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Physiological discharge vaginal discharge
- normal and healthy for women of reproductive age to have some degree of
- quantity and type of cervical mucus changes during the menstrual cycle
as a result of hormonal fluctuations
- prior to ovulation, estrogen levels increase, altering cervical mucus from
non-fertile (thick and sticky) to fertile (clearer, wetter, stretchy and slippery).
After ovulation, estrogen levels fall and progesterone levels increase; cervical
mucus becomes thick, sticky and hostile to sperm.
The vagina is colonised with commensal bacteria (normal vaginal flora)
- rising estrogen levels at puberty lead to colonisation with lactobacilli
which metabolise glycogen in the vaginal epithelium to produce lactic acid.
Thus the vaginal environment is acidic and normally has a pH <=4.5
- other commensal bacteria include anaerobes, diphtheroids, coagulase-negative
staphylococci and alpha-haemolytic streptococci.
- some commensal organisms can cause a change in discharge if they 'overgrow'
- includes Candida albicans, Staphylococcus aureus and Streptococcus
agalactiae (Group B streptococcus).
- 1) FSRH and BASHH Guidance (February 2012) Management of Vaginal Discharge
in Non-Genitourinary Medicine Settings.
Last reviewed 05/2019