Leucorrhoea
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CDC vaginal discharge bacterial vaginosis candidiasis trichomoniasis diagnosis guidance
Leucorrhoea means vaginal discharge. It is a symptom, not a diagnosis.
A small amount of clear or white, non-smelly discharge can be normal, particularly around ovulation, before menstruation, in pregnancy, or with sexual arousal.
Abnormal leucorrhoea may result from vaginitis or cervicitis. Typical patterns include:
- Bacterial vaginosis: thin grey-white discharge with a fishy odour.
- Candida (yeast) infection: thick white, curdy discharge with marked itching, redness, or burning. Vaginal pH is usually normal. CDC candidiasis guidance
- Trichomoniasis: yellow-green, sometimes frothy or foul-smelling discharge, often with irritation. It is sexually transmitted and testing is recommended when symptomatic. CDC trichomoniasis guidance
- Cervicitis/STIs: mucopurulent discharge, post-coital bleeding, pelvic discomfort, or dysuria.
Diagnosis should be based on history, examination, vaginal pH, microscopy or swabs/NAAT testing rather than discharge appearance alone. CDC vaginal-discharge evaluation
Seek medical assessment promptly if there is pelvic/lower abdominal pain, fever, pregnancy, bleeding, genital sores, a new sexual exposure, or persistent/recurrent discharge. Avoid douching and self-starting antibiotics, as they can obscure the cause or worsen imbalance.
Treatments
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site:cdc.gov/std/treatment-guidelines bacterial vaginosis vulvovaginal candidiasis trichomoniasis recommended regimens
Treatment depends on the cause. Do not treat leucorrhoea with antibiotics or antifungals without assessment, because normal discharge needs no treatment and the wrong medicine can worsen symptoms.
| Likely cause | Usual treatment |
|---|---|
| Normal physiological discharge | Reassurance, genital hygiene, breathable cotton underwear. Avoid douching, perfumed washes, and vaginal deodorants. |
| Bacterial vaginosis - thin grey-white discharge, fishy odour | A clinician may prescribe metronidazole 500 mg by mouth twice daily for 7 days, or vaginal metronidazole/clindamycin preparations. Male partners are not routinely treated. CDC BV treatment guidance |
| Vaginal candidiasis - itching, redness, thick curdy white discharge | A vaginal azole such as clotrimazole/miconazole, or fluconazole 150 mg by mouth once for uncomplicated confirmed infection. In pregnancy, use a topical azole for 7 days and avoid oral fluconazole unless specifically prescribed. CDC candidiasis guidance |
| Trichomoniasis - yellow-green/frothy discharge, odour, irritation | Metronidazole 500 mg by mouth twice daily for 7 days is recommended for women. Sexual partner(s) need treatment too, and sex should be avoided until everyone has completed treatment and symptoms have settled. CDC trichomoniasis guidance |
| Cervicitis or other STI - pus-like discharge, bleeding after sex, pelvic pain | Testing for chlamydia, gonorrhoea, trichomoniasis and other infections is needed. Treatment is cause-specific and should be prescribed after examination/testing. |
See a clinician urgently if you are pregnant, have fever, lower abdominal/pelvic pain, vaginal bleeding, ulcers/sores, pain during sex, or symptoms after a new sexual contact. If discharge keeps returning, request a vaginal swab or NAAT test rather than repeatedly using over-the-counter treatments.
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