Symptom finder - The causes of vaginal discharge
Symptom finder - The causes of vaginal discharge
The common causes of vaginal discharge are vaginal carcinoma, vulva carcinoma, salpingitis, bacterial vaginosis, colovaginal fistula, Bartholin gland’s infection, intrauterine contraceptive device, Trichomonas vaginosis, pyometra, tampon, pessary,retained foreign bodies, excessive normal secretion and cervicitis due to herpes, chlamydia and gonorrhea. Diabetes mellitus is associated with recurrent thrust.
Patient may suffer from pelvic inflammatory disease if complaining of fever, tenderness and pain in the pelvic region. Bacterial vaginosis and trichomonal vaginosis may lead to offensive smell. Just feel wet is commonly associated with excessive normal secretion. Thrush is highly suggestive in case of intense itch. Full sexual history is vital such as the number of partners, changes in partners or any sexual protection intake. It is rare for vaginal discharge to occur before puberty. At this stage, vaginal discharge is associated with sexual abuse or foreign bodies. If sexually transmitted disease is suspected, consider full sexual history and refer the patient to the GUM clinic and consider contact tracing. Full history of discharge is also vital which include consistency, color, smell and timing.
Full pelvic examination is performed in post menopausal woman as vaginal discharge at post menopausal years are associated with malignancy. Candidiasis may present with thick odorless discharge as well as itchy red swollen vulva.Gonorrhea is characterized by cervical discharge which is thick , yellow brown in color. Chlamydia may produce thinner yellow brown discharge from the cervix. Bacterial vaginosis is characterized by thin, grey white fishy smelling discharge. Speculum examination is performed. Inflamed cervix may occur due to herpes, chlamydia and gonococcus as well as due to trichomonal vaginosis.
The common causes of vaginal discharge are vaginal carcinoma, vulva carcinoma, salpingitis, bacterial vaginosis, colovaginal fistula, Bartholin gland’s infection, intrauterine contraceptive device, Trichomonas vaginosis, pyometra, tampon, pessary,retained foreign bodies, excessive normal secretion and cervicitis due to herpes, chlamydia and gonorrhea. Diabetes mellitus is associated with recurrent thrust.
Patient may suffer from pelvic inflammatory disease if complaining of fever, tenderness and pain in the pelvic region. Bacterial vaginosis and trichomonal vaginosis may lead to offensive smell. Just feel wet is commonly associated with excessive normal secretion. Thrush is highly suggestive in case of intense itch. Full sexual history is vital such as the number of partners, changes in partners or any sexual protection intake. It is rare for vaginal discharge to occur before puberty. At this stage, vaginal discharge is associated with sexual abuse or foreign bodies. If sexually transmitted disease is suspected, consider full sexual history and refer the patient to the GUM clinic and consider contact tracing. Full history of discharge is also vital which include consistency, color, smell and timing.
Full pelvic examination is performed in post menopausal woman as vaginal discharge at post menopausal years are associated with malignancy. Candidiasis may present with thick odorless discharge as well as itchy red swollen vulva.Gonorrhea is characterized by cervical discharge which is thick , yellow brown in color. Chlamydia may produce thinner yellow brown discharge from the cervix. Bacterial vaginosis is characterized by thin, grey white fishy smelling discharge. Speculum examination is performed. Inflamed cervix may occur due to herpes, chlamydia and gonococcus as well as due to trichomonal vaginosis.
The investigations required are urine analysis, triple swabs, vaginal pH testing, gram stain, MRI, barium enema , D&C and hysteroscopy.
First catch urine analysis is useful for DNA amplification of Chlamydia. Triple swabs may include endocervical swab ( for detection of chlamydia trachomatis and gonorrhea) and high vaginal swab ( for detection of candidiasis, bacterial vaginosis and trichomonal vaginosis).
Vaginal pH testing is useful as pH> 4.5 indicates bacterial vaginosis while pH< 4.5 is due to candidiasis. Gram stain on urethral or cervical exudates are useful as gonorrhea is detected to be caused by gram negative intracellular diploccoci. MRI and barium enema may detect colovaginal fistula . D&C or dilation and curettage are useful to detect the present of malignancy. Hysteroscopy is useful for menorrhagia ( excessive menstruation) and malignancy.
First catch urine analysis is useful for DNA amplification of Chlamydia. Triple swabs may include endocervical swab ( for detection of chlamydia trachomatis and gonorrhea) and high vaginal swab ( for detection of candidiasis, bacterial vaginosis and trichomonal vaginosis).
Vaginal pH testing is useful as pH> 4.5 indicates bacterial vaginosis while pH< 4.5 is due to candidiasis. Gram stain on urethral or cervical exudates are useful as gonorrhea is detected to be caused by gram negative intracellular diploccoci. MRI and barium enema may detect colovaginal fistula . D&C or dilation and curettage are useful to detect the present of malignancy. Hysteroscopy is useful for menorrhagia ( excessive menstruation) and malignancy.
