Etiology, Diagnosis, and Management of Vaginitis

Jane Mashburn, CNM, MN, FACNM


J Midwifery Womens Health. 2006;51(6):423-430. 

In This Article

Abstract and Introduction

Women often seek medical care for vaginal complaints. Many times, the cause of the complaint is misdiagnosed by the woman and/or her provider. These vaginal complaints may be related to infections, which when misdiagnosed or mistreated, can lead to more severe problems. This article describes the three most common vaginal infections, bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis. Appropriate diagnostic techniques and management therapies are reviewed.

Vaginitis is one of the most common conditions for which women seek medical care. Approximately 10 million office visits each year are attributed to vaginal discharge complaints.[1] Many women with vaginal complaints self-treat incorrectly with over-the-counter drugs.[2] Health care providers themselves may miss the correct diagnosis if they fail to confirm the diagnosis with the proper laboratory tests.[3]

Vaginal symptoms are usually related to one of three conditions: bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and trichomoniasis.[1] These infections usually respond to appropriate treatment; however, misdiagnosis and pharmacologic failure may occur. Other less common forms of vaginal symptoms include atrophic vaginitis, chemical irritation, lichen planus, allergic vaginitis, desquamative vaginitis, and foreign body.[1,4]

It is important to accurately diagnose the problem and prescribe the appropriate treatment. This is relatively easy to do by performing a thorough assessment, including wet mount microscopy, pH testing, and cultures as needed.[1,4]

This article discusses the etiology, diagnosis, and management of the three most common vaginal infections.


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