What's Normal (And Not) Down There?

What woman hasn't been a little concerned at finding discharge in her underwear? Or worried over an odor? Or wondered, "Is it supposed to look like that down there?"

What's normal in the v-zone will vary from woman to woman. Irregularities certainly do exist and some could warrant medical attention. But for the majority of women, there are a wide range of characteristics that can all be considered "normal."

Here's a general guide to what's completely normal and common, and what may be out of the ordinary, meriting a phone call or visit to your doctor. Most importantly, anything you feel is out of the ordinary should warrant a call to your physician.

What's considered excessive bleeding?
Normal: It can seem like a gallon of blood is shed with every period, but in actuality, 2-3 tablespoons (or up to 44 milliliters) of menstrual fluid is what's normally produced. Still, the menstrual cycle isn't the same for every woman. Some women may be heavier bleeders, even experiencing clotting.

Blood clots are normal in most instances and are caused when rapid bleeding occurs preventing the body from releasing anticoagulants fast enough. But very few women experience blood loss severe enough to require medical treatment.

Suspect: Menstrual flow that soaks through one or more pads or tampons every hour, for several hours in a row. When this occurs, seek medical care. Over time and with each cycle, excessive blood loss can lead to anemia.

Should I be concerned with discharges?
Normal: Vaginal discharge that ranges in color from clear to milky white is normal and actually serves an important housekeeping function. It's the vagina's way of keeping itself clean and preventing infection. Discharge can vary in amounts and odor depending on your menstrual cycle and hormone fluctuations.

Suspect: Any discharge accompanied by itching or burning. Discharge with a cottage-cheese consistency and a yeasty odor suggests a yeast infection. A white, gray or yellowish discharge with a fishy odor may indicate a vaginal infection. Call your healthcare provider for a proper diagnosis and treatment.

Is my vulva supposed to be that color? Is my labia supposed to be that size?
Normal: No two vulvas are alike and differences are reflected in colors, shapes and sizes. The vulva can range in color from pink to brown, and every shade in between. Pubic hair can be dense or sparse. Labia, or your vulval lips can be full and large, or thin and small, and just like your feet or ears, can also be unevenly sized from one side to the other.

Your monthly cycle, childbirth, and sexual intercourse can also affect changes in the appearance of your vulva region, both temporarily and permanently, and most always in normal ways.

Suspect: Although bumps, lumps and wrinkles are common and typically do not warrant concern, raised skin lesions accompanied by chronic itching or burning can be a sign of something serious. If you experience symptoms like these, contact your doctor.

What's that smell?
Normal: The vagina has a natural odor, just like our breath has a natural odor. Whether that smell is pleasant or offensive depends on our health and hygiene habits.

Menstrual blood can develop a distinctive odor when it comes in contact with oxygen or air, but it's not usually an odor that can be detected by anyone but you. Change your protection often to help avert "period smell."

Suspect: A dramatic change in vaginal odor, such as the development of a fishy smell, can indicate an infection or even an STD. See your physician immediately.

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