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So Many Discharges!

Dear clients & friends,

Welcome to my sixth issue of "The Good Fruit" newsletter by Natural Fruit FertilityCare Services.

Since learning and teaching the Creighton Model System, I have realized that women can have so many discharges - many that are completely normal, and others that may signify a health issue. In this week's newsletter, I would like to mention the various discharges that a woman can have and what they mean.

Traditionally, women's discharges were categorized into a single term called leukorrhea, but obviously this was not helpful in distinguishing the different discharges that a woman can see and it was unclear where these discharges actually came from and whether they were considered normal or not. This term left the concept of discharges a mystery even to the woman experiencing them. The Creighton Model System was the first fertility tracking method to very clearly standardize the various fluid observations in terms of sensation, appearance, color, consistency, stretch, and change, as well as their origin.
When a woman who has just started charting presents a chart with either continuous discharge, a greater than 8-day mucus cycle, or post-Peak mucus, I do not know immediately why she is seeing so much discharge. I first make sure that she isn't overreading her observations or incorrectly making observations. Then, I clarify with her the different possible observations according to the Creighton Model System Picture Dictionary and later discuss the other special discharges. A woman should normally see an average of 5-6 days of mucus in her mucus cycle near ovulation. If she observes much more than this, we need to correct this (in charting with the use of yellow stamps and with treatment from a physician) as it can lead to more abstinence than necessary for a couple who is currently using this method to avoid pregnancy.
Here is a brief summary list of the many types of discharges that we can see:
1. Bleeding discharges
Of course, if a woman is not pregnant, she would naturally see a bleeding discharge of varying flows, which is the sloughing of the lining cells of the uterus, as her menstrual period at the beginning of the cycle. In addition, some women might see "light, very light, brown (or black)" bleeding at other times during the cycle, which we call "unusual bleeding," and indicates a health issue of either hormonal or organic cause. Two types of estrogen-related bleeding that can occur near ovulation include break-through bleeding and withdrawal bleeding. Progesterone-related bleeding include premenstrual spotting and tail-end brown bleeding (TEBB). Organic causes of unusual bleeding may include: cysts, fibroids, polyps (cervical or endometrial), cervicitis (e.g. post-coital bleeding), endometritis, pregnancy (e.g. implantation bleeding), and cancer. After birth, women will also have a unique lochia discharge. Placenta accreta and postpartum hemorrhage are serious health issues.
2. Dry sensation vaginal discharges
The vagina is a mucous membrane, so it should always be moist to some extent. It is also a self cleansing organ. As a result, women could see "dry sensation discharges" when wiping that are either damp, shiny, or wet in appearance. A dry observation that is shiny is a sloughing of the vaginal cells.
3. Pasty vaginal discharge
A woman may see a unique discharge that has the characteristics of hand lotion or flour paste, or it may even be milky in appearance if the water content is high. This discharge is pasty (creamy) and cloudy (or yellow), and it may stretch a very small amount (sticky). A woman may see this pasty vaginal discharge if she is sensitive to scented hygiene products, fabric softeners, and fragrances that cause irritation. We recommend discontinuing the use of these products. The pasty vaginal discharge may also be due to an imbalance in the vaginal flora (such as with bacterial vaginosis), so in this case, a probiotic (the Lactinex or Acidophilus protocol) may help to eliminate this discharge.
4. Cervical mucus discharge
Cervical mucus is produced by the cervical crypts (grooves) in the cervical canal. There is cervical mucus in the cervix throughout the cycle (just as there is some level of estrogen hormone in the body throughout the cycle), but the cervical mucus should normally be seen as a discharge only as estrogen increases and gets towards its peak near ovulation. As a result, cervical mucus discharge is our fertility sign that we observe in the Creighton Model System - and its quantity and quality are very important to a couple's fertility. The vitamin B6 protocol may help to improve the mucus quantity and quality for women with infertility who have either limited mucus cycles or dry cycles. In general, the mucus discharge in a mucus cycle begins as sticky or tacky, cloudy and progresses to clear, stretchy, or lubricative at its Peak near ovulation. The cervical mucus during the "mucus days" of the Creighton Model System (when there is a cervical mucus discharge) microscopically contains parallel strands that allow sperm to travel through to get to the Fallopian tubes for a possible conception. Interestingly, on the other hand, cervical mucus in the cervix on "dry days" (when there is no cervical mucus discharge seen) microscopically looks like a stone wall that blocks sperm from traveling through.
5. Gummy cervical mucus discharge
Gummy (gluey) is a unique characteristic of cervical mucus, where the mucus is thick in consistency, similar to half-dried airplane glue or rubber cement. It may be yellow or just cloudy (white) in color. This discharge is often associated with an inflammation of the cervix (for example, cervicitis, erosion, ectropion, or eversion). For example, if some of the tissue of the cervical canal presents in the vagina through the cervical opening, this can cause this type of discharge. This is one explanation for a continuous discharge seen throughout the cycle. The vitamin C protocol may help to eliminate continuous mucus discharge.
6. Endometrial fluid discharge
If a discharge is observed at the very end of the cycle (just before the next period starts), this fluid could actually be endometrial fluid coming out as the body is preparing for the start of the menstrual period. It can be either non-Peak-type or Peak-type. We call this secretory fluid "premenstrual mucus" and it can be considered infertile with the use of yellow stamps, since it is seen well after ovulation has already been confidently identified in the current cycle.
7. Arousal fluid vaginal discharge
One of the special discharges that we discuss with clients is called "arousal fluid." This fluid occurs in response to sexual stimulation (either physical or mental). It comes from the Bartholins Glands, which are at the opening of the vagina (so it is not a cervical fluid). Arousal fluid is designed to facilitate intercourse (it is a natural lubricant). If a client is confident that the fluid is arousal fluid (i.e. due to the timing of it), then it may be ignored for charting.
8. Seminal fluid discharge
The other special discharge that we discuss with clients is "seminal fluid." Seminal fluid becomes a discharge following intercourse (the woman may see it as a discharge the day after intercourse, or even 2 days after). We teach a "seminal fluid instruction" to help eliminate the extra seminal fluid in order to prevent confusion, bladder infections, and the discomfort of an additional discharge. A client should never assume that a discharge is seminal fluid - she must observe all discharges after the seminal fluid instruction on its merits for charting and if needed she may need to adjust the details of the instruction.
9. Early pregnancy-related discharges
In the conception cycle, women can see a Peak-type mucus discharge around the time of implantation called "implantation mucus." Similarly, women may experience "very light" bleeding for 2-5 days within 1-2 weeks since conception. This bleeding is caused by the borrowing of the new embryo into the side wall of the endometrium and is called "implantation bleeding." Both are not very common and they do not signify any health issue for the woman or the baby. Of course, other bleeding during pregnancy could be a sign of health issue such as a miscarriage, so it is important to note and to seek testing and treatment.
10. Late pregnancy-related discharges
A woman may see unique discharges in late pregnancy, just prior to labor, and during labor. If bleeding occurs during the second half of pregnancy, it may be a health issue such as placenta previa, so again it is important to seek healthcare right away if there is any bleeding during pregnancy. Right before or during labor, a woman may see a bloody show (thick discharge that contains mucus and blood from the cervix). And the cervix's mucus plug that helped prevent bacteria from entering the uterus will come out at the end of pregnancy.
11. Hormonal contraceptive cervical mucus discharge
Clients who are on or have recently come off of hormonal contraception have consistently described their cervical mucus discharge as being "very thick," different than any of the natural discharges that are defined in the Creighton Model System. This makes sense as many hormonal contraception methods will affect the cervical mucus and the endometrium lining as backups to try to further prevent a successful pregnancy if ovulation actually occurs. With the mucus extra thickened, it would try to prevent sperm from traveling through.
12. Vaginal discharges from infections and STDs
Vaginitis is an inflammation or infection of the vagina. The most common causes of vaginitis are yeast infection (fungal - monilia or candida - infection), trichomonas (a protozoan parasite STD infection), and bacterial vaginosis (bacterial infection). Most vaginal infections cause a discharge. The discharge of a yeast infection looks like cottage cheese. A trichomonas infection's discharge looks milky, bubbly, and grayish-green. With bacterial vaginosis, the discharge is pasty and often yellowish in color (see list item #3 above).
As you can see, there are so many types of possible discharges that it is important to know the difference between them! Women who chart with the Creighton Model System are more likely to be able to identify these differences and to tell when something appears unusual or is a potential health issue.
Have a fruitful day!

Patricia Deshane, FCP
My services are intended to provide information and education and are not intended as medical, psychological, or psychiatric advice.
Copyright © 2019 Natural Fruit FertilityCare Services, All rights reserved.

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