Vaginal Discharge

Question 1

Is a small amount of vaginal discharge normal?

Answer 1

Yes

Question 2

What is a vaginal discharge normally made of?

Answer 2

Secretions from
- Cervix
- Vaginal walls
- Glands at entrance to vagina
Exfoliated epithelial cells
Bacteria

Question 3

What does the amount of fluid normally discharged vary depending on?

Answer 3

Phase of menstrual cycle
Pre-/post-menopausal
Medications; eg: oral contraceptive pill

Question 4

Describe the physiological vaginal discharge

Answer 4

Usually colourless
- Can be white/pale yellow
Can have mild odour depending on balance of microflora
Unusual to have unpleasant odour
Consistency can vary
- Thinner and more profuse before ovulation
- Thicker after ovulation

Question 5

What is the most common pathological cause for vaginal discharge?

Answer 5

Infection

Question 6

What can cause an infection producing vaginal discharge?

Answer 6

Overgrowth of bacteria normally present in vagina
- Bacterial vaginosis
- Candidiasis
Sexually transmitted diseases
- Trichomonas
- Occasionally chlamydia

Question 7

What are the less common causes of vaginal discharge?

Answer 7

Local dermatological condition

Foreign body; eg: retained tampon

Question 8

What is the typical vaginal discharge produced in candidiasis?

Answer 8

White discharge
Clumped
Similar to curd/cottage cheese

Question 9

What is the typical vaginal discharge produced in bacterial vaginosis?

Answer 9

Whitish-grey discharge

Unpleasant fishy smell

Question 10

What is the typical vaginal discharge produced by trichomonas?

Answer 10

Frothy discharge

Green/yellow

Question 11

How do you interrogate the quality of the vaginal discharge?

Answer 11

Colour
Odour
Consistency

Question 12

How do you interrogate the severity of the vaginal discharge?

Answer 12

Estimate volume

Do you need to wear pads/panty liners?

Question 13

How do you interrogate the time course of the vaginal discharge?

Answer 13

How long the discharge has been present
Has it changed over time
Had this before

Question 14

How do you interrogate the context of the vaginal discharge?

Answer 14

Taking antibiotics
Are you sexually active?
- When was the last time you had any sexual contact?
- Does your partner have any symptoms?
- Does your partner use condoms?

Question 15

How do you interrogate the aggravating factors of the vaginal discharge?

Answer 15

What makes it worse; eg: physiological discharge could be made worse by use of the oral contraceptive pill

Question 16

How do you interrogate the relieving factors of the vaginal discharge?

Answer 16

Tried any treatment

How effective this has been

Question 17

How do you interrogate the associated features of the vaginal discharge?

Answer 17

Pruritis
Dysuria
Pelvic pain
Dyspareunia
Fever
Abnormal bleeding
Rashes
Lumps
Sores