From the Guidelines
Vaginal discharge during running is typically caused by increased sweat production from the numerous sweat glands in the genital area, which mixes with normal vaginal secretions, and can also be influenced by friction, hormonal fluctuations, and potentially underlying infections such as bacterial vaginosis (BV) or other sexually transmitted diseases (STDs) as noted in 1 and 2. The discharge may increase during running because physical activity raises body temperature, leading to more sweating throughout the body, including the vaginal area. Additionally, friction from clothing and movement can stimulate the vagina's natural lubrication process. Hormonal fluctuations throughout your menstrual cycle can also affect the amount and consistency of discharge during exercise. To manage this normal occurrence, wear moisture-wicking, breathable athletic clothing and change out of damp clothes promptly after exercise. Cotton underwear or athletic underwear with cotton gussets can help absorb moisture. If the discharge has an unusual color, strong odor, is accompanied by itching, burning, or pelvic pain, consult a healthcare provider as these could indicate an infection or other medical condition requiring treatment, such as those described in 3 for diagnosing the cause of vaginal infection. Some key points to consider include:
- The pH of the vaginal secretions can be determined to help diagnose the cause of vaginal infection, as an elevated pH (>4.5) is typical of BV or trichomoniasis 3.
- Discharge can be examined by diluting one sample in one to two drops of 0.9% normal saline solution on one slide and a second sample in 10% potassium hydroxide (KOH) solution to identify motile T. vaginalis or the clue cells of BV 3.
- The presence of objective signs of external vulvar inflammation in the absence of vaginal pathogens, along with a minimal amount of discharge, suggests the possibility of mechanical, chemical, allergic, or other noninfectious irritation of the vulva 3.
From the Research
Causes of Vaginal Discharge
- Bacterial vaginosis (BV) is a common cause of vaginal discharge in women of childbearing age 4
- Vaginal infections, including those caused by Trichomonas vaginalis, Candida albicans, and bacterial vaginosis, can lead to vaginal discharge 5, 6
- The use of certain medications, such as metronidazole, can help treat vaginal infections and reduce vaginal discharge 4, 7, 8
Factors Contributing to Vaginal Discharge
- High rates of recurrence of bacterial vaginosis can contribute to persistent vaginal discharge 4, 8
- The presence of Gardnerella vaginalis after treatment can lead to recurrent disease and vaginal discharge 4, 7
- Mixed infections, where multiple pathogens are present, can make treatment more challenging and contribute to vaginal discharge 5, 6
Treatment Options
- Metronidazole is a commonly used treatment for bacterial vaginosis and trichomoniasis, and can be administered orally or topically 4, 7, 8
- Clotrimazole is often used to treat fungal infections, such as those caused by Candida albicans 5, 6
- Combination therapies, such as the use of metronidazole and clotrimazole, can be effective in treating mixed infections and reducing vaginal discharge 5, 6