Vaginal Discharge

Cause:

  • In reproductive years – infection is most common cause
  • Atrophy may affect pre-pubertal or post-menopausal women
  • Poor hygiene, foreign body and sexual interferences are likely causes in pre-pubescent girls

Infections

Summary of infective causes

  • candida
    • Not STI
    • Clotrimazole pessery
  • Trichomoniasis vaginalis
    • Thin yellow/green smelly discharge
    • Dysparunia & dysuria (external)
    • Metronidazole
    • treat the partner
  • BV
    • Most common cause of discharge
    • Fishy smell – especially post coital
    • “Sexually Associated”
    • Metronidazole
    • Treat Female partners
  • Gonorrhoea
    • 50% of women are assymptomatic
    • Can lead to PID
    • IM Ceftriazone + Oral azithromycin
  • Chlamydia
    • 70% women are asymptomatic
    • Most common STI
    • Can cause PID & fetal problems
    • Doxycycline or erythromycin if pregnant

Non-Infective Causes

  • Physiological Discharge
  • Atrophic change
    • Prepubertal
    • Postmenopausal
  • Foreign Body
    • small object in child
    • forgotten tampon or more bizarre object
    • forgotten ring pessary
  • Chemical Irritation
  • Excretions
    • Urine from vesicovaginal fistula
    • faecess from rectovaginal fistula
  • Serosanguinous discharge
    • from carcinooma of vagina/cervix/endometrium/fallopian tubes
    • Necrotic polyp