Physiological Discharge and Non-Infectious Vulvovaginitis

by Dr. Inthush Kavisha 

Physiological Discharge

1. clear or white discharge
2. smear contains epithelial cells
3. pH < 4.5
4. increases with increased estrogen states: pregnancy, BCP, mid cycle
5. if increased in perimenopausal woman, investigate for other effects of excess estrogen (e.g. endometrial cancer)

Non-Infectious Vulvovaginitis

Prepubertal Vaginitis

1. most common causes:
   1. foreign objects, trauma (consider child abuse)
   2. poor hygiene (e.g. pinworm infection)

Postmenopausal Vaginitis/Atrophic Vaginitis

symptoms

1. dyspareunia
2. post-coital spotting
3. mild pruritus

Treatment

1. rule out malignancy
2. estrogen creams
3. oral or transdermal hormone replacement therapy
4. good hygiene

Chemical Vulvovaginitis

1. symptoms and signs of irritation present without infection
2. irritants in vaginal contraceptives, bubble baths, soaps, genital deodorants, coloured or scented toilet paper, detergents, and fabric softeners
3. frequent minipad or tampon use tight synthetic clothing
4. pools, hot tubs