What Types of STDs Cause Abnormal Discharge?

Does an STD Cause Your Abnormal Discharge?

What Types of STDs Cause Abnormal Discharge?

To know how to address STDs, each individual must likewise be made aware that there are no two diseases that are entirely distinct from one another – each one carrying a similar symptom along with millions of other conditions, making it increasingly more difficult for physicians to provide a conclusive diagnosis, much less a layperson.

Each condition would always present with a particular plethora of symptoms, and each one would usually be utilized to provide that distinctive mark and narrow down the range of diagnosis that the physician can start with. Of course, this is not saying that the diagnosis at this point is conclusive and final. Still, it does provide a great starting point that could not only save time but could also eliminate unnecessary efforts, expenses, and invasive procedures that could precipitate more harm than good in the long run.

The case becomes even more complex when it comes to STDs, especially considering that a vast bulk of the symptoms that most STDs precipitate are often isolated in the genital region – each one being a derivative of others, while some being precisely similar with the rest. It is often hard to provide a conclusive say as to what is causing your condition when the manifestations are isolated in the genitalia, but it does not necessarily mean that the patient is deprived of any ability to employ any preventive measures to avoid further transmission of their condition. In fact, by being able to recognize even a few tell-tale signs of STDs that cause a particular manifestation, the patient may immediately employ abstinence, be more careful in their sexual contacts, and overall protect themselves and their partners from whatever condition it is that is causing their manifestations – STD or not.

To begin with, discharge is a particular symptom that is sometimes mistaken for other conditions or even maybe just an issue of poor hygiene. Odor, color, viscosity, and volume are just of the factors that are often examined when there is an observed discharge in your genitalia, and each of these aspects is the ones that are commonly utilized to provide an initial, or rather, rough diagnosis about what the condition may be. Although discharge, by nature, is essentially similar in definition, the distinctive characteristics of its manifestation, along with the plethora of other symptoms that coexist with it, would provide you an initial idea of what may be causing your condition once and for all. Although you should always avoid self-medication at all costs, knowing what diseases cause discharge, whether it is an STD or not, will help you in narrowing down your testing options and give you an idea of some of the management procedures that you could employ to avoid its progression while you wait for your appointment with your physician.

Once again, always note that self-medication, especially when it involves antimicrobials, is highly discouraged to avoid antimicrobial resistance. Resistance is a very prevalent issue associated with the misuse of antibiotics – resulting in the mutation of the microbe’s genetic material and the scarcity of available medications that could be used to address even minor conditions. Always consult your physician before taking any medication, and always employ abstinence if your symptomatic analysis is pointing towards a potential STD.

What is Discharge?

Genital discharge is a normal bodily function employed mainly in females' bodies to clean, protect, and lubricate the genitalia. It is also commonly used when the individual is ovulating or along with sexual arousal to aid intercourse and allow penetrative sex without causing any damages to the internal structures of the female genitalia. Male genitalia discharge is not often seen as the fluid release is only commonly employed during ejaculation and urination. As such, it is widely more straightforward to diagnose abnormal discharge in men due to its rarity – allowing individuals to immediately notice an underlying condition that is maybe causing this particular manifestation.

However, it should also be noted that vaginal discharge is also susceptible to abnormal presentations – showing changes in its color, texture, volume, and even smell to signal a particular infestation in that region. The typical characteristics of vaginal discharge would always vary between each person – some showing white discharge, others manifesting discharge that is stringy and more viscous during ovulation, and some experiencing less discharge following their menstrual period. It is also important to note that taking oral contraceptives could likewise affect the characteristics of your discharge, making this particular symptom extremely variable depending on how the genitalia of a female individual performs.

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Types of Vaginal Discharge

As previously mentioned, vaginal discharge is highly variable because it is difficult to restrain the definition of “normal” to just one manifestation. The characteristics of your discharge would often vary as the flora of the genitalia, along with the performance of your vagina during particular points of your cycle, would alter the composition of this fluid. As such, it might be more efficient for you to be more familiar with the typical characteristics of discharge – including those that may be notorious for its infamous association with various sexually transmitted conditions.

White

A white discharge often observed at the beginning or end of your menstrual cycle is usually noted as usual. This color is particularly not indicative of any other condition for as long as any other manifestation does not accompany the discharge. However, in cases where the white discharge comes along with itching, has a thick consistency, and has a cottage cheese-like appearance, it may indicate a yeast infection that is predominant within your genitalia. The condition must be examined and addressed immediately to avoid systemic progression.

Clear and Watery

A clear and watery discharge is perhaps the safest manifestation that you could ever experience. It is usual for most, if not all the time, and it is more common following heavy exercise. However, it is still imperative to have yourself tested, especially when you observe other manifestations within the area or if the discharge is accompanied by a foul odor that was not previously observed.

Clear and Viscous

Having a clear, thick, and stretchy discharge is your body’s way of telling you that your genitalia is ready for fertilization – indicating that you are currently at the ovulating stage of your cycle. Once again, this manifestation is usually typical unless it is accompanied by other symptoms that may be causing alarm or any discomfort.

Bloody or Brown

A bloody or brown discharge may cause some level of alarm to the individual, but this is not always the case. A bloody discharge, commonly known as “spotting,” is expected for females who recently had their menstrual period or are currently between cycles. It is normal in most cases, especially when your period is relatively recent or still ongoing. If you recently had unprotected sex and are not currently experiencing your period, this might also be a sign of an ongoing pregnancy. Do note, however, that spotting during the early stages of pregnancy could be a sign of miscarriage – making it imperative for you to discuss everything regarding your pregnancy with your OB-GYN.

It might also be essential to know that spotting can likewise be caused by an abnormal growth of tissue within the vagina – indicating either a fibroid or a cancerous growth within the endometrial lining of the genitalia. It is essential to be tested annually to know whether some level of development is occurring within your organ – providing you with the opportunity to have it addressed and managed at the soonest time possible.

Yellowish to Green

A yellowish or green discharge that is often thick and clumpy would almost always indicate an ongoing infection, particularly Trichomoniasis. An unpleasant fishy odor would usually accompany this, and it might likewise be coupled with a few other manifestations that are often associated with an infestation. Immediately have yourself tested and checked following the presentation of these symptoms.

Does an Abnormal Discharge Automatically Point to an STD?

Much like what was discussed early on, observing a particular “abnormal” manifestation could be attributed to more than one condition – making it difficult for physicians, much fewer common individuals, to provide a conclusive diagnosis without the proper testing method that utilizes cultures and other microscopic means that could determine the causative microorganism of the condition. As such, observing an abnormal discharge within your genitalia is not particularly indicative of an STD. Still, it could show signs of a particular disease that is transmitted and received in another way.

Although STDs are incredibly prevalent within this region, and it is understandable to assume that any abnormality is associate with such, declaring that the condition is an STD without proper testing is simply an irresponsible outlook towards medicine and healing. As previously mentioned, the definition of what a “normal” discharge is would vary with each person – making everything completely variable and subjective without any conclusive evidence of the existence of specific pathogenic microorganisms. Although this is a particularly long way of saying it, the ultimate point is that many aspects of abnormality should not and could not always be associated with an STD, especially considering the plethora of other conditions that are likewise under this category.

Other Conditions That May Be Causing Discharge

To give you an insight as to what other conditions may be causing your abnormal discharge, the following are the conditions that, while are evident infestations of particular microorganisms, are not, in any way, sexually transmitted to other individuals.

Bacterial Vaginosis

Bacterial Vaginosis is a condition that is often misunderstood as it does not lead to other health problems, nor does it lead to long-term issues like other conditions due, especially when it comes to conception attempts following infection. It is a condition caused by the change of balance in the vaginal flora – leading to the predominance of harmful bacteria that was previously subdued and controlled by the good flora. The condition would remain asymptomatic for most cases as it is generally mild and minor in its magnitude. However, when it does manifest a few symptoms, it would often be the following set of manifestations that are observed:

  • Painful urination
  • Fishy smell in the vagina
  • Thin white, gray, or greenish discharge
  • Itchiness

It is often mistaken for yeast infection due to the presence of a white discharge. However, it lacks the cottage cheese-like texture that is often indicative of the said infection.

Bacterial Vaginosis often manifests when the bacteria known as Lactobacillus drops in numbers due to either the use of immunosuppressants or excessive washing of the vagina. When that happens, the acidic environment that these bacteria continuously maintain is disrupted, allowing harmful microorganisms to penetrate the area due to this vulnerability.

Vaginal Candidiasis

Vaginal Candidiasis, or any other type of Candidiasis, is a condition that is caused by a yeast species known as Candida. This species naturally exists in the body’s normal flora – existing as a harmless fungus that contributes to maintaining the body’s environment. However, when this balance is disrupted, the yeast may multiply abnormally, causing manifestations associated with the overgrowth of this particular species.

Although most cases are mild, some individuals may develop severe progressions that may include redness and swelling, on top of the common symptoms that are observed for this condition:

  • Itching and soreness in the genitalia
  • Painful intercourse and urination
  • Abnormal Discharge

STDs That Cause Discharge in Both Men and Women

Trichomoniasis

Trichomoniasis is a condition that is caused by a parasitic protozoan known as Trichomonas vaginalis – commonly being asymptomatic in patients, remaining undetectable unless a proper testing procedure is employed. It is considered by the Centers for Disease Control and Prevention as the “most common curable STD,” with over two million cases recorded by the institution in 2018. Among these numbers, an approximation of around 30% is symptomatic, while the rest remain asymptomatic even following diagnosis. It is currently unclear why the condition manifests in some individual while it remains asymptomatic in other, but it is known that the transmission can be performed both ways – penis to vagina, or vagina to the penis. The lower genital tract is the most susceptible area in women, while the infection mainly resides in the urethra for males.

Symptoms

Considering that roughly 70% of the infected population does not manifest symptoms, a routine annual examination must be performed to determine asymptomatic conditions. However, in cases where the infection becomes symptomatic, the symptoms remain mild, ranging only from mild irritation to some level of discomfort. The disease has a 5 to 28-day incubation period, but symptoms may likewise appear weeks or days following this timeframe.

In symptomatic cases, the following manifestations are the most common signs and symptoms that are observed:

  • Itching inside the penis
  • Burning urination or ejaculation
  • Discharge (clear, white, yellowish, or greenish with fishy smell in females)
  • Redness or soreness of the genitals.

An infected patient may likewise observe discomfort during sexual intercourse. If your discharge seems unusual based on your regular observations, have yourself checked immediately to avoid further transmission of the parasite.

General Diagnostic Process

The diagnosis of Trichomoniasis, much like any other STD, should not be based on examining the symptoms alone. Considering that its common manifestations like discomfort during urination and intercourse, as well as its presentation of an abnormal discharge, is parallel with the symptomatic manifestations of other conditions, it is imperative that laboratory testing is performed to determine the microscopic composition of any discharge, as well as the causative microorganism of the condition of concern.

Apart from a thorough physical examination, the physician may likewise employ a nucleic acid amplification test (NAAT), DNA assay, FDA-cleared rapid test, or a culture test to detect the presence of the microorganism within the body of the patient. Trichomoniasis may also be detected during a Pap Test, but it should not be used as a diagnostic procedure to determine Trichomonas vaginalis' presence in the patient.

Common Management

Trichomoniasis is often addressed by antiprotozoal medications commonly taken over seven days or with just a single dose. The drug itself is safe for pregnant women to take, but it should be noted that infected individuals may contract the condition again when exposed later on. According to the CDC, the reinfection rate is about 20% - indicating that no resistance is developed from being exposed to this condition. Based on the 2015 Standard Treatment Guidelines of the CDC, Metronidazole is usually prescribed for men and women, differing in dose depending on the severity of the condition. Tinidazole may likewise be prescribed depending on the tolerance of the patient with the previous medication.

Chlamydia

Chlamydia is a condition in both men and women caused by the microorganism known as Chlamydia trachomatis – causing cervicitis in women and proctitis and urethritis in both sexes. Chlamydial infections are considered dangerous due to their tendency to progress into more severe conditions such as ectopic pregnancy, pelvic inflammatory disease, tubal factor infertility, and chronic pelvic pain – all of which have lasting effects that could even affect a couple’s attempt at conception. According to the Centers for Disease Control and Prevention, it is estimated that there were around four million cases that were diagnosed in the United States in 2018 alone. However, this is still despite the fact that a considerable chunk of patients is left unreported due to the lack of any symptomatic manifestations in infected individuals – only being diagnosed and detected upon progressing into a more severe condition.

Symptoms

Chlamydia is notorious for being the “silent infection,” quickly infecting other individuals through sexual encounters but remaining asymptomatic even following its incubation period. Due to this, the exact incubation period of Chlamydia also remains unclear – making its diagnosis even more difficult to ascertain. In women, the symptomatic manifestations of Chlamydia would often be associated with cervicitis (discharge, endocervical bleeding). The infection may spread towards the cervix, causing complications such as pelvic inflammatory disease.

On the one hand, men would often experience a watery discharge and painful urination during the infection period. They may also contract a complication known as epididymitis, wherein patients experience testicular pain, tenderness, and swelling.

General Diagnostic Process

Several tests could be performed to provide a conclusive diagnosis for this condition. Following a physical examination to rule out other disorders with similar yet slightly distinct manifestations, laboratory analysis of your sample, particularly vaginal swabs in females, will be performed to determine and ascertain the presence of the microorganism within your system. Physicians would commonly employ NAATs as this is the most sensitive among the tests that could be performed. Still, cell cultures could likewise be utilized depending on the facilities and resources that can be used for this analysis.

Common Management

Chlamydia is a condition that can be quickly resolved with a continuous regimen of antibiotics, albeit self-medication is strictly discouraged without a proper examination from the physician. A 7-day course of antibiotics would often be prescribed to eliminate the microorganism. Abstinence is likewise advised throughout this period to avoid the possible transmission of the condition to your partner.

It should also be noted that reinfection is a highly prevalent case when it comes to Chlamydia, especially in cases where their partners were not simultaneously treated following the diagnosis of the patient. It is also important to note that although the medication will resolve any existing symptoms and eliminate the bacteria from the system completely, it will not be able to repair any damaged structures of the genitalia – making it essential to have yourself treated and diagnosed as soon as the first manifestations are observed. Routine testing may likewise be an efficient option to address this risk.

Gonorrhea

Gonorrhea is a sexually transmitted infection caused when the bacterium Neisseria gonorrhoeae is transmitted through sexual contact – infecting the mucous membranes of the genitalia and reaching even the fallopian tubes in the female reproductive system. The bacterium has also been known to infect other areas of the body such as the mouth, throat, eyes, and rectum, depending on the site that has been exposed to the potential pathogen.

According to the Centers for Disease Control and Prevention, the condition recorded a total of 1.6 million new cases in the United States in 2018, and this number was mainly recorded for individuals at the age of 15 to 24. Like with other STDs, the condition is widely asymptomatic in other individuals, making this approximation representative of the diagnosed cases only, excluding those that remain undiagnosed until its resolution.

The condition’s most significant risk factor is sexual activity, and it was found that the highest proportion of infected people originated from sexually active teenagers, young adults, and African Americans.

Symptoms

Although the condition would mainly remain asymptomatic for most of the population, there are also cases wherein the disease will manifest particular symptoms, indicative not of the specific infection but an ongoing infestation within the genitalia. For males, they would mainly experience dysuria and white, yellow, or green urethral discharge that would appear fourteen days following exposure. Comorbidity with a complication such as epididymitis may also precipitate testicular pain as a manifestation of the condition.

On the one hand, infected females would often experience mild symptoms mistaken for a minor bladder or vaginal infection. Symptoms may include dysuria, abnormality in the patient’s vaginal discharge, and bleeding in between periods. Rectal variations of the disease may also precipitate discharge, anal itching, soreness, bleeding, and painful defecation, among others. However, this could likewise be highly variable as rectal infections are likewise massively asymptomatic.

General Diagnostic Process

Due to the association of its symptomatic manifestations with other conditions, it is imperative that proper testing is likewise performed to determine the presence of the microbe itself. Most physicians would employ a nucleic acid amplification test (NAAT) using urine, urethral, endocervical, or vaginal samples. However, due to the scarcity of resources, some may also employ culture testing and rectal and oral diagnostic tests for clinical use.

Common Management

For most cases, the Centers for Disease Control and Prevention recommends using a single dose of 500mg Ceftriaxone administered intramuscularly to resolve Gonorrhea infections. However, other antibiotics may also be utilized, especially in cases where tolerance is an issue or in variant infections such as rectal and urogenital Gonorrhea. A follow-up test known as a test of cure is likewise required following the treatment and recovery regimen to verify the patient's safety. However, this is only necessary for pharyngeal cases and is no longer essential for other infection variants.

Human Papillomavirus (HPV)

Human Papillomavirus or HPV is a sexually transmitted condition that may cause the manifestation of an abnormal discharge, but not in the conventional sense like how other STDs do. HPV is a condition among people in their 20s, and the condition is mainly identified using the presence of warts and other manifestations, albeit proper testing will still be necessary for an accurate diagnosis.

The way HPV causes an abnormal discharge is by how it can cause cervical cancer among infected women. Early-stage cervical cancer would often produce no signs and symptoms. However, in more progressive stages, the condition may cause manifestations such as vaginal bleeding, water and bloody discharge with a foul odor, and pelvic pain during or without intercourse.

Frequently Asked Questions (FAQs)

How long does HPV stay contagious?

Most cases of HPV would become non-contagious after 1 to 2 years as the immune system fights off the infection. However, this number could vary, and you might have to consult your physician to be guaranteed of your safety.

Is HPV able to survive on inanimate surfaces?

Yes. However, the exact time of survival within these surfaces is still unknown.

What is it like living with HPV?

The experience would generally vary, but for most cases, infected individuals would often be asymptomatic and would not experience any discomfort throughout the infection.

Can you get gonorrhea from kissing?

No. Gonorrhea is not spread through casual contact like sharing food, kissing, holding hands, coughing, and sneezing.

What is the longest known period before symptoms appear for gonorrhea?

Symptoms usually appear after 2 to 5 days, but it can take up to 30 days before the manifestations become evident.

Does chlamydia affect any attempts at conception?

According to various studies, a single infection is not correlated whatsoever with infertility. Repetitive infections, however, have been found to have a significant impact on an individual’s chances at conception.

How fast is chlamydia resolved following treatment?

It usually takes around 1 to 2 weeks for the condition to be resolved entirely.

What are the complications of trichomoniasis in men?

Untreated trichomoniasis in men may develop prostatitis, epididymitis, urethral stricture, and infertility.

Can trichomoniasis be resolved without treatment?

No. It can only be managed with the proper and consistent use of antimicrobials.

How contagious is trichomoniasis?

It is not known whether trichomoniasis is heavily transmitted from infected individuals, but it is known that even asymptomatic individuals may infect other people without knowing about their condition – making its transmission extremely high based on its numbers.

What are the added risks of contracting trichomoniasis?

Contracting trichomoniasis may make your body more susceptible to HIV and more at risk of developing AIDS.

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American Society for Microbiology

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475227/
  • Read more on the various ways to prevent and manage trichomoniasis – a condition that is not often highlighted by other health organizations due to its relative rarity. This article outlines the background behind the disease and its preventive strategies for your information needs.

National Institute of Allergy and Infectious Diseases

International Agency for Research on Cancer

  • https://www.ncbi.nlm.nih.gov/books/NBK321770/
  • Explore how the IARC was able to dissect the lifelong condition precipitated by the Herpes Simplex Virus, and the various management strategies that could be used to address the symptomatic manifestations of this condition.
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Written by Mark Riegel, MD

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