Vaginal discharge

Question 1

Physiological

Answer 1

Usually non-offensive

Increases around ovulation, during pregnancy and in women taking the COC

Question 2

Bacterial vaginosis

Answer 2

Grey-white
Not itchy
Raised pH
Fishy odour
Antibiotics

Question 3

Atrophic vaginitis

Answer 3

Clear
Raised pH
Redness
Due to oestrogen deficiency
Common before menarche, during lactation and after menopause
Topical oestrogen cream or systemic HRT for postmenopausal women

Question 4

Foreign body

Answer 4

Retained tampons or swabs after childbirth
Not uncommon in young child
May be many organisms
Discharge usually very offensive

Question 5

Ectropion

Answer 5

Clear discharge
Not itchy
Columnar epithelium of endocervix visible around os
Normal finding in younger women, esp pregnant or taking the pill
Can cause post-coital bleeding
Smear, swab and colposcopy to exclude malignancy and infection
Cryotherapy or diathermy

Question 6

Candidiasis

Answer 6

White
Itchy
Redness
Imidazoles

Question 7

Trichomoniasis

Answer 7

Grey-green
Itchy
Raised pH
Redness
Funny odour
Antibiotics

Question 8

Malignancy

Answer 8

Bloody, red-brown
No itch
Offensive odour
Biopsy