Vaginal discharge

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shankar Kumar, M.B.B.S. [2]

Synonyms and Keywords: Discharge from the vagina

Overview

Vaginal discharge is a common patient complaint that is paired with anxiety regarding sexually transmitted diseases. If a STD is detected, a search for all other STDs should be done. Advise the infected patient to inform all sexual partners of their diagnosis.

Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic Scabies
Drug Side Effect Amoxicillin and Clavulanic Acid , Butoconazole Vaginal Cream , Clotrimazole , Combined oral contraceptive pill, Estradiol Topical , Estradiol Transdermal , Estrogen and Progestin (Oral Contraceptives) ,Estrogen Injection , Estrogen Vaginal , Etonogestrel and Ethinyl Estradiol Vaginal Ring , Glatiramer Injection ,Hormone replacement therapy (trans), Letrozole, Leuprolide , Medroxyprogesterone Injection , Metronidazole Topical ,Miconazole , Nafarelin , Natalizumab injection , Norelgestromin and ethinyl estradiol transdermal system , Ospemifene, Oxcarbazepine , Pramipexole, Progesterone, Tamoxifen , Terconazole Vaginal Cream, Vaginal Suppositories , Toremifene, Zoledronic Acid Injection
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic Colposcopy
Infectious Disease Pelvic inflammatory disease, Urethritis, Cervicitis, Vaginitis, Vulvitis

Bacteria: Bacterial Vaginosis, Chlamydia, Gonorrhea, Syphilis

Viral: Herpes simplex, HIV, Human Papillomavirus infections

Fungal: Candidiasis

Parasitic: Trichomonas vaginalis, Trichomoniasis

Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Lochia, Menstrual cycle, Postnatal, Pregnancy
Oncologic Cervical cancer, Endometrial cancer, Uterine sarcoma, Vaginal cancer
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Allergic vaginitis
Sexual Atrophic Vaginitis, Cervical cancer, Cervical polyp, Cervicitis, Endometrial cancer, Foreign body vaginitis, Salpingitis, Uterine sarcoma, Vaginal cancer, Vaginitis, Vesicovaginal fistula, Vulvitis,Colposcopy, Pelvic inflammatory disease, Allergic vaginitis, Vaginal trauma, Bacterial Vaginosis,Candidiasis
Trauma Vaginal trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


Laboratory Findings

Initial tests include:

Other Diagnostic Studies

Type pH Discharge Odor Wet Mount
Trich >4.5 yellow-green, copious present motile, flagellated
BV >4.5 white-grey fishy clue cells
Candida <4.5 white, curd-like none pseudo-hyphae
GC mucopurulent varies PMNs
A.V. thin,gray,watery none few epithelial cells

Treatment

See most recent CDC guidelines for all STD's

Acute Pharmacotherapies

Bacterial Vaginosis

Candida and Chlamydia

Gonorrhea

Trichomonas

References




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