Vaginal discharge

Vaginal discharge is a common presenting symptom at gynaecology and sexual health clinics and in general practice. It is usually physiological and is subject to hormonal variations in consistency and quantity. With this in mind, appropriate diagnosis and treatment of abnormal vaginal discharge can be challenging. Concurrent pregnancy can also complicate the situation. Some pathological conditions may contribute to vaginal discharge, including cervicitis, aerobic vaginitis, atrophic vaginitis and mucoid ectopy. We mainly focus on the three most prevalent pathological causes namely; bacterial vaginosis, vulvovaginal candidiasis and Trichomonas vaginalis and will also provide a brief overview of atypical inflammatory vaginitis as well. Obtaining a methodical and detailed history from the patient should give the majority of the information required. Examination and analysis of discharge with swabs are a useful adjunct to aid diagnosis. Once a diagnosis is made, appropriate treatment must then be instigated and in some cases partner notification and treatment may also be required.