I have a discharge that is clear and exactly like water. It is so bad that even though I wear a tampon and a pad I still have to change them several times a day. There is absolutely no substance to this discharge. Do you have any idea what could be causing this? I am 44 years old, and this just started about a year ago.

--N.L.

There are several possibilities for a copious watery discharge. The most common is midcycle ovulatory cervical mucus. This type of mucus is very much like egg white -- clear and somewhat stretchy. It occurs for a few days right around the time an egg is released. If you had been on birth control pills and stopped them, you may be noticing this type of discharge for the first time.

The second thing that immediately comes to mind is that this heavy, watery discharge may represent urinary incontinence. Leakage of urine usually has an associated odor -- it smells like urine. If you have had pelvic surgery such as a hysterectomy, another possibility is a fistula (connection) between the bladder and the top of the vagina; this can cause urine to leak out almost constantly.

A third, and much less common, reason for such a discharge is cancer of the fallopian tubes. This type of cancer is exceedingly rare, occuring in only 3-4 women in a million, with the average age at diagnosis being in the 50s. A clear watery discharge or vaginal bleeding are two signs of this rare cancer.

You should see your gynecologist for a thorough exam. While some amount of discharge is normal, the amount you describe (requiring a tampon and a pad) is excessive.