Vaginal discharge

Vaginal discharge is a common presentation in sexual health clinics, gynaecology clinics and general practice. The three common causes with vaginal pathology - candidiasis, bacterial vaginosis and trichomoniasis - are diagnosed with the aid of relatively simple diagnostic tests. Cervicitis caused by organisms such as Chlamydia can cause a purulent discharge. Other causes include atrophic vaginitis, desquamative inflammatory vaginitis, cytolytic vaginosis and rarely neoplasia. Candidiasis is treated initially with oral or topical azoles. Bacterial vaginosis and trichomoniasis are treated with metronidazole, and partner notification is required for the latter. Frequently recurrent candidiasis and bacterial vaginosis are problematic, and specialist advice should be sought.