.
Diagnosis and Treatment
As with gonorrhea, those with chlamydia may initially mistake it for another infection and attempt to self-treat. This is why, again, going to the doctor if you are not absolutely certain is essential. Doctors can diagnose chlamydia with a urine sample or a swab of your vagina or cervix. Treatment usually either involves a one-dose antibiotic or seven-day antibiotic course, and all sexual activity should be ceased for seven days after treatment is completed. Sex partners should also be treated to avoid reinfection.
If chlamydia goes untreated it may develop into PID, which while still treatable may cause permanent damage to reproductive tissues and future fertility.
Okay, so this isn’t an infection, but if your vulva is exposed to an allergen or irritant it can cause similar symptoms to an infection, including:
- Increased, changed, or smelly discharge
- Vulvar pain
Common culprits in the allergy area include spermicides, vaginal douches, scented soaps and lotions, and scented laundry products (detergents and fabric softeners). Try using only mild products on anything that will be in direct contact with your vagina/vulva.
You can also get an infection from leaving in a tampon too long, which can cause similar symptoms. If this has happened to you, you may want to start setting an alarm when you put a tampon in so you remember to take it out after eight hours.
How to Avoid Vaginal Infections
If you are prone to vaginal infection, there are several steps you can take to help minimize your risk.
Tip 1: Eat Vaginal Health-Promoting Foods
Did you know that eating a high-sugar diet can promote yeast infections? Well, now you do! Something to consider if you are prone to contracting them.
In general, a healthy diet means a healthy vagina. But there are also a number of foods with particular powers to help promote a happy, infection-free vagina:
- Cranberries: The acidic compounds in cranberries help promote the proper vaginal pH to prevent a bacterial invasion. Just make sure you get low- or no-sugar cranberry juice to get the benefits. Most store-bought cranberry juices are very high in sugar, low in actual juice, and will not really improve the health of your vagina.
- Low-sugar yogurt: Low-sugar yogurt with live and active cultures has a probiotic effect and helps the good bacteria down there thrive. Greek is a good choice.
- Kimchi and other fermented foods: Like yogurt, fermented foods like kimchi are probiotics, keeping the good bacteria happy and the bad bacteria out of your delicate parts.
- Garlic: Because garlic is anti-microbial, it helps keep yeast infections away.
- A variety of fruits and veggies: eating lots of different fruits and veggies will help provide you with the micronutrients you need to have a healthy immune system, which will help you fight infection.
- Water: Staying hydrated helps your vagina’s self-regulatory cleaning functions running smoothly, so your body can do its job to fight and prevent genital infection.
Tip 2: Wear The Right Clothes
What you wear can actually have a pretty profound effect on your vaginal health. So follow these tips to prevent vaginal infection:
- Cotton underwear is a must if you’re prone to infection because it’s breathable and won’t trap bacteria-fueling moisture in your crotch. You may also want to avoid thongs, which can transfer bacteria from the anus to the vagina.
- Avoid tight clothing and pantyhose that’s not made out of natural-fiber, breathable fabrics. These will trap moisture and can rub and chafe.
- For working out, avoid spandex and change out of your moist, sweaty clothes as soon as you can when you’re done.
Tip 3: Keep Germs Away From Your Vulva and Vagina
There are a few things you can do to avoid introducing germs to your vagina in your day-to-day life:
- After using the bathroom, wipe from front-to-back to avoid transferring bacteria from your rectum to your vagina.
- Wash your hands before and after masturbation and keep anything that goes inside your vagina (sex toys, diaphragms, medicine applicators, etc) clean and dry.
- Wash the labia with a gentle cleanser when you shower or bathe, and make sure you stay dry down there the rest of the day!
- Don’t go longer than 8 hours without changing your pads and tampons! This can cause bacteria to bloom and infection to occur.
Tip 4: Don’t Get Irritated (Down There)
The vagina and vulva are made of delicate tissues, and it doesn’t take a lot to irritate them, creating a cycle of itching, discharge, discomfort, and infection. Here’s how to keep everything comfy:
- Keep scents away—chances are, if it’s scented, it might irritate you. So if you’re prone to irritation and/or infection, keep away from scented or soapy bubble baths, scented tampons and pads, fragrant laundry projects, and scented vaginal deodorants or wipes.
- Use only gentle products around the labia and vulva. Avoid strong soaps and spermicides, and use gentle lubricants with low glycerin levels to prevent irritation.
Tip 5: Avoid Upsetting Your Vaginal pH
Your vagina is self-cleaning and maintains a particular pH to prevent infection. To this end, there’s one extremely important thing you can do for your vaginal health: do not douche or place soap or cleansers inside your vagina. The vagina does not need to be flushed out or washed out. In fact, this makes the vagina even less hygienic by disrupting the pH balance in the vagina, altering the balance of good to bad bacteria, and even forcing existing infections up further into the reproductive tract. Douching and cleansing the vaginal canal actually cause infection.
Tip 6: Practice Safe Sex
As several of the infections listed are sexually transmitted (or sometimes associated with sexual activity, like BV), an important way to protect yourself is to practice safe sex. So use condoms or dental dams with your partner unless you are in a sexual relationship where all parties have been tested for STIs.
Vaginal Discharge: Key Facts
If you’re experiencing white vaginal discharge in your panties, it’s almost certainly completely normal. Here are some benign causes of white vaginal discharge (or leukorrhea):
- You’re ovulating
- Your period is about to start
- You’re stressed
- You’ve changed your diet
- You’re aroused and/or were recently sexually active
- You’re pregnant
- You’re on hormonal birth control
Here are signs you may have cause for concern:
- The discharge has an unusual texture—especially if it’s very thick or has clumps like cottage cheese
- A strong, unpleasant odor, particularly one that’s fishy or rotting
- It’s accompanied by pain, swelling, burning, itching or redness in the vulva
- It’s an unusual color—yellowish, greenish, grayish—when wet
These are the most common vaginal infections associated with white discharge:
- A yeast infection—causes clumpy cottage-cheese discharge
- Bacterial Vaginosis—causes fishy-smelling, thin, watery discharge
- Trich—causes a frothy, fishy-smelling discharge
- Gonorrhea—causes increased quantities of whitish or greenish-yellow discharge, potentially with some blood
- Chlamydia—causes increased quantities of smelly, milky-white discharge or yellow discharge
- Allergies—Not an infection, but if you’re allergic or sensitive to a product that’s being exposed to your vagina, it can cause unusual discharge.
If you are prone to infection, here’s how to help minimize your risk and promote a robustly healthy vulva/vagina:
- Eat vaginal health-promoting foods like cranberry juice, low-sugar yogurt, kimchi and other fermented foods, garlic, fruits and veggies, and lots of water!
- Wear cotton undies, avoid tight clothes, and change out of damp clothes immediately.
- Make sure anything that goes near your vulva (including your hands!) is clean to keep germs away.
- Keep scents and harsh chemicals away from your vulva/vagina.
- Don’t douche or use soaps or cleansers in the vaginal canal—this will disrupt your vaginal pH and cause infection.
- Practice safe sex!