Vaginal discharge – what is normal, and what is not
Discharge changes through the cycle and that is healthy. What thrush, bacterial vaginosis and an infection needing treatment actually look like.
Normal changes through the month
Some vaginal discharge is normal and healthy — it is how the vagina cleans itself. It changes across the cycle, from thicker and creamier after a period to clearer and stretchier around ovulation, and it increases in pregnancy and with hormonal contraception.
What matters is a change from your own normal: a new smell, a new colour, itching, soreness, or discharge with pain or bleeding.
Telling the common causes apart
- Thrush — thick white discharge like cottage cheese, with intense itching and soreness, and usually no strong smell.
- Bacterial vaginosis — thin grey or white discharge with a distinctly fishy smell, often stronger after sex, and usually little or no itch. It is an imbalance rather than an infection caught from someone.
- Trichomoniasis — frothy yellow-green discharge, offensive smell, soreness. Sexually transmitted, and partners need treating.
- Chlamydia and gonorrhoea — often NO symptoms at all, which is exactly why they cause damage. May cause discharge, bleeding between periods or after sex, or pelvic pain.
Treatments, depending on the cause:
Clotrimazole — Canesten, Candid, Trimysten, Mycelex
Vaginal candidiasis; dermatophyte infections; oral candidiasis
Fluconazole (Single-dose OTC) — Diflucan One, Flucazole Once
Single-dose treatment of vaginal candidiasis (thrush) and associated candidial balanitis
Metronidazole — Flagyl, Adco-Metronidazole, Metrosa, Medazol
Anaerobic infections; Trichomonas; bacterial vaginosis; Giardia; amoebic dysentery; C. diff
When to be seen rather than self-treat
Thrush treatment is available from a pharmacy and is reasonable for a straightforward, recognisable, first or occasional episode. Beyond that, self-treating is how an untreated sexually transmitted infection quietly does damage.
Untreated chlamydia and gonorrhoea can cause pelvic inflammatory disease, chronic pain and infertility. Testing is quick and free at public clinics, and in South Africa an HIV test should be offered alongside.
Reducing recurrence
- Skip scented soaps, bubble baths, wipes and vaginal deodorants.
- Wear cotton underwear and avoid staying in tight damp clothing.
- Wipe front to back.
- Use condoms, which reduce both infections and the disruption to balance that triggers bacterial vaginosis.
- Get blood sugar checked if thrush keeps returning — recurrent thrush is a recognised presentation of undiagnosed diabetes.
- Take probiotics with a realistic expectation: the evidence is modest and strain-specific.
Common questions
- Is thrush sexually transmitted?
- Not usually — the yeast is normally present and overgrows when the balance shifts, often after antibiotics. Partners do not routinely need treatment unless they have symptoms.
- Why do I get thrush every time I take antibiotics?
- Antibiotics reduce the normal bacteria that keep yeast in check. It is common and predictable — ask a pharmacist about having treatment on hand if it happens to you every course.
- Can bacterial vaginosis go away on its own?
- Sometimes, but it is worth treating, particularly in pregnancy where it is associated with premature birth. It also recurs frequently, which is not a sign the treatment failed.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Clinical and public health guidanceWorld Health Organization
Last reviewed 4 August 2026.