Sexual health is the subject women find hardest to raise in person and easiest to get wrong information about. This guide covers what symptoms mean, what testing involves, and the questions that make an appointment useful.
Discharge: what changes matter
Some discharge is normal and it changes across the cycle. What is worth having checked is a change in smell, colour or amount that is new for you, or discharge that comes with itching, soreness, pain passing urine, pain during sex, bleeding between periods, or lower abdominal pain.
Common causes — thrush, bacterial vaginosis, and infections such as chlamydia or trichomoniasis — are told apart by testing rather than by description, and their treatments are completely different. That is why guessing and self-treating so often fails and then delays the right treatment.
A strong or fishy smell, particularly after sex, most often points to bacterial vaginosis rather than to hygiene. Douching and vaginal washes make it more likely rather than less.
Testing, and why symptoms are not the trigger
Several of the commonest sexually transmitted infections cause no symptoms at all, which is why testing is offered on the basis of risk rather than only on the basis of feeling unwell. Asking to be tested is a reasonable request and it is not an accusation of anything.
Timing matters: tests do not detect an infection immediately after exposure, and the interval differs between infections. "When did this happen" is one of the first questions and can mean testing now and again later.
Testing is usually a combination of a swab, a urine sample and a blood test depending on what is being looked for. Not all of it needs an internal examination, and you can ask which parts do. Ask which infections you are actually being tested for — "a full check" means different things in different places.
Partners
Several infections come straight back if only one person is treated. Clinicians will usually raise this. If telling a partner is difficult or unsafe, say so — that is a real problem and there are ways around it.
Pain during sex
It is common, it has identifiable causes, and it is not something to accept. Pain at the entrance points towards dryness, infection, skin conditions or the involuntary muscle tightening called vaginismus. Deeper pain points towards conditions such as endometriosis, fibroids or pelvic infection. Where it hurts and when it started are the two most useful things you can describe.
Cervical screening
Screening looks for changes in the cells of the cervix, or for the virus that causes them, before they ever become cancer — and it is a test for women without symptoms. If you have bleeding after sex, bleeding between periods or unusual discharge, those need assessing now; a screening appointment is not the route, and a normal screening result does not explain a symptom. Almost all cervical cancer is caused by persistent HPV infection, and vaccination and screening are the two things that prevent it.
The same-day list
Lower abdominal pain with fever and discharge. Any bleeding after your periods have stopped for a year. A painful or spreading sore or ulcer. And after an assault: emergency contraception, infection prevention and support are all time-sensitive, and a health facility can help with all three.
How this guide was written
AskHer's editorial team wrote this from the published guidance listed at the end of the explanations it links to — FOGSI, the Ministry of Health and Family Welfare, the ICMR, the World Health Organization, the RCOG and the NHS among them. It has not been signed off by a clinician registered in India, because no clinician has yet joined AskHer and had her registration checked. That is why no clinical reviewer is named on this page.
Nothing here is a diagnosis, and nothing here is advice about your particular situation. When a clinician does review a guide, her name and the date she reviewed it will appear here in place of this note.
This is general education. It cannot tell what is happening in your own body, and it does not replace seeing a clinician.