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Vaginal Health 101: What’s Normal?
Figuring out what is considered “normal” when it comes to the vagina is a struggle that many people go through. Vaginal health can be a confusing topic, especially for younger people who don’t have access to comprehensive sex education or trusted adults they can go to with questions.
To gain some clarity on this issue, I spoke to Cheryl Brown, R.N., M.S., A.P.N.-C., a certified family nurse practitioner who has worked at Rutgers University Health Services since 1990. She enjoys helping young adults because it gives her pleasure to “educate them about health and their bodies in the hopes of helping them to develop healthy lifestyle choices.” Here’s what she had to say:
Sex, Etc.: What vaginal conditions do patients see you for that are not sexually transmitted diseases (STDs)?
Cheryl Brown: Women [and girls] may [come to see me] when they have vaginal discharge that they are unsure of or that is different from what they normally have. Often, someone may come in for irregular periods or for vaginal odor. The most common vaginal infections that are not caused by sexually transmitted infections (STIs) are yeast and bacterial vaginosis (BV).
Sex, Etc.: How can you distinguish between normal and unhealthy vaginal discharge?
Cheryl: Vaginal discharge is normal…. This is your body’s way of keeping your vagina healthy and clean. The discharge is usually clear or milky and does not smell bad…. Changes that may signal a problem include an increase in the amount, a change in the color or smell and irritation, itchiness or burning in or around your vagina. Discharge that is stained with blood when you are not having your period may also indicate a problem.
Sex, Etc.: What is considered normal vaginal spotting and when might it signal a problem?
Cheryl: During the first few years of having your period, it’s not unusual to have irregular periods, bleeding between periods or spotting. Once a pattern is established, if bleeding in between periods occurs and is accompanied by an odor, unusual vaginal discharge or pain with or after intercourse, it is probably wise to have it checked out by a health care professional.
Sex, Etc.: Can certain lifestyle factors have an impact on developing yeast infections or BV?
Cheryl: Changes in vaginal discharge can occur if the normal balance of healthy bacteria in your vagina is upset. Many things can cause this imbalance, including douching, feminine hygiene spray, certain soaps or bubble baths, antibiotics, diabetes, pregnancy or infections.
Sex, Etc.: Do these conditions affect your ability to engage in sexual activity?
Cheryl: If you have an active infection, it is always a good idea to wait until you are symptom-free to engage in sexual activities. You want to give your body a chance to heal and also to protect your partner from becoming infected.
Sex, Etc.: How are these conditions typically treated?
Cheryl: It depends on the type of infection. Some are treated with antibiotics and others with antifungals. Some are treated with a pill and others with a cream that is inserted into the vagina. It depends on the person, the type of infection and other circumstances.
Sex, Etc.: Is seeing a doctor always necessary? What can happen if you don’t get treatment?
Cheryl: It’s always suggested that you see a provider if this is the first time you’re experiencing symptoms or if the symptoms just “don’t seem right.” Not all vaginal discharge is a yeast infection and letting a bacterial infection or sexually transmitted infection go without treatment can lead to long-term complications or spread the infection to others.
Sex, Etc.: Some teens might be intimidated by the idea of visiting a doctor for one of these problems. What can they expect?
Cheryl: You can expect to have someone sit down with you and take a thorough history. This includes asking personal questions about your sexual health. You can also expect to have someone examine the area and possibly take samples of secretions to examine under a microscope.
Sex, Etc.: Any message you’d like to share about vaginal health in general?
Cheryl: Practicing good personal care and keeping a healthy vagina are important. If you have specific questions about what is normal, you should always contact your health care provider. Do not make yourself crazy by practicing the “what-if game” or researching things on the Internet. Sometimes the information on the web is too general and the potential diagnoses are frightening. Get yourself checked out and treated the right way the first time!
