It’s common to wonder what “normal” or healthy vaginal discharge looks like. If you have endometriosis, you may wonder whether changes to your usual discharge — like different colors, textures, or smells — are within the realm of endometriosis-related symptoms. If you have not been diagnosed with endometriosis, you may wonder whether changes in your vaginal discharge could point toward a condition like endometriosis.
Endometriosis can sometimes change a person’s discharge, so it can be helpful to understand what is normal for you — and what may warrant a trip to the doctor. Changes in your discharge, especially when accompanied by symptoms like severe abdominal pain and irregular menstrual periods, may indicate a bacterial or viral infection or a chronic condition like endometriosis.
In endometriosis, tissue similar to the lining of the uterus (the endometrium) grows outside the uterus, often on the reproductive organs or in the abdomen. Just like the normal uterine lining, this endometrial-like tissue can shed during the menstrual cycle, though it may become trapped in the body instead of exiting through the vagina.
Vaginal discharge is a combination of vaginal fluids and cells from the cervix, uterus, and vagina. This fluid is shed from the vagina and serves several purposes, including providing natural lubrication (moisture), protecting the vagina from irritants and infection, and generally keeping the vaginal tissues healthy.
Both the growth of endometriosis lesions and endometriosis’s effects on the menstrual cycle may cause changes in a person’s usual discharge — typically in color and, less often, in smell or texture.
One of the common symptoms of endometriosis is irregular menstrual bleeding. People with endometriosis frequently experience abnormally heavy bleeding during menstruation or abnormal vaginal bleeding at other times during the menstrual cycle (spotting). Spotting between periods can cause vaginal discharge to appear pink, brown, or black.
Lighter colors, like pink, typically result from fresh bleeding. Pink vaginal discharge in endometriosis may be caused by spotting between periods. It may also be related to hormonal changes due to endometriomas, or cysts that have developed in the ovaries (also known as chocolate cysts).
Darker (brown or black) discharge in endometriosis tends to result from blood that has been trapped in the body for longer periods of time. Both irregular menstrual bleeding and abnormal endometrial tissue that has become trapped (prevented from shedding) may contribute to dark-colored discharge. Black discharge, in particular, may also be caused by the release of trapped blood from vaginal endometriosis.
Endometriosis itself is unlikely to affect the texture or smell of vaginal discharge. However, one research review suggested that endometriosis may be linked to an increased risk of developing infections in the upper genital tract, such as bacterial vaginosis. These types of infections can cause changes to the texture, smell, and color of vaginal discharge.
Differences in vaginal discharge are normal — the amount, consistency, look, texture, and smell of vaginal discharge can vary from person to person. Discharge can also change with the menstrual cycle, varying from thin, clear, or watery to white, thick, and sticky. Changes in the texture of vaginal discharge are particularly common around ovulation, or the period in the menstrual cycle during which an egg is released from an ovary into the fallopian tube.
Healthy vaginal discharge typically varies from whitish to clear and has only a mild odor. Vaginal discharge that has a strong smell, an out-of-the-ordinary change in texture, or a green or yellow color may indicate bacterial or viral infections, including sexually transmitted infections. These changes may necessitate a trip to the doctor.
Though variations in vaginal discharge are normal, it is important to understand what is out of the ordinary for you. According to the Mayo Clinic and the National Health Service, you should visit your health care provider or a gynecologist if you notice the following:
If you experience these changes, your doctor may recommend undergoing tests for certain bacterial or viral infections. If you have other symptoms of endometriosis, talk to your doctor about whether it’s appropriate to look into an endometriosis diagnosis.
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