Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

Thin mucinous discharge at the external os is normal and is more abundant in the first half (the follicular phase) of the menstrual cycle. During the second half (the luteal phase) of the menstrual cycle, especially before menstruation, the mucus is less abundant and is more tenacious. The amount and the consistency of normal vaginal discharge also vary with age, pregnancy status, and use of oral contraceptive pills.

Visualization of the cervix during pregnancy may be difficult because of the presence of copious tenacious mucus covering the cervix. Sometimes it is not possible to remove the mucus and it must be manipulated with a cotton swab to visualize the entire cervix.

The next section discusses the appearance of the cervix during normal menstrual bleeding.