3. Causes
Physiological
1. During puberty – increased estrogen – endocervical
epithelium overgrowth – ectopy – increased secretion
2. During Ovulation- increased estrogen – increased activity of
cervical glands
3. Pregnancy-hyperestrinism- increased vascularity – vaginal
transudate and cervical gland secretion
4. Sexual excitement from Bartholin’s gland
4. Pathological-
1. Noninfective-nonpurulent, nonoffensive and nonirritant
Cervical cause- cx ectopy, chronic cervicitis, mucous polyp and ectropion
Vaginal cause- uterine prolapse, acquired retroverted ut, chronic pelvic infection, pill
use and vaginal adenosis
2. Infective- purulent , offensive and irritant
Specific- vulvovaginitis, Trichomoniasis, Moniliasis, Vaginitis due to C. Trachomatis,
Atrophic vaginitis
Nonspecific
3. Neoplastic
4. Foreign body
5. Trichomoniasis
C/F
1. Sudden profuse and offensive vaginal discharge
2. Irritation and itching
3. Urinary symptoms – dysuria and frequency of micturition
O/E
1. Vaginal discharge- thin greenish yellow frothy and offensive
2. Vulva is inflamed
3. Vagina- painful ex, vx walls become inflamed with multiple punctate
hemorrhagic spots- giving appearance of strawberry
6. Investigation
1. Hanging drop preparation
2. Culture of HVS
Treatment –
Metronidazole 200 mg TDS for 1 week
2 gm single dose
7. Moniliasis(Candida vaginitis)
C/F
1. Vaginal discharge with intense vaginal pruritis
2. Dyspareunia
O/E
1. Discharge is thick , curdy white and in flakes adherent to vaginal wall
2. Vulva may be red and swollen
3. Vaginal ex tender
8. Investigation
1. Wet smear- KOH solution 10% - filamentous form of mycella , pseudo hyphae
seen under microscope
2. Culture- Nickerson’s or Sabourauds nedua
Treatment
Cap Flucanozole 150mg per week
Nystatin vaginal prep
