Why You Shouldn't Wear Underwear To Bed, And Other Surprising Things To Know About Vaginal Discharge

Considering that everyone who has a vagina deals with vaginal discharge, it's a little strange that the topic feels almost taboo. Bringing it up in conversation feels like mentioning something somewhere between vulgar and just plain gross. The real drawback about all the squeamishness? It was probably glossed over in the birds-and-the bees conversation with your parents, and it often goes forgotten in sex-ed classes, but vaginal discharge can tell you a lot about your health.

So, I asked Dr. Yolanda Kirkham, an obstetrician-gynecologist at Women’s College Hospital and St. Joseph’s Health Centre in Toronto, a ton of questions about vaginal discharge. Here's how our totally non-awkward conversation went.

So, what is vaginal discharge, exactly?

It’s the vagina cleaning itself. It’s just like your nose and your eyes — we make a small amount of mucous every day. That’s how the vagina cleans itself, whether by getting rid of old cells, or other material.

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When does it start?

When you are peri-pubertal, when you’re expecting your first ever period, you would notice some clear discharge from six months to a year before that. It’s an indicator your time is coming.

During your reproductive life, the [purpose] discharge is for intercourse to become easier as you become sexually active. Once you hit menopause, because your ovaries are not secreting as much estrogen anymore and getting ready to wind down, you get less discharge. In menopause, a lot of patients come in and complain they’re dry. It’s a big problem for intercourse. A lot of post-menopausal women come for estrogen or other treatments because they’re so uncomfortable. So cherish it while you have it.

Excuse my ignorance: Is there a difference between vaginal discharge and the lubrication that happens during intercourse?

It's generally the same, though it may come from different areas. The vagina walls themselves secrete mucous, as does the cervix, and we have these glands called the Bartholin's glands near the entrance of the vagina, and they make that lubrication as well.

The more aroused you are, the more blood supply you get to your vagina, and the more extravasation — that's a fancy word for when the vaginal wall becomes fluid and filters out.

It has multiple purposes!

Yes! It’s for cleaning, but also for making sex pleasurable, and it helps you reproduce. It also helps the sperm swim and migrate to where they are going. It helps with pregnancy, too.

When does it normally happen?

About 14 days before your period (i.e., before your egg gets released), your discharge gets more thin and stringy, kind of like egg whites — it would be sticky between your fingers. That’s called ovulatory mucus. For people who are trying to get pregnant, when they see that, they’ve got 12–24 hours to conceive. If you’re trying to avoid getting pregnant, then you would avoid having sex at that time, or use condoms. As you approach your period, it may get a thicker, white and creamy texture.

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All right, when should I be concerned?

It should not get itchy or smelly. You shouldn’t have any burning, or painful intercourse, any painful urination, or any other bleeding with intercourse — those are worrisome signs. It also shouldn't be green, tinged with blood, chunky or cottage cheese–like. You shouldn’t be so uncomfortable that you can’t sit still.

What causes this cottage cheese–like discharge?

The most common thing is yeast. We all have yeast, but it’s an overgrowth when it bothers you. Bacterial vaginosis (BV) discharge will have more of that thin texture and fishy smell. If you have it, go to a walk-in or your family doctor and get a vaginal swab done, to diagnose.

Okay, any other discharge-related advice?

At night, sleep without underwear — let your vagina breathe. Wear a nightgown or really loose pyjama pants with no underwear, something airy. And don't put any soap up there, just water. Soap changes the vaginal pH, and that’s why you get strange discharge. Also, no creams, no douches ever. You don’t wash your eyes and nose with soap, so do the same for your vagina.

And this is important: Sometimes people make a comment about vaginal discharge and it’s terrible, but it’s normal. We shouldn’t have to feel ashamed about a normal process.

This interview has been condensed and edited for clarity.