Cervical mucus is a normal, healthy secretion produced by the cervix. It plays an important role in fertility and conception. Monitoring changes in cervical mucus can provide insight into your reproductive health and cycle. Abnormal cervical mucus may indicate an underlying condition that requires medical attention.
What is cervical mucus?
Cervical mucus is a gel-like discharge produced by the cervix. It contains water, proteins, salts, and mucins – large glycoproteins that give mucus its gel-like texture.
Cervical mucus has several important functions:
- It protects the cervix from infection by trapping pathogens and preventing them from entering the uterus
- It facilitates sperm transport and nourishment, allowing sperm to survive for several days inside the female reproductive tract
- It controls pH and maintains an acidic environment in the vagina, which deters pathogens
- It cleans and moisturizes the vagina
The amount and consistency of cervical mucus changes throughout the menstrual cycle in response to hormonal fluctuations. Estrogen causes increased production of thin, stretchy, and lubricative mucus. After ovulation, progesterone dries up cervical mucus and makes it thicker and cloudy.
What does normal cervical mucus look like?
The appearance of normal cervical mucus varies based on where a woman is in her menstrual cycle:
- There is little to no discharge immediately after menstrual bleeding stops
- Any mucus is cloudy, sticky, and has a white or pale yellow color
- Mucus increases in amount and becomes wetter, more slippery, and transparent
- It develops an egg white-like consistency that can stretch an inch or more between fingers
- The mucus may take on a fern-like pattern when dry
- Cervical mucus decreases in amount and becomes thick, opaque, and sticky again
- It loses the egg white-like quality
These cyclic changes allow cervical mucus to facilitate successful reproduction. The most fertile mucus occurs right before ovulation, providing an optimal environment for sperm transport.
What are some abnormalities in cervical mucus?
Abnormal cervical mucus refers to changes in color, texture, smell, and amount that are unusual for a particular phase of the menstrual cycle. Some abnormalities to look out for include:
Thick, sparse mucus:
- Scant, thick, tacky mucus throughout the cycle may indicate low estrogen levels
- This can make it harder for sperm to reach the egg for fertilization
Thin, watery discharge:
- Persistent thin, watery discharge may signal an infection, inflammation, or hormonal imbalance
- Infections may produce gray, green, yellow, or foul-smelling mucus
- Pink, red, or brown mucus may occur due to ovulation spotting or cervical/endometrial irritation
- It should resolve quickly, but recurring bloody mucus warrants medical evaluation
Increased sticky mucus:
- Excessive thick, sticky, tacky mucus can indicate high estrogen levels
- It obstructs sperm movement and impairs fertility
What causes abnormal cervical mucus?
Some potential causes of abnormal cervical mucus include:
- Hormonal imbalances – Excess androgens, low estrogen, thyroid disorders
- Medications – Birth control pills, estrogen supplements
- Cervical inflammation – Cervicitis
- Vaginal infections – Bacterial vaginosis, yeast infections, STIs like chlamydia and gonorrhea
- Cervical polyps – Benign cervical growths
- Gynecologic cancers – Cervical, uterine, ovarian cancers
- Menopause – Declining estrogen levels
- Intrauterine devices (IUDs) – Can provoke increased mucus production
- Pregnancy – Hormone changes during pregnancy alter mucus consistency
- Cigarette smoking – Associated with excessive cervical mucus
If you notice persistent abnormal cervical mucus, discuss it with your doctor. They can help determine the underlying reason and appropriate treatment.
When to see a doctor
Consult your doctor if you experience any of the following:
- Changes in cervical mucus color (green, yellow, gray, bloody)
- Bad-smelling or foul mucus
- Significant changes in mucus amount
- Changes that persist for more than 1-2 cycles
- Mucus that lasts longer than 12 days/cycle
- Itching, burning, or irritation around the vulva and vagina
- Discomfort during sex
- Unexplained vaginal bleeding
- Fever, chills, abdominal pain
- Atypical discharge in postmenopausal women
Evaluation of abnormal discharge may involve a pelvic exam, Pap smear, vaginal culture, biopsy, or imaging tests. Prompt diagnosis and treatment can resolve many causes of abnormal mucus.
Treatments for abnormal cervical mucus
Treatment depends on the underlying cause but may include:
- Antibiotics – For STIs like chlamydia and gonorrhea
- Antifungals – For yeast infections
- Estrogen therapy – For low estrogen levels
- Surgery – To remove cervical polyps or cancers
- Switching contraceptives – Stopping birth control pills or removing IUDs may resolve symptoms
- Treating underlying conditions – Getting thyroid disorders or androgen excess under control
- Smoking cessation – Quitting smoking often reduces excessive mucus
If an infection is ruled out, making healthy lifestyle choices is recommended. This includes:
- Practicing safe sex with condoms to prevent STIs
- Avoiding douching, which disturbs vaginal pH balance
- Wearing cotton underwear and avoiding tight clothes
- Using mild, unscented soaps externally
- Eating yogurt with live cultures
- Staying hydrated
When abnormal cervical mucus may indicate cancer
In rare cases, abnormal cervical mucus can signal cervical or uterine cancer:
Signs of cervical cancer:
- Watery, foul-smelling discharge tinged with blood
- Heavier or irregular vaginal bleeding
- Bleeding after sex
- Unexplained pelvic pain
- Discomfort during intercourse
- Vaginal itching or burning
Signs of uterine cancer:
- Thin, watery, blood-streaked discharge
- Vaginal bleeding between periods
- Periods that are longer or heavier than usual
- Pelvic pain
Postmenopausal women experiencing new onset of vaginal discharge or bleeding should always get evaluated for cancer. Fortunately, cancer is unlikely to be the reason for abnormal mucus.
When to see a fertility specialist
Abnormal cervical mucus can negatively impact a couple’s ability to conceive. See a fertility specialist if you experience:
- Few days of egg white cervical mucus per cycle
- Little to no fertile quality mucus during cycle
- Inability to conceive after 6 months of trying under 35, or 1 year over 35
Testing can determine if inadequate cervical mucus is contributing to infertility. Ovulation induction medications, intrauterine insemination, or IVF may be recommended.
Tracking abnormal cervical mucus
Keeping a record of your cervical mucus pattern over several cycles can help identify abnormalities. Note mucus characteristics each day:
|7/12||Clear||Thick and sticky||Scant||Itchy vulva|
|7/15||White||Thick and creamy||Moderate|
This mucus monitoring, along with tracking periods and symptoms, provides your doctor helpful information to evaluate discharge abnormalities.
Cervical mucus fluctuates normally through the menstrual cycle. Abnormal variations in color, consistency, smell, and volume may indicate underlying health issues needing evaluation. While cervical cancer is rare, persistent abnormal discharge should not be ignored. Talk to your doctor for proper diagnosis and treatment. With care and follow up, most causes of abnormal mucus can be effectively managed.