White Urethral Discharge in Females: 9 Causes & When to Worry

The Short Answer

In women, white discharge from the urethra can indicate various conditions, ranging from normal sections (vaginal) to infections. It’s essential to comprehend the potential causes and recognize when it’s necessary to consult with a healthcare professional.

Key Facts

White discharge from the urethra can be a normal part of the menstrual cycle or an indication of an infection.
The properties of the discharge, such as its color, texture, and odor, can offer insights into the underlying cause.

It’s crucial to distinguish between discharge from the urethra and vaginal secretion and discharges, as they can have different causes and implications.

Difference Between Urethral Discharge and Vaginal Discharge

Urethral discharge originates from the urethra, the tube that carries urine from the bladder out of the body.

In contrast, vaginal discharge is produced by the cells of the vaginal wall and cervix. While both types of discharge can be normal, color, consistency, or smell changes can indicate a problem.

Many women mistake vaginal discharge for urethral discharge. vaginal discharge can occur normally, while urethral discharge is almost always due to infection.

So, it is important to inspect the area carefully to make sure that the white discharge is actually urethral, not vaginal.

Moreover, some diseases may cause both vaginal and urethral discharge. The table below summarizes the differences between vaginal and urethral discharge:

	Vaginal Discharge	Urethral Discharge
Source	Produced by the cells of the vaginal wall and cervix.	Originates from the urethra, the tube that carries urine from the bladder out of the body.
Normal Characteristics	Typically clear or white, it can change in color, consistency, and volume at different times throughout the menstrual cycle.	Usually clear and not noticeable. Any noticeable discharge from the urethra is often not normal.
Changes Indicating a Problem	Changes in color, consistency, volume, or smell, especially if associated with other symptoms like itching, burning, or pain.	Any noticeable discharge, especially if it’s colored or associated with other symptoms like burning during urination.
Common Causes of Abnormal Discharge	Yeast infections, bacterial vaginosis, sexually transmitted infections, changes in hormone levels, and certain medications.	Sexually transmitted infections, urinary tract infections.

Purulent (Whitish Pus) vs. Clear Urethral Discharge

Purulent discharge, which appears like whitish pus, often indicates an infection. Clear discharge, on the other hand, can be a normal part of the menstrual cycle or a sign of certain infections or conditions.

The consistency, color, and odor of the discharge can provide valuable information about potential causes.

Remeber to make sure that the discharge comes exclusively from the urethal opening, as it is more common to be due to vaginal discharge contaminating the area around your urethral opening.

Causes of White Urethral Discharge in Females

1. Yeast Infection (Candidiasis)

A yeast infection triggered by an overgrowth of the fungus Candida is a common cause of white discharge (typically from the vaginal, but may also cause urethral white cheesy discharge).

Yeast infection (candida vulvovaginitis) is one of the most common causes of vaginal discharge. Alone, it accounts for about one-third of vaginitis cases in women leading to a white discharge that is often mistaken for urethral discharge (reference).

The discharge is typically thick, white, and often described as resembling cottage cheese. It may also be associated with itching, redness, and a burning sensation during urination or intercourse.

2. Gonorrhea

Gonorrhea, a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, can cause a variety of discharge colors, including white color (reference).

The risk factors include (reference):

Engaging in sexual activity with a new partner

Having multiple sexual partners
Being unmarried
Being of a young age

Belonging to an under-represented ethnic population
Having low educational and socioeconomic levels

However, the discharge is often yellow or green and may be associated with pain during urination or intercourse, lower abdominal pain, or irregular menstrual bleeding.

3. Chlamydia Infection

Chlamydia, another sexually transmitted infection caused by the bacterium Chlamydia trachomatis, can cause white discharge, although it’s often clearer or yellow.

**Symptoms in females:**

Some women with C. trachomatis infection don’t have symptoms but can still get serious health problems.

The infection often starts in the cervix and can spread, causing pelvic inflammatory disease (PID), infertility, and chronic pain.
Some women with this infection have changes in vaginal discharge, bleeding between periods, or bleeding after intercourse.
The infection can also affect the urethra, causing symptoms like a urinary tract infection (UTI), such as frequent urination and pain during urination.

If the infection spreads to the upper reproductive tract, it can cause PID, which often presents as abdominal and pelvic pain.
Sometimes, the infection can cause inflammation around the liver, known as perihepatitis.
If a woman has this infection during pregnancy, it can lead to premature birth and low-birthweight babies.

4. Bacterial Vaginosis

Bacterial vaginosis occurs when the normal balance of bacteria in the vaginal cavity is disrupted. It can cause a thin, white, or gray discharge with a fishy odor. Other symptoms may include vaginal itching or burning.

Symptoms:

People with bacterial vaginosis (BV) can have different symptoms or no symptoms at all.

Typical symptoms include vaginal discharge and a “fishy” odor. The discharge is usually off-white and thin.
The odor might be stronger after sex or during periods.
If there are symptoms like pain during urination, pain during sex, itching, burning, or vaginal inflammation, it could mean there’s more than one infection present.

BV doesn’t affect the cervix but can be associated with cervicitis, which involves discharge or bleeding from the cervix.
Many people with BV (50 to 70 percent) don’t have any symptoms.

5. Trichomoniasis

Trichomoniasis, a sexually transmitted infection caused by a parasite, can cause a discharge that is white, yellow, or green and is often frothy with a strong odor (reference).

It may also cause itching, burning, redness, or soreness in the genitals, discomfort during urination, or discomfort during intercourse.

6. Non-Specific Urethritis or Non-Gonococcal Urethritis

This condition can cause a variety of discharge colors, including white, especially if the cause is not a typical sexually transmitted infection (reference).

Symptoms may include pain or burning during urination, the urge to urinate frequently, or discomfort during intercourse.

7. Herpes Simplex Virus (HSV)

Herpes can cause clear or white discharge, but it’s more commonly associated with painful blisters or ulcers in the genital area.

Other symptoms may include fever, body aches, swollen lymph nodes, or pain during urination (reference).

8. Normal Vaginal Discharge

Normal vaginal discharge often appears white or clear. It can change in color, consistency, and volume at different times throughout the menstrual cycle. This discharge is typically not associated with any discomfort.

Diagnosis of the cause of white urethral discharge in women.

Identifying the cause of white urethral discharge in women involves a comprehensive approach that includes a detailed medical history, physical examination, and laboratory testing.

During the medical history, the healthcare provider will ask about the nature of the discharge, associated symptoms, sexual history, menstrual cycle, contraceptive use, personal hygiene practices, and any previous similar episodes or treatments.

The physical examination usually involves a pelvic exam, during which the healthcare provider may observe the color, consistency, and smell of the discharge. They may also look for signs of inflammation, sores, or lesions on the external genitalia, vaginal cavity, and cervix.

Laboratory testing is a crucial part of the diagnostic process. It may include (reference):

Microscopy: A sample of the discharge is examined under a microscope to look for bacteria, yeast, or parasites.
Culture: A sample of the discharge is cultured in a lab to identify any bacteria or yeast that may be causing the infection.

Nucleic Acid Amplification Tests (NAATs): These tests are used to detect the genetic material of bacteria or viruses, such as Chlamydia trachomatis or Neisseria gonorrhoeae, which cause chlamydia and gonorrhea, respectively.
pH Testing: The pH of the vaginal fluid is tested. A high pH may indicate bacterial vaginosis or trichomoniasis.

Here is a table comparing the diagnostic tests for the causes of white urethral discharge in women:

Condition	Diagnostic Tests
Yeast Infection (Candidiasis)	Microscopy of a vaginal swab to identify yeast cells, fungal culture
Gonorrhea	Nucleic Acid Amplification Tests (NAATs) of a urethral or cervical swab or urine, bacterial culture
Chlamydia Infection	Nucleic Acid Amplification Tests (NAATs) of a urethral or cervical swab or urine
Bacterial Vaginosis	Microscopy of a vaginal swab to identify clue cells, pH testing of vaginal fluid, whiff test (amine test)
Trichomoniasis	Microscopy of a vaginal swab to identify Trichomonas parasites, antigen tests, NAATs.
Non-Specific Urethritis or Non-Gonococcal Urethritis	Microscopy of a urethral swab to identify white blood cells, NAATs for potential pathogens
Herpes Simplex Virus (HSV)	Viral culture of a lesion swab, PCR test of a lesion swab or spinal fluid, blood test for HSV antibodies
Normal Vaginal Discharge	Microscopy of a vaginal swab to rule out infection, pH testing of vaginal fluid

Treatment of Female White Urethral Discharge

The management of white urethral discharge in women depends on the underlying cause (reference).

Antibiotics treat bacterial infections like gonorrhea, chlamydia, and bacterial vaginosis.
Antifungal medications are used for yeast infections.

Antiviral medications are used for viral infections like herpes.
Antiparasitic medications are used for parasitic infections like trichomoniasis.

In addition to medication, it’s important to follow good personal hygiene practices and use protection during sexual activity. Partners should also be treated to prevent reinfection.

For cause-specific treatment, the table below summarizes the effective treatment for each cause:

Condition	Treatment
Yeast Infection (Candidiasis)	Antifungal medications (e.g., fluconazole, clotrimazole)
Gonorrhea	Antibiotics (e.g., ceftriaxone and azithromycin)
Chlamydia Infection	Antibiotics (e.g., azithromycin, doxycycline)
Bacterial Vaginosis	Antibiotics (e.g., metronidazole, clindamycin)
Trichomoniasis	Antiparasitic medication (e.g., metronidazole, tinidazole)
Non-Specific Urethritis or Non-Gonococcal Urethritis	Depending on the cause, antibiotics may be prescribed
Herpes Simplex Virus (HSV)	Antiviral medications (e.g., acyclovir, valacyclovir)
Normal Vaginal Discharge	No treatment is necessary as it is a normal physiological process

Why You Must See a Doctor

If you’re experiencing white urethral discharge, it’s important to consult with a healthcare provider for several reasons:

Accurate Diagnosis: While some causes of white discharge are benign, others can be serious and require treatment. Only a healthcare provider can accurately diagnose the cause.

Effective Treatment: Over-the-counter treatments may not be effective for all causes of white discharge. A healthcare provider can prescribe the appropriate medication based on the cause.
Prevention of Complications: Untreated infections can lead to complications like pelvic inflammatory disease (PID), which can cause chronic pelvic pain and infertility.
Prevention of Transmission: If the cause of the discharge is a sexually transmitted infection, it’s important to get treated to prevent spreading the infection to others.

Here’s a comparison of the potential complications for each condition:

Condition	Potential Complications
Yeast Infection (Candidiasis)	Recurrent infections, the spread of the infection to the bloodstream (in individuals with an impaired immune system)
Gonorrhea	Pelvic inflammatory disease (PID), infertility, ectopic pregnancy, increased risk of getting HIV, and disseminated gonococcal infection.
Chlamydia Infection	PID, infertility, ectopic pregnancy, increased risk of getting HIV, reactive arthritis
Bacterial Vaginosis	Increased risk of getting STIs, including HIV, complications during pregnancy such as preterm birth
Trichomoniasis	Increased risk of getting STIs, including HIV, complications during pregnancy such as preterm birth and low birth weight
Non-Specific Urethritis or Non-Gonococcal Urethritis	PID, chronic pain, increased risk of getting STIs
Herpes Simplex Virus (HSV)	Recurrent outbreaks, increased risk of HIV, severe infection in newborns if transmitted during delivery, meningitis, or encephalitis (in rare cases).