[4] The solid components or elements are exfoliated epithelial cells from the vaginal wall and cervix as well as some of the bacteria that inhabit the vagina.

[1] The majority of the discharge pools in the deepest portion of the vagina (the posterior fornix)[3] and exits the body over the course of a day with the force of gravity.

[1][4] A typical reproductive-age woman produces 1.5 grams (half to one teaspoon) of vaginal discharge every day.

[4] However, some individuals may experience changes in vaginal discharge due to underlying conditions such as stress, diabetes, inflammatory disorders, lactation, certain medications, or autoimmune diseases.

Neonatal vaginal discharge may be white or clear with a mucous texture, or it may be bloody from normal transient shedding of the endometrium.

[10]   The composition of the bacterial population in pre-pubertal girls is dominated by staphylococcus species, in addition to a range of anaerobes, enterococci, E. coli, and lactobacillus.

[3] Even before the beginning of menses (up to 12 months before menarche, typically at the same time as the development of breast buds[4]) vaginal discharge increases in amount and changes in composition.

[10] Estrogen matures vaginal tissues and causes increased production of glycogen by epithelial cells of the vagina.

[13][2] Discharge may be red and heavy for the first few days as it consists of blood and the superficial mucous membrane that lined the uterus during pregnancy.

This discharge normally begins to taper and should become more watery and change in color from pinkish brown to yellowish white.

[9] Specifically, the vaginal tissues thin, and become less elastic; blood flow to the vagina decreases; the surface epithelial cells contain less glycogen.

[9] With decreased levels of glycogen, the vaginal flora shifts to contain fewer lactobacilli, and the pH subsequently increases to a range of 6.0-7.5.

[16] Abnormal discharge can occur in a number of conditions, including infections and imbalances in vaginal flora or pH.

[7] 32% of patients were found to have sexually transmitted infections including Chlamydia, Gonorrhea, Trichomonas, or Genital Herpes.

The physician will insert the speculum into the vagina while the patient lies on their back to exam for foreign bodies, vaginal warts, inflammation, as well as rashes/bruises.

[citation needed] Bacterial vaginosis (BV) is an infection caused by a change in the vaginal flora, which refers to the community of organisms that live in the vagina.

[21] In BV, the vagina experiences a decrease in a bacterium called lactobacilli, and a relative increase in a multitude of anaerobic bacteria with the most predominant being Gardnerella vaginalis.

[20] The discharge in BV has a characteristic strong fishy odor, which is caused by the relative increase in anaerobic bacteria.

[30] Vaginal discharge is not always present in yeast infections, but when occurring it is typically odorless, thick, white, and clumpy.

[30] The diagnosis of Candida vulvovaginitis is made by looking at a sample taken during speculum exam under the microscope that shows hyphae (yeast), or from a culture.

[32] Trichomonas is diagnosed by looking at a sample of discharge under the microscope showing trichomonads moving on the slide.

[35] The causes of abnormal vaginal discharge in pre-pubertal girls are different than in adults and are usually related to lifestyle factors such as irritation from harsh soaps or tight clothing.

[35] The bacteria that are more commonly responsible for vaginal discharge in pre-pubertal girls are distinct from those in other age groups, and include Bacteroides, Peptostreptococcus, and Candida (yeast).

[36] Another cause of vaginal discharge in pre-pubertal girls is the presence of a foreign object such as a toy or a piece of toilet paper.