Author Archives: Tessa Farley

About Tessa Farley

Tessa has been a Phoenix resident for over 15 years. She graduated from Arizona State University with undergraduate degrees in both Nursing and Biology. She worked as a Labor and Delivery nurse at Banner University Medical Center, beginning her career in Women’s Health. She continued to grow her practice and expertise by earning her Doctorate in Nursing Practice. Learn More About Tessa Farley

Strengthening Your Pelvic Floor

Strengthening Your Pelvic Floor

This entry was posted in Healthy Aging and tagged on by .

Your body is made up of many different organs, muscles, bones, and other tissues. Down to the last cell, each of these components has a specific function to help you stay healthy and live your best life. However, many of these important body parts and systems don’t receive the attention they deserve to operate to the best of their ability.

One muscle group that is a vital component of your health, yet often goes forgotten, is the pelvic floor. Your pelvic floor plays an essential role in your day-to-day life, especially as a woman, but it can become weak if you don’t care for it properly. Here’s a quick guide to help you better understand the function of a woman’s pelvic floor and the natural ways you can strengthen yours.

While you may have heard the term “pelvic floor” before, if you’re like the majority of women, you might be a little unsure regarding its precise function. The pelvic floor is actually a group of two primary muscles, each with different components that work together to stabilize your core and help your body perform basic functions like urinating. These muscles are what give you the ability to “hold on” when you have the urge to urinate, helping prevent incontinence.

Your pelvic floor also works to support important organs like your uterus, bladder, and intestines. Without the support that the pelvic floor offers, you could be subject to medical issues like prolapse, which occurs when the lower abdominal organs press against weakened muscles and bulge into the vaginal area.

What Can Weaken a Woman’s Pelvic Floor?

Because the pelvic floor assists in a variety of important bodily functions, it can be weakened over time with repeated use. More often, the pelvic floor can become weak after strenuous situations. As your pelvic floor weakens, it can lose its ability to perform as well or even begin to become dysfunctional, causing prolapse and other issues.

Some of the most common causes of weakened pelvic floor muscles in women include the following:


In addition to supporting a variety of other organs, a woman’s pelvic floor supports her uterus for the entire nine months she is pregnant. With the consistent pressure of a growing fetus, amniotic sac, and uterus on the pelvic floor, pregnancy can weaken this muscle group over time. Pregnancy also causes a wide range of hormonal changes, which are known to soften the pelvic floor and ultimately make it more elastic than usual.


After nine full months of pregnancy, women are already facing a potentially weakened pelvic floor. Unfortunately, the stress that childbirth puts on the body can weaken the muscles to an even greater extent. Because childbirth involves consistent, strenuous pushing using core muscles, it’s easy to strain the pelvic floor during the process. Women that experience long deliveries with extended pushing and women who give birth to heavier babies face an elevated chance of straining their pelvic floor muscles during birth.

Excessive Heavy Lifting

The pelvic floor works with the abdominal muscles and diaphragm to form what is known as the core. All these different muscles work together to help people lift objects varying in size and weight. However, consistent heavy lifting can put a great deal of stress on the core muscles and can ultimately strain them. If heavy lifting is paired with other factors that have weakened the pelvic floor, including pregnancy, women have a much higher risk of straining these muscles and causing dysfunction.

Hormonal Changes or Old Age

Women face hormonal changes during pregnancy as well as during menopause, and these changes in the body’s hormone levels can affect the pelvic floor. As women age, the pelvic floor must work harder to support the various organs and other musculature while it slowly softens. This is why many older women have issues with incontinence or leakage as their ability to control their pelvic floor muscles gradually diminish.

Consistent Constipation

While constipation isn’t always something that can be controlled, it can also have a negative effect on the pelvic floor and overall health, especially if constipation continues. Because the pelvic floor supports the bowels, constipation can not only put too much consistent pressure on those muscles, but they’ll also face excessive straining while in use. If this happens for an extended period of time, the muscles can weaken as a result.

Excessive Coughing

While it might seem like a minor issue, especially as it concerns the muscular system, women that are constantly coughing are putting a great deal of wear and tear on their lungs, throat, and pelvic floor. This is because every time a cough occurs, the core muscles are forced to contract and relax. Excessive coughing constantly tightens your pelvic floor muscles and can strain them as time goes on.

Suggested Reading: What Is a Prolapsed Bladder?

How Do You Know If Your Pelvic Floor Is Weak?

How Do You Know If Your Pelvic Floor Is Weak?

If your pelvic floor is weak, your body may begin to show a variety of symptoms that are a result of this muscle dysfunction.

Some of the most common signs that you have a weak or softened pelvic floor include:

  • Inability to control your bladder or bowels
  • Leaking during certain kinds of exercises, activities, or even when laughing too hard
  • Painful sex
  • Lack of feeling or sensation during sex
  • Recurring UTIs or yeast infections
  • Consistent inability to reach a bathroom on time
  • Pain putting tampons in
  • Tampons falling out
  • A feeling of “heaviness” in the vagina
  • Accidentally passing gas when lifting or bending over
  • A distinct bulge in the vagina

How Can You Strengthen Your Pelvic Floor?

Fortunately, there are natural methods you can use to strengthen your pelvic floor, even if strenuous situations have caused it to weaken over time. Some of the best exercises and tips to follow when trying to strengthen your pelvic floor muscles include:

Kegel Exercises

Kegels exercises for women are among the most well-known pelvic floor exercises for a reason: they’re extremely effective and can be done by almost anyone. Kegels can be done in a variety of different ways and positions and are relatively simple to do at almost any time. Once you have familiarized yourself with your pelvic floor muscles, squeeze and relax those muscles about 15 times while regulating your breathing. As you begin to do them more often, you can increase the number of contractions you complete. Within just a few months of doing Kegels regularly, most women begin to see results.

Heel Slide Exercises

Heel slides are a great exercise that helps you engage your core muscles and work your pelvic floor. To do heel slides, lay on the floor with your legs straight and arms flat at your sides. You’ll begin by inhaling and sliding one leg up until your knee is fully bent and then sliding it back down to a resting position on an exhale. Depending on what’s most comfortable for you, it’s recommended to start with ten slides for the first leg, then switch. You can do multiple sets of ten for each leg if you feel you’re able to do more.

Diaphragmatic Breathing

Diaphragmatic breathing, sometimes referred to as belly breathing, is a breathing exercise that encourages using all your core muscles to inhale and exhale deeply. This technique is not only useful for building your lung capacity and strengthening your diaphragm, but it also helps to build a stronger relationship between your pelvic floor and your diaphragm. As an added benefit, it often helps people relax.

Diaphragmatic breathing is a simple exercise you can perform either lying down or seated. To begin, place one hand on your stomach and the other comfortably on your chest. Then, take a deep breath in for about four to five seconds, and feel your diaphragm expand as you inhale. Hold that breath for about two to three seconds, and then whenever you’re ready, very slowly exhale for around five or six seconds until you feel empty. You can repeat this process for your desired time period, often anywhere from five to 25 minutes.

Yoga or Pilates

Strengthen Your Pelvic Floor

Both yoga and Pilates focus on increasing mobility and encouraging strong relationships between you and your body, as well as among your most important bodily systems. With an emphasis on breathing techniques in addition to stretching and slow, steady workouts, yoga and Pilates can help to strengthen your pelvic floor over time through simple, consistent practice. Even practicing yoga for as little as ten minutes three times a week can make a significant difference in your flexibility, mobility, muscle strength, and overall health.

How Long Does It Take to Strengthen Your Pelvic Floor?

Because every woman’s body is unique and each pelvic floor may have a different level of strength, the amount of time it takes a woman to strengthen their pelvic floor muscles can vary. On average, regular pelvic floor exercises and maintaining healthy habits can help to rebuild your pelvic floor’s strength within just a few weeks. Many women begin to see and feel noticeable results at around four weeks of consistent pelvic floor work. By eight to twelve weeks, you can replenish a great deal of your pelvic floor strength.

Can Your Pelvic Floor Be Too Tight?

While a weak pelvic floor can be dangerous, sometimes, muscles that are too tight can also cause medical problems. When the muscles of a pelvic floor are constantly tensed, you have a condition that is referred to as a “hypertonic pelvic floor.” A hypertonic pelvic floor occurs when the pelvic floor is too tight, and the muscles within it are unable to relax and stop contracting.

The symptoms of a hypertonic pelvic floor can be much like those of a weakened pelvic floor, with a few differences:

  • Painful sex
  • Difficulty initiating urination
  • Pain or discomfort while eliminating urine or waste
  • Random bursts of pain in the core or pelvic region during specific movements
  • Urinary incontinence
  • Pain in the lower back
  • Frequent urination
  • Constipation
  • Bloating
  • Consistent pressure on the lower back, pelvis, and hips
Suggested Reading: Overcoming Pelvic Pain

Signs of a Healthy Pelvic Floor

Because most people wait until health issues occur before seeking medical advice regarding the pelvic floor, many women are unsure about the health of their pelvic floor until symptoms are severe. It’s important to keep the health of your pelvic floor in mind, and fortunately, it’s relatively simple to self-monitor between appointments.

If you’re still a few months away from your next gynecology appointment, here are some signs to look for that indicate you have a strong, healthy pelvic floor:

  • No pain or discomfort while urinating or eliminating waste
  • No incontinence
  • No accidental leakages when exercising, laughing, or lifting
  • No pressure or heaviness within the vagina
  • Sex isn’t painful
  • You do pelvic floor exercises regularly
  • You can hold urine until you can reach a bathroom
  • You maintain a healthy weight
  • You noticed increased sensitivity to sex
  • You have a strong abdomen
  • Kegels do not make you excessively tired

Women’s Care at Arizona Gynecology Consultants

Talk to Arizona Gynecology Consultants for Issues with Your Pelvic Floor

Your pelvic floor plays a key role in your health and your everyday life. Here at Arizona Gynecology Consultants, we advocate for pelvic floor care and preventing the issues that can come with pelvic floor issues. That’s why our team is dedicated to working with women and providing them with the compassionate, high-quality care they deserve.

At Arizona Gynecology Consultants, our skilled medical providers are prepared to work with you and help you find solutions to your women’s health concerns. To learn more about our available gynecology services in Arizona or to schedule your next appointment, contact us today.

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Treatment For Decreased Libido in Women

Causes and Treatment For Decreased Libido in Women

This entry was posted in Ask An Expert and tagged on by .

When it comes to limited sex drive or low libido in women, what is considered normal varies greatly, especially across the lifespan. The desire for sex in women is impacted by physical, psychological, and lifestyle factors that may or may not cause a decrease in libido. In fact, women have desires that fluctuate naturally over time and are especially influenced by drastic life changes like pregnancy, childbirth, and menopause. Outside of these life events, there are also medical reasons for a woman to experience a decrease in libido.

The following information is for women experiencing a disruptive decrease in sexual desire who may be concerned that the issue stems from a medical or psychological disorder that needs professional treatment. However, if you suspect your drop in sexual desire is of a temporary nature, it is still a good idea to speak to a medical professional to rule out other issues and get advice on how to make sound decisions for your sexual health. Never be afraid to reach out to a medical doctor for advice that contributes to improving your well-being. Professionals like the team at Arizona Gynecology Consultants are trained to help you determine the root causes of any sexual health problems and find appropriate solutions.

Is Low Libido in Women Normal?

Women are often assumed to have a much lower libido than their male counterparts. While it is normal for women to experience fluctuations in sexual desire over time due to the natural highs and lows of life, it isn’t fair to say that all women experience equally low libido. What is most important is for each woman to have a sex life that meets her standards and is enjoyable to the degree she desires.

When a woman is not satisfied with the current state of her sex life, her personal well-being and the well-being of her relationships tend to suffer. Thus, it is important for each woman to find her normal, maintain a satisfactory sex life and take care of any chronic health issues that may be contributing to her low libido. For that reason, if you are experiencing dissatisfaction with your libido, it can be considered outside the norm for you.

What Can Cause a Low Libido?

Many issues can arise that negatively impact a woman’s sexual desire. Each woman handles life events and stressors differently, so a major life change that affects one woman’s sexual health minimally could drastically affect another woman and diminish her sexual desire. This is why it is so important to refrain from comparing yourself to others—sexual desire is subjective. The subjectivity of sexual health means you will need a unique set of solutions to achieve a state of overall sexual wellness, and that is perfectly normal.

The causes of low libido vary from woman to woman, with some cases requiring a few simple lifestyle adjustments and others requiring more extensive therapeutic solutions. Understanding the most common causes of a low female sex drive can help shed light on any underlying issues. At the very least, developing an understanding of the causes of low libido may help you gain some information that can be used when speaking to a medical professional about your decreased libido.

Causes of a low sex drive in women include but are not limited to the following.

Physical Issues

There is a range of physical factors and medications that can lead to a low sex drive in women:

  • Medical disease or chronic health problems. Arthritis, high blood pressure, cancer, diabetes, heart disease, and neurological disease are all nonsexual issues that can cause a lowered libido.
  • Sexual issues. Some women experience drops in their libido when sex is painful, or they have trouble reaching orgasm. These issues often cause dissatisfaction and reduce the desire for sex and intimacy.
  • Reactions to medications. There are prescription drugs known to cause a drop in sex drive, especially selective serotonin reuptake inhibitors, a type of antidepressant.
  • Counter-productive lifestyle practices. Drinking excessive amounts of alcohol, using street drugs, and smoking are all known to restrict blood flow, which can lead to a dip in sexual arousal.
  • Surgical procedures. Any form of surgery, especially surgery involving the breasts or genitals, can negatively impact body image, the desire to have sex, and sexual function.
  • Exhaustion and fatigue. Caring for young children, tending to an aging parent, or working long hours are examples of stressful events that contribute to a decreased sex drive. Fatigue stemming from surgery or chronic illness can also have this effect.

When a physical issue causes a drop in libido, it is best to identify the problem and take steps to adjust for an improvement in sexual satisfaction. Seeking professional help is especially helpful for finding safe solutions to overcome the physical causes of a low sex drive.

Hormonal Issues

Woman with Hormonal Issues

Fluctuations in hormone levels can reduce the desire for sex, especially in cases of menopause and issues with pregnancy and breastfeeding. When a woman’s estrogen levels drop, the body makes the transition to cease menses. When menopause sets in, many women become less interested in having sex due to vaginal dryness and painful sex resulting from low estrogen. Some women can and will still experience pleasurable sex during menopause, but others will experience a drop in libido.

A similar situation can occur during pregnancy. During and after pregnancy, a woman goes through several phases of hormonal changes that can dampen sexual desire. Many who decide to breastfeed will continue to have elevated levels of hormones that lower their estrogen production so significantly that it can cause a lowered libido.

A lack of sexual desire from hormonal fluctuations can be a drastic change for many women and their partners because a healthy sex drive is largely determined by hormonal balance. Many suspected hormonal issues can be discussed with your doctor and detected through saliva and blood tests. In cases where sexual desire is caused by hormonal shifts, women may find solutions, including dietary changes, exercise, hormonal therapy, or a combination of these methods.

Psychological Distress

Believe it or not, your mental state can impact your libido.

There are numerous ways poor mental health can cause sex drive to diminish, including:

  • Mental health disorders like depression and anxiety
  • Chronic stress from issues surrounding money, work, or family
  • Body image disorders
  • Low self-worth and self-esteem
  • Trauma from sexual or physical abuse
  • Negative sex experiences (past or present)

When psychological distress is at the root of low sex drive, solutions can take on both medical and psychotherapeutic forms. Depending on the situation, there may be a need for a combination approach where both medicine and therapy are required to help women manage the mental issue blocking their sexual desire. If you have an existing mental health diagnosis or suspect you may be suffering from poor mental health, speaking to your doctor can set you on the path to improved mental and sexual well-being.

Relationship or Marital Problems

Many women lose interest in sex and intimacy when they don’t feel an emotional connection to their partner or spouse. Romantic relationship problems can take a major toll on a woman’s sex drive and leave both partners feeling frustrated and dissatisfied with the relationship.

The decrease in sexual interest often results from longstanding issues that go unresolved, such as:

  • Lacking an emotional connection to a partner or spouse
  • Fights and arguments that lack resolution
  • Poor communication between partners
  • Trust Issues

When it comes to relationship issues, it is important to remember that sex (or lack thereof) affects both partners. In this way, a woman’s low sex drive can have serious consequences for a relationship if the issue goes untreated. If you want your relationship to thrive, addressing sexual health issues with the support of your partner can help you both cope with difficult periods. Talking over your concerns with your partner allows you both to grant one another grace and compassion.

Hypoactive Sexual Desire Disorder

In some cases, women with low sex drive receive a diagnosis of hypoactive sexual desire disorder or HSDD. HSDD leads many women to experience interpersonal distress and difficulty and can be caused by a combination of medical, psychiatric, or substance abuse problems. Women with HSDD often don’t feel desirable or have sexual desire for their partner. Unfortunately, while this presents issues for many couples, the phenomena of HSDD and its impact often go unaddressed and untreated.

Hypoactive sexual desire disorder, like other causes of low sex drive, can take a substantially negative toll on women’s quality of life. Therefore, it is an issue that researchers should study more thoroughly so they can understand and develop adequate solutions. Based on recent research, the recommended approach to treating HSDD is biopsychosocial, meaning that treatment focuses on healing the mind, body, and relationships to achieve better sexual health. Gynecologists and other sexual health professionals are often recruited to work in tandem with other clinicians to help women treat HSDD through complementary health approaches.

How Do You Treat Low Libido in Women?

Patient talking with doctor about low libido

Low sex drive in women is an issue that can stem from one or many of the aforementioned causes, each of which may or may not be treatable with patient care by a physician. Your sexual health is the result of the complex interactions between your physical, emotional, and relational well-being at any given time. Therefore, it must be assessed thoroughly to pinpoint any dysfunction. If the cause of your low libido requires medical treatment, it is best to reach out for help sooner rather than later to complete the proper exams and testing necessary to safely and effectively treat the issue.

Solutions can be medical, psychological, or sociological in nature.

Medical Solutions

If your libido is lower than you would desire and it causes you interpersonal distress, you should seek medical help. There are ways for physicians to assess your health to determine the cause of your decreased sex drive. Women who have medical reasons for low sex drive may find hormone therapy and lifestyle changes helpful in increasing their desire for intimacy.

Psychological Solutions

Impaired mental health is a major risk factor for decreased sex drive in women and often contributes to their struggles to maintain a healthy sex life. Depression and anxiety are closely linked to low libido in women, as are the medications that treat these issues, like antidepressants and antipsychotics. In addition, depression triggered by living with a mental health disorder can lead to women experiencing sexual limitations and lowered libido. Treating reduced sex drive caused by a psychological disorder may require a medication change to medications that are considered sexually neutral. Medication should be administered in the lowest effective dosage to ensure the disorder is properly managed without having a negative impact on sexual health.

Once an effective medication has been prescribed, a form of psychological therapy is used to help address symptoms of the disorder, such as low self-esteem, low self-image, distracting thoughts, and issues regarding fear of physical sensations. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive behavioral therapy (MCBT) are two effective therapies for helping women overcome issues pertaining to arousal, libido, and sexual desire.

Sociological Solutions

If your reduced libido is due to relationship issues or poor communication, you may try couples therapy to address the problem together with your partner. Some women report that the use of supportive therapy methods was more impactful on their mental health improvement than medications. They credit the benefits of learning to communicate changing sexual needs in healthier ways by improving their sex life with their partner.

You don’t have to allow your physical health, psychological health, or your romantic relationship to be negatively impacted by a low sex drive. If you want help, there are solutions available that can help you resume a satisfying sex life.

When Should You See a Doctor for Diminished Sex Drive?

The best time to seek medical help with sexual health issues is the moment you become concerned about your reduced or non-existent desire for sex. Sometimes, the solution to your problem lies in changing your current medication or taking actionable steps to treat an existing chronic medical condition like diabetes or elevated blood pressure.

Any time you feel distressed about a dip in your sex drive, you should seek the help of a professional who has experience helping women improve their sexual health. Getting a professional assessment will make it possible to receive medical treatment or even a referral to additional resources like sex therapy. Your medical doctor can help you reclaim your sexual comfort and connect you to additional helpful options.

Getting Help for a Low Sex Drive

Getting Help for a Low Sex DriveIf you are worried about your decreased sex drive and lack of sexual arousal, Arizona Gynecology Consultants has plenty of resources available to help you discover what lies behind the changes you’re experiencing. If you choose to consult with a physician, we will listen to your concerns and provide both help and compassion. Our team of trusted gynecologists is always willing to assist women on the journey to improved health and wellness.

You should not be ashamed to reach out for professional help with sexual health concerns. Contact us directly for Arizona Gynecology services and consultation.


PCOS Awareness Month

September is PCOS Awareness Month

This entry was posted in Health FAQs and tagged on by .

Irregular periods? Could it be due to PCOS?

Polycystic ovarian syndrome (PCOS) is one of the most common hormonal disorders among women of reproductive age. PCOS affects 5 million women in the United States, which is about 1 in 10 women (CDC, 2020). Menstrual disorders are defined as absent periods, heavy periods, unpredictable periods, or periods that occur infrequently or too frequently. A woman who is not on any hormonal birth control, should have their period about every four weeks.

What is PCOS?

PCOS is a hormonal imbalance where your ovaries produce an abnormal amount of androgens or male sex hormones. Women with PCOS have increased levels of testosterone, multiple follicles on the ovaries, and/or irregular periods. PCOS signs and symptoms include irregular menstrual cycles, excessive body or facial hair, hair loss, acne, obesity, infertility, insulin resistance, and polycystic ovaries.

PCOS affects all areas of the body, not just the reproductive system. Due to the hormone imbalance, 70% of women will have insulin resistance that can lead to obesity (NIH, 2016). Obesity places a woman at risk for metabolic syndrome, diabetes mellitus, sleep apnea, high cholesterol, fatty liver disease, and cardiovascular disease. Some women with PCOS develop a condition called endometrial hyperplasia, where the lining of the uterus becomes too thick. This condition is due to not shedding the endometrium and increases the risk of endometrial cancer. It is important that a woman with these symptoms schedule with their gynecologist to discuss likely causes and treatment.

PCOS Symptoms

How is it diagnosed?

Your provider will take a detailed history on your periods, symptoms, physical signs, check labs, and sometimes order a pelvic ultrasound. To diagnose PCOS, clinicians use the Rotterdam criteria. This criteria is met by having 2 out of 3 of the following; increased levels of androgens or signs such as facial hair, acne, or male pattern hair loss, irregular or absent periods, or having polycystic appearing ovaries on pelvic ultrasound.

What is the treatment?

There are a variety of treatment options to help manage PCOS. Your provider will tailor the specific treatment options to your goals, health concerns, and whether you want to become pregnant. PCOS is most commonly treated using combined oral birth control with progestin and estrogen. The consistent balance of hormones in your body will help regulate the menstrual cycle and lower androgen levels. In combination with birth control pills or used separately are insulin sensitizing medications such as Metformin. These medications help the body respond to insulin, lower glucose levels, regulate weight, decrease androgens, and establish normal menses.

Lifestyle modifications play a vital role in managing PCOS as well! Maintaining a low carbohydrate and low sugar diet has been shown to balance hormones and periods. Due to the known insulin resistance with PCOS, patients should eliminate carbohydrates such as pasta, bread, tortillas, potatoes, cereal, bagels, rice, etc. Healthy replacement foods include spaghetti squash, cauliflower, quinoa, mixed vegetables, or zucchini slices. Low carbohydrate options are eggs, turkey, fish, salads, mixed nuts, protein bars, yogurt, cheese, etc. Our providers provide a weight loss program that includes nutrition, exercise, and medication management! We suggest a maximum of 25 grams of carbohydrates a day and less than 25 grams of sugar a day.

Want to learn more about PCOS?

The providers at Arizona Gynecology Consultants are trained and knowledgeable on PCOS diagnosis, treatment, and helping each patient reach their goals. PCOS is more complex than having irregular periods, as studies show it also affects many aspects of your metabolism and long-term health.

Learn more about PCOS


What is a Normal Amount of Vaginal Discharge?

Understanding Vaginal Discharge

This entry was posted in Ask An Expert and tagged on by .

It is rarely talked about and often misunderstood. The term “vaginal discharge” is unfairly associated with embarrassment and shame. Most vaginal discharge is normal. Every day, fluids are produced by small glands in the vagina and cervix. These fluids make up vaginal discharge, also called cervical mucus. Vaginal discharge provides clues to general vaginal health, as well as fertility. Changes from normal discharge can be signs of inflammation or hormonal imbalance. Becoming familiar with your own vaginal discharge can empower you to understand your body and the signals it is trying to send.

What is Considered a Normal Amount of Vaginal Discharge?

The vagina is a “self-cleaning oven”. One of the functions of this discharge is to help flush out unwanted substances or microorganisms (i.e., bacteria and yeast). Healthy microscopic organisms live inside the vagina, interacting with cervical mucus, fluids, and your body’s epithelial cells. It creates an environment that benefits the female human body, just like the relationship with our gut bacteria and digestion. The good bacterium that keeps vaginas healthy is called Lactobacillus. There are several species of Lactobacillus, and they can vary from person to person. There is never a need to clean out the vagina with douching or soap because healthy Lactobacillus keep potentially harmful microorganisms from growing. A sign of healthy vaginal environments is discharge that is clear or creamy consistency, and mostly odorless.

The pH, or acidity, of the vagina is an essential part of vaginal health. The typical pH is 4.0 to 4.5. It is balanced and maintained with a combination of the natural fluids secreted by the tissue, microorganisms, and hormone balance. This pH allows healthy Lactobacillus organisms to thrive, while keeping more harmful microorganisms that cause bacterial vaginosis (BV), yeast infections, and others from flourishing. When there is a noticeable change in vaginal discharge, it may be a sign of infection.

What Can Vaginal Discharge Tell You?

What Can Vaginal Discharge Tell You?

Normal Discharge

  1. Egg white: For women who menstruate, discharge changes throughout the menstrual cycle. The color, texture, and consistency may change depending on the cycle’s relation to ovulation. One to two days prior to ovulation, estrogen levels rise, and discharge becomes clear and sticky. It is referred to as “egg white” discharge because it resembles clear sticky raw egg whites. This time is called the fertile window and is an ideal time to try to conceive. This discharge supports the transport of sperm for fertilization and lubrication during sex. If pregnancy is not your goal, avoid unprotected sex especially during this time
  2. Creamy white: Milky or creamy discharge that is white or off-white is called leukorrhea. This normal discharge is present throughout the cycle and can dramatically increase in quantity during pregnancy. White discharge may be more noticeable toward the end of your cycle and the before the start of your period.
  3. Clear watery: As the fertile window approaches, discharge may become clearer in color. Clear slippery discharge is also produced after arousal or exercise.

Abnormal Vaginal Discharge

  1. Thick white “cottage cheese”: Thick white discharge may indicate that you have yeast infection, a.k.a Candida. Candida are species of fungus that are normally present inside the vagina in low levels. When the healthy flora or pH of the vagina is disrupted, these fungal organisms flourish and cause a yeast infection. Additional symptoms may include itching, redness, and pain with urination or sex. Candida is the most common cause of vulvar and vaginal irritation, with nearly half of all women reporting a history of at least one diagnosed yeast infection in their life. About 1 in 10 women report having at least 4 yeast infections in a year. Recurrent yeast infections can be a sign of another underlying condition that increases the likelihood of recurrence. Women with frequent yeast infections should seek care from their gynecology healthcare provider. Yeast infections can be treated with over-the-counter or prescription antifungals.
  2. Watery-grey with “fishy” odor: This abnormal discharge is characteristic of bacterial vaginosis (BV). BV is an overgrowth of a bacteria called Gardnerella, which is also normally present in the vagina. BV is the most common cause of vaginal discharge. BV also occurs when the normal flora of the vagina is imbalanced. BV infections are not normally associated with pain or itching and may require antibiotics to clear. Like yeast infections, frequent reoccurrence of BV may be a sign of an underlying condition and seeing a gynecology healthcare provider is recommended.
  3. Frothy yellow or green: This characteristic discharge, along with a foul odor, may indicate an infection of a protozoan called Trichomonas vaginalis (aka Trich). Trich is a sexually transmitted infection that can be treated with prescription antibiotics. It is necessary for sexual partners to also get treated, although men may not show any symptoms. The most common symptoms that women may experience in addition to the abnormal discharge are burning, itching, pain with sex or urination. Anyone with these symptoms should seek care from a gynecology healthcare provider.
  4. Blood or dark brown spotting: Dark brown discharge or dark colored blood may be caused by several various conditions. It is normal to experience dark brown spotting right before or after a period. In this case, it is most likely oxidized or “old” blood. Thick brown discharge may be a sign of a foreign body left in the vagina or a cervical blockage. Continual dark discharge may also be caused cervical irritation, lesions, hormonal changes, or stress. If these symptoms are present between periods, you should be evaluated by gynecology healthcare provider.

Sexually transmitted infections, such as chlamydia and gonorrhea may be asymptomatic. However, many women may experience abnormal discharge, burning, pain with sex or urination, bleeding after sex, or unusually spotting. Birth control does not protect against STIs, so use condoms every time you have intercourse with a new partner.

Vaginal Self-care

Healthy habits and hygiene practices can optimize your vaginal health and decrease the chances of developing abnormal discharge. Here are some helpful tips to keep your vagina happy:

  1. Avoid douching and scented soaps: These may disrupt your vagina’s normal pH and increase the chances of developing an infection. In fact, you vagina does not require soap at all. Health Lactobacillus inside the vagina will keep it clean. Sensitive unscented soaps are appropriate externally to keep your body clean and free from irritants.
  2. Wear 100% cotton underwear: Cotton is soft and absorbent to whisk away moisture. Silky polyester and other synthetic fabric may keep moisture trapped, increasing the likelihood of developing a yeast infection.
  3. Change your exercise clothes and swimsuits as soon as you are done: Tight leggings, especially after intense exercise keep your groin moist, leading to increased risk of yeast and BV. After swimming or working out, change out of the damp clothing and keep your vagina dry.
  4. Always wipe from front to back: After using the restroom, always wipe in a front-to-back direction. This is especially true for going number 2. Wiping the opposite direction can push stool and potentially pathogenic bacteria into the vagina and urethra, leading to vaginal infections or urinary tract infections (UTIs)
  5. Vaginal Probiotics: If you are prone to getting yeast infections, BV, or abnormal discharge, you may want to consider adding a vaginal probiotic to your daily routine. The supplements contain the good bacteria that you want in your vagina to maintain a healthy flora and pH
  6. See your gynecologist every year- It is highly recommended to see your gynecologist for a yearly preventative exam. Women aged 21-65 may need to get their pap smear done about every 3 years with regular vaginal check-ups in between. And of course, see your gynecologist sooner than a year if you are concerned about any symptoms.

Understanding what is normal may help you feel more confident in your vaginal and health. Most vaginal discharge is normal, but when it is not, seek help from your gynecologist for accurate diagnosis and treatment.