Vaginal discharge is a normal part of female reproductive health. Changes in colour, smell, consistency, or amount can indicate infection or other conditions requiring treatment.
Assess the discharge carefully using this guide before deciding whether treatment is needed.
NORMAL discharge: clear to white or slightly yellow when dry on underwear, no strong odour, consistency varies throughout the month — watery around ovulation, thicker before a period. No itching or burning.
BACTERIAL VAGINOSIS (BV): thin, greyish-white discharge with a strong fishy odour that is worse after sex. Usually no itching. Very common and easily treated.
THRUSH (yeast infection / candidiasis): thick, white, cottage-cheese-like discharge with little or no odour. Accompanied by intense itching, burning, and redness around the vagina.
TRICHOMONIASIS: yellow-green, frothy discharge with a strong unpleasant odour. Often accompanied by itching, burning, and discomfort when passing urine. This is a sexually transmitted infection.
If symptoms suggest BV or thrush, treatment is available from a pharmacy without a prescription in most African countries.
For BV: complete the full course of antibiotics even if symptoms improve early.
For thrush: use antifungal cream or pessary as directed. Avoid tight synthetic underwear. Wear cotton underwear.
Keep the vaginal area clean with water only — soap, douching, and scented products disrupt the natural balance and worsen infections.
Discharge accompanied by pelvic or lower abdominal pain — possible pelvic inflammatory disease.
Discharge with fever above 38°C.
Discharge that is brown or blood-stained and not related to your period — especially after sex.
Symptoms do not improve after completing a full course of appropriate treatment.
Discharge with sores, blisters, or ulcers around the vagina or vulva.
Discharge in a girl who has not started her period.
Discharge after a procedure or during pregnancy.
Never douche — it destroys the natural protective bacteria and worsens infections.
Do not use scented soaps, bubble baths, or feminine hygiene sprays inside or around the vagina.
Do not self-treat if you are pregnant — see a doctor or midwife first.
Do not share towels, underwear, or clothing during an active infection.
If you have a new sexual partner and develop discharge, get tested for sexually transmitted infections.
✓ What Helps
· Clotrimazole cream or pessary for thrush — available without prescription
· Fluconazole 150mg single oral tablet for thrush — available at most pharmacies
· Metronidazole (Flagyl) 400mg twice daily for 7 days for bacterial vaginosis
✗ What To Avoid
· Alcohol when taking metronidazole — causes severe nausea and vomiting
· Sexual intercourse during treatment for any vaginal infection
· Scented products in the vaginal area at all times
→ Ask The Pharmacist For
· Metronidazole for bacterial vaginosis
· Clotrimazole pessary and cream for thrush
· STI testing if trichomoniasis is suspected — this requires a prescription treatment and partner treatment
🏥 Get Professional Help
See a doctor or nurse if you have pelvic pain with discharge, fever, discharge during pregnancy, discharge that does not clear with appropriate treatment, or if you suspect a sexually transmitted infection. STIs require testing and specific treatment.