Vaginal discharge is one of the most common reasons women see their gynecologist. In fact, 18% of women have seen their doctor for vaginitis symptoms in the last year. So, how do you know what’s normal, and what’s not?

First, it’s important to know that the vagina is a self-cleaning entity, with its own secretions that help with the cleansing process. A healthy vagina will produce discharge, and this “normal” discharge is clear to white, and may appear yellow when dried on underwear. There is often more discharge, and a change in texture, if you are ovulating, breastfeeding, stressed, or sexually aroused. A sticky, egg white like discharge is typical in the first half of your cycle and the discharge becomes thicker and more milky white in the latter half of your cycle due to progesterone release. Normal discharge can vary in smell too, anything from odorless to pungent to metallic can be normal.

So, when should you be concerned about that mushy, moist, musky stuff?

1. If it has a strong fishy odor.

Bacterial vaginosis (BV) occurs when there is a change in bacteria in the vagina, specifically, when there is a decrease in one of the normal bacteria found in the vagina called lactobacillus. If your discharge has a super strong, fishy odor, especially if this worsens with sex or your period, you should see your doctor. BV is not an STD and is easily treated with antibiotics.

2. If you have a terrible itch.

Yeast infections typically cause very intense irritation and burning, to the point that you may not be able to keep from scratching. Sometimes yeast infections are associated with a cottage cheese like discharge. Yeast is not an STD and is easily treated with antifungal medications.

3. If you have new pain in your belly, or if you have pain with sex.

Heavy vaginal discharge that is associated with pain could be a sign of an STD like gonorrhea, chlamydia, or trichomonas. You should definitely see your doctor in this case to get tested.

To maintain good vaginal health, avoid using any perfumed soaps, sprays or lotions. It’s really not necessary to scrub with soap, just let soapy water from the shower run over your genitals and dry with a clean towel. If you’re having symptoms of an infection, try wearing loose fitting clothes and cotton underwear that breathes – remember bacteria and yeast love moisture. You also shouldn’t douche because that can actually remove some of the healthy bacteria in the vagina that protect against infection.

Bottom line, some discharge can be normal and healthy. You and your vagina deserve good care, so if something’s not right down there, go see your doctor.