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Vaginal Discharge - When to Test
The following section is a guide if you are experiencing vaginal discharge and would like to proceed with a self swab at a local laboratory.
Only order a self swab if:
    You are experiencing new vaginal discharge or vaginal odour
    You do not have any abdominal pain, fevers or chills or feel unwell
    You have an up-to-date normal pap test
In the event you have a normal swab result and your symptoms are persistent, we advise to proceed to a local walk in clinic for a cervical assessment, as vaginal discharge can be associated with more serious conditions (see below - Other Causes of Vaginal Discharge).
If you are concerned about STI exposure or partner infidelity, we suggest adding an STI screen as a vaginal swab WILL NOT show chlamydia or gonorrhea.
When you order a self-swab (Swab Instructions)
    Proceed to the laboratory and the lab technician will supply you with a vaginal swab you can complete in the on-site bathroom. Instructions are included below.
    If your swab confirms BV or a yeast infection, you will be notified and offered treatment in an included follow-up phone call with our doctor.

Vaginal Discharge

Bacterial Vaginosis (BV) and Yeast Infections (Vulvovaginal Candidiasis) are two common causes of changes in vaginal discharge. These are not considered sexually transmitted infections. Most yeast infections and bacterial vaginosis self-resolve without medical intervention.
Vaginal discharge can also be related to transmissible infections like chlamydia, gonorrhoea or trichomoniasis. With new partner exposure and new onset vaginal discharge, we recommend completing both STI screening and a vaginal self-swab to clarify the cause of discharge. If you are in a mutually monogamous relationship, usually only a vaginal swab is necessary, unless there are concerns about partner infidelity or you were never screened at the onset of the relationship.

Bacterial Vaginosis (BV)

Bacterial vaginosis is a clinical condition characterized by a change in the vaginal flora towards a diverse set of species. Lactobacillus is a common vaginal organism that maintains an acidic vaginal pH. Changes away from lactobacillus can lead to a rise in the pH of the vagina causing a change in vaginal discharge and vaginal odour. Discharge is often off-white, thin, and often has a “fishy smell” that can be more notable after intercourse and menses.

Yeast Infections (Vulvovaginal Candidiasis)

Yeast infections or vulvovaginal candidiasis is one of the most common causes for changes in vaginal discharge, often associated with intense itching. It is caused by inflammation attributable to the Candida species. Risk factors for recurrent yeast infections include diabetes, antibiotic usage, increased estrogen levels (post-menopausal estrogen therapy/pregnancy) or immunosuppression. Common symptoms include vulvar erythema, and a think curd like or cottage cheese like discharge with no or little odour.

Other Causes of Vaginal Discharge

It is important to note that vaginal discharge can also less commonly be a symptom related to a more serious medical condition. If you complete screening through TeleTest and have normal results (a normal STI screen and a normal swab) we recommend you proceed to a local walk in clinic for a speculum exam to assess your cervix and an in-person assessment. Rare and less common causes of discharge include cervical and endometrial cancer, and your health care provider can determine if further investigations are necessary.

About PAP Testing

PAP testing (cervical cancer screening) is recommended in Ontario starting at the age of 25 or 3 years after becoming sexually active, whichever comes later. The Ontario Cervical Screening Program recommends that women who are or have been sexually active have a Pap test every 3 years. Abnormal pap results often require earlier follow up. Your provider will notify you of an abnormal Pap test result and notify you of earlier required follow up. An abnormal pap might prompt your provider to refer you for a special exam called colposcopy, or simply repeat the test in 6 months.
Regular screening should continue until at least age 70 or when advised by a doctor or nurse practitioner to stop. Pap tests can stop at the age of 70 if a woman has had 3 or more normal tests in the previous 10 years.
Eligible people need to get cervical screening even if they:
    feel healthy and have no symptoms
    are no longer sexually active
    have only had 1 sexual partner
    are in a same-sex relationship
    have been through menopause
    have no family history of cervical cancer
    have received the HPV vaccine

Swab Instructions

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Contents
Vaginal Discharge
Bacterial Vaginosis (BV)
Yeast Infections (Vulvovaginal Candidiasis)
Other Causes of Vaginal Discharge
About PAP Testing
Swab Instructions