Vaginal symptoms such as itching, discharge, or odor are common reasons women seek medical advice. — Photo: canva.com

Vaginal symptoms are one of the most common reasons women visit a gynaecologist. Understanding what is normal and when to seek care can reduce anxiety and help ensure timely treatment when needed.

Many women experience changes in discharge, itching or irritation at different stages of life. While many of these changes are harmless, some symptoms may signal infection or another medical condition that should be evaluated by a healthcare professional.

What is normal vaginal discharge?

Normal vaginal discharge:

• Is usually clear, white or slightly milky
• Has little or no odour
• May change during the menstrual cycle
• Can increase around ovulation, pregnancy or sexual arousal

These changes reflect normal hormonal fluctuations and help keep the vagina clean and protected.

Common vaginal symptoms that need evaluation

You should consult a gynaecologist if you notice:

• Persistent itching or burning
• Strong or unpleasant odour
• Thick, clumpy, yellow, green or grey discharge
• Pain during urination or sex
• Vaginal redness or swelling
• Bleeding unrelated to menstruation

These symptoms may indicate infection or another vaginal condition.

Most common vaginal infections

Bacterial vaginosis (BV)

BV is the most common vaginal infection in women of reproductive age. The condition is caused by an imbalance of vaginal bacteria and overgrowth of Gardnerella vaginalis, not by poor hygiene.

Bacterial vaginosis is not considered a sexually transmitted infection, but sexual activity may increase the risk of developing BV.

Typical symptoms:

• Thin grey or white discharge
• Strong fishy odour, especially after sex
• Usually no itching, but some women may experience vaginal discomfort

Vulvovaginal candidiasis (yeast infection)

Yeast infections are caused by an overgrowth of Candida species.

Typical symptoms:

• Intense itching
• Thick, white, “cottage cheese-like” discharge
• Redness and irritation
• Burning during urination or sex

Yeast infections are more common after antibiotics, oral contraception or hormonal treatment, glucose imbalance such as diabetes, vaginal douching or the use of deodorant products.

Trichomoniasis

Trichomoniasis is a sexually transmitted infection.

Typical symptoms:

• Yellow-green, frothy discharge
• Strong odour
• Vaginal irritation or pain during intercourse

Some women may have no symptoms.

Both partners must be treated to prevent reinfection.

Conditions that mimic infection

Not all vaginal symptoms are caused by infection. Common non-infectious causes include:

• Hormonal changes, including perimenopause, menopause or pregnancy
• Vaginal dryness or atrophy
• Contact irritation from soaps, wipes, pads or detergents
• Vulvar skin conditions
• Pelvic floor tension

These conditions require different treatment than infections, which is why self-diagnosis can be misleading.

Why infections can recur

Recurrent symptoms are common and may occur because:

• The original diagnosis was incorrect
• Treatment was incomplete
• Reinfection from an untreated partner
• Underlying conditions such as hormonal changes or diabetes
• Disruption of normal vaginal flora

Repeated use of over-the-counter treatments without proper diagnosis may worsen symptoms.

How vaginal infections are diagnosed

Diagnosis may include:

• Clinical examination
• Vaginal pH testing
• Microscopy or rapid tests
• Swabs or PCR testing in selected cases

Accurate diagnosis helps ensure appropriate and effective treatment.

When to see a gynaecologist

Seek medical advice if:

• Symptoms are severe or persistent
• This is your first episode
• Symptoms keep returning
• You are pregnant
• Over-the-counter treatment does not help

Changes in discharge, itching, odour, burning or discomfort often cause concern, but not all vaginal symptoms mean infection. Early evaluation can help identify the cause and guide the right treatment.

Clinical evaluation by a gynecologist is important for accurately diagnosing vaginal infections and related conditions. — Photo courtesy of Family Medical Practice

Key take-home messages

• Vaginal symptoms are common and in many cases easily treated. However, not all symptoms indicate an infection.
• An accurate diagnosis is important because many vaginal conditions share similar symptoms and require different treatments.
• Avoid unnecessary self-treatment and do not wash inside the vagina, a practice known as douching, as this can disrupt the natural balance of vaginal bacteria.
• Consult an obstetrician-gynaecologist if symptoms persist for more than two to three days or recur frequently. — Family Medical Practice

Dr Olga Sambolska. — Photo courtesy of Family Medical Practice

*Dr Olga Sambolska graduated from Lviv National Medical University in 1996 and began her medical career at the Volyn Regional Maternity Hospital in Ukraine. Since 1998, she has been a registered obstetrics and gynaecology doctor, providing health care to women in relation to pregnancy, birth control, menopausal issues, contraception, menstrual cycle disorders and sexually transmitted diseases. She is fluent in English, Ukrainian, Polish and Russian.

FMP Healthcare Group operates medical centres in major cities, including HCM City, Hà Nội, and Đà Nẵng, offering consultations with international doctors, check-up services and emergency ambulance services.

Visit FMP Hà Nội 24/7 at 298I Kim Mã Street, Ngọc Hà Ward, Hà Nội.

To book an appointment, please call us at (024).3843.0784, or contact us via WhatsApp, Viber or Zalo on +84.944.43.1919 or email hanoi@vietnammedicalpractice.com.