Evaluation of vaginal discharge

References

Key articles

Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication].Full text

Sherrard J, Wilson J, Donders G, et al. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2018 Nov;29(13):1258-72. Abstract

Workowski KA, Bachmann LH, Chan PA, et al. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text  Abstract

Miller JM, Binnicker MJ, Campbell S, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018 Aug 31;67(6):e1-94.Full text  Abstract

Reference articles

1. Watson LJ, James KE, Hatoum Moeller IJ, et al. Vulvovaginal discomfort is common in both premenopausal and postmenopausal women. J Low Genit Tract Dis. 2019 Apr;23(2):164-9. Abstract

2. Foxman B, Marsh JV, Gillespie B, et al. Frequency and response to vaginal symptoms among white and African American women: Results of a random digit dialing survey. J Womens Health. 1998 Nov;7(9):1167-74. Abstract

3. Patel V, Pednekar S, Weiss H, et al. Why do women complain of vaginal discharge? A population survey of infectious and pyschosocial risk factors in a South Asian community. Int J Epidemiol. 2005 Aug;34(4):853-62.Full text  Abstract

4. Hillier SL, Austin M, Macio I, et al. Diagnosis and treatment of vaginal discharge syndromes in community practice settings. Clin Infect Dis. 2021 May 4;72(9):1538-43.Full text  Abstract

5. National Institute for Health and Care Excellence (UK). Antenatal care. Aug 2021 [internet publication].Full text

6. da Fonseca TM, Cesar JA, Mendoza-Sassi RA, et al. Pathological vaginal discharge among pregnant women: pattern of occurrence and association in a population-based survey. Obstet Gynecol Int. 2013;2013:590416.Full text  Abstract

7. Prasad D, Parween S, Kumari K, et al. Prevalence, etiology, and associated symptoms of vaginal discharge during pregnancy in women seen in a tertiary care hospital in Bihar. Cureus. 2021 Jan 14;13(1):e12700.Full text  Abstract

8. Cesar JA, Mendoza-Sassi RA, González-Chica DA, et al. Prevalence of self-reported vaginal discharge and associated factors in pregnant women [in Portuguese]. Cad Saude Publica. 2009 Dec;25(12):2705-14.Full text  Abstract

9. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication].Full text

10. Mitchell H. Vaginal discharge-causes, diagnosis, and treatment. BMJ. 2004 May 29;328(7451):1306-8. Abstract

11. Sobel JD. Vulvovaginitis in healthy women. Compr Ther. 1999 Jun-Jul;25(6-7):335-46. Abstract

12. Sobel JD. Pathogenesis of recurrent vulvovaginal candidiasis. Curr Inf Dis Rep. 2002 Dec;4(6):514-9. Abstract

13. Goje O, Munoz JL. Vulvovaginitis: Find the cause to treat it. Cleve Clin J Med. 2017 Mar;84(3):215-24. Abstract

14. Angelou K, Grigoriadis T, Diakosavvas M, et al. The genitourinary syndrome of menopause: an overview of the recent data. Cureus. 2020 Apr 8;12(4):e7586.Full text  Abstract

15. Koumans EH, Sternberg M, Bruce C, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007 Nov;34(11):864-9. Abstract

16. Hoffmann JN, You HM, Hedberg EC, et al. Prevalence of bacterial vaginosis and Candida among postmenopausal women in the United States. J Gerontol B Psychol Sci Soc Sci. 2014 Nov;69 Suppl 2(suppl 2):S205-14.Full text  Abstract

17. Peebles K, Velloza J, Balkus JE, et al. High global burden and costs of bacterial vaginosis: a systematic review and meta-analysis. Sex Transm Dis. 2019 May;46(5):304-11. Abstract

18. Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med. 2005 Nov 3;353(18):1899-911.Full text  Abstract

19. Hill GB. The microbiology of bacterial vaginosis. Am J Obstet Gynecol. 1993 Aug;169(2 Pt 2):450-4. Abstract

20. Hay P. Recurrent bacterial vaginosis. Curr Infect Dis Rep. 2000 Dec;2(6):506-12. Abstract

21. Sobel JD, Kaur N, Woznicki NA, et al. Prognostic indicators of recurrence of bacterial vaginosis. J Clin Microbiol. 2019 Apr 26;57(5):e00227-19.Full text  Abstract

22. Schwebke J, Desmond R. A randomized trial of metronidazole in asymptomatic bacterial vaginosis to prevent the acquisition of sexually transmitted diseases. Am J Obstet Gynecol. 2007 Jun;196(6):517;e1-6.Full text  Abstract

23. Peipert J, Montagno AB, Cooper AS, et al. Bacterial vaginosis as a risk factor for upper genital tract infection. Am J Obstet Gynecol. 1997 Nov;177(5):1184-7. Abstract

24. British Association for Sexual Health and HIV. UK National guideline for the management of bacterial vaginosis. 2012 [internet publication].Full text

25. Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998 Sep 10;12(13):1699-706. Abstract

26. Sena AC, Miller WC, Hobbs MM, et al. Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clin Infect Dis. 2007 Jan 1;44(1):13-22. Abstract

27. Vutyavanich T, Pongsuthirak P, Vannareumol P, et al. A randomized double-blind trial of tinidazole treatment of the sexual partners of females with bacterial vaginosis. Obstet Gynecol. 1993 Oct;82(4 Pt 1):550-4. Abstract

28. Leitich H, Bodner-Adler B, Brunbauer M, et al. Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol. 2003 Jul;189(1):139-47. Abstract

29. Hillier SL, Nugent RP, Eschenbach DA, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995 Dec 28;333(26):1737-42.Full text  Abstract

30. Brocklehurst P, Gordon A, Heatley E, et al. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000262.Full text  Abstract

31. Klebanoff MA, Schuit E, Lamont RF, et al. Antibiotic treatment of bacterial vaginosis to prevent preterm delivery: systematic review and individual participant data meta-analysis. Paediatr Perinat Epidemiol. 2023 Mar;37(3):239-51.Full text  Abstract

32. Kahwati LC, Clark R, Berkman N, et al. Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020 Apr 7;323(13):1293-1309.Full text  Abstract

33. Kahwati LC, Clark R, Berkman ND, et al. Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Apr. Report No.: 19-05259-EF-1.Full text  Abstract

34. Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA. 2004 Mar 17;291(11):1368-79. Abstract

35. Kreisel KM, Spicknall IH, Gargano JW, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2018. Sex Transm Dis. 2021 Apr 1;48(4):208-14.Full text  Abstract

36. Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019 Aug 1;97(8):548-62P.Full text  Abstract

37. Centers for Disease Control and Prevention. ​Sexually transmitted infections (STIs) are very common and costly to the nation’s health and economy. Jan 2021 [internet publication].Full text

38. Krieger JN. Urologic aspects of trichomoniasis. Invest Urol. 1981 May;18(8):411-7. Abstract

39. Sherrard J, Pitt R, Hobbs KR, et al. British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021. Int J STD AIDS. 2022 Jul;33(8):740-50. Abstract

40. Sherrard J, Wilson J, Donders G, et al. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2018 Nov;29(13):1258-72. Abstract

41. Røttingen JA, Cameron DW, Garnett GP. A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known? Sex Transm Dis. 2001 Oct;28(10):579-97.Full text  Abstract

42. Wang CC, McClelland RS, Reilly M, et al. The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type 1. J Infect Dis. 2001 Apr 1;183(7):1017-22.Full text  Abstract

43. Kissinger P, Amedee A, Clark RA, et al. Trichomonas vaginalis treatment reduces vaginal HIV-1 shedding. Sex Transm Dis. 2009 Jan;36(1):11-6.Full text  Abstract

44. Sobel JD. Vaginal infections in adult women. Med Clin North Am. 1990 Nov;74(6):1573-602. Abstract

45. Yano J, Sobel JD, Nyirjesy P, et al. Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Womens Health. 2019 Mar 29;19(1):48.Full text  Abstract

46. Ferris DG, Nyirjesy P, Sobel JD, et al. Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis. Obstet Gynecol. 2002 Mar;99(3):419-25. Abstract

47. De Leon EM, Jacober SJ, Sobel JD, et al. Prevalence and risk factors for vaginal Candida colonization in women with type 1 and type 2 diabetes. BMC Infect Dis. 2002 Jan 30;2:1. Abstract

48. National Institute for Health and Care Excellence (UK). Candida - female genital: what are the risk factors? July 2022 [internet publication].Full text

49. Eckert LO, Hawes SE, Stevens CE, et al. Vulvovaginal candidiasis: clinical manifestations, risk factors, management algorithm. Obstet Gynecol. 1998 Nov;92(5):757-65. Abstract

50. Jensen JS, Cusini M, Gomberg M, et al. 2021 European guideline on the management of Mycoplasma genitalium infections. J Eur Acad Dermatol Venereol. 2022 May;36(5):641-50. Abstract

51. Sobel JD. Vaginitis. N Engl J Med. 1997 Dec 25;337(26):1896-903. Abstract

52. Verstraelen H, Verhelst R, Vaneechoutte M, et al. Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women. Arch Gynecol Obstet. 2011 Jul;284(1):95-8. Abstract

53. Yirenya-Tawiah D, Amoah C, Apea-Kubi KA, et al. A survey of female genital schistosomiasis of the lower reproductive tract in the Volta basin of Ghana. Ghana Med J. 2011 Mar;45(1):16-21.Full text  Abstract

54. Foda AA, El-Malky MM. Prevalence of genital tract infection with Entamoeba gingivalis among copper T 380A intrauterine device users in Egypt. Contraception. 2012 Jan;85(1):108-12. Abstract

55. Rodrigues AC, Teixeira R, Teixeira T, et al. Impact of pelvic radiotherapy on female sexuality. Arch Gynecol Obstet. 2012 Feb;285(2):505-14. Abstract

56. Baessler K, Hewson AD, Tunn R, et al. Severe mesh complications following intravaginal slingplasty. Obstet Gynecol. 2005 Oct;106(4):713-6. Abstract

57. US Food and Drug Administration. Urogynecologic surgical mesh implants. Aug 2021 [internet publication].Full text

58. US Food and Drug Administration. FDA's activities: urogynecologic surgical mesh. Oct 2022 [internet publication].Full text

59. Sanfilippo JS, Wakim NG. Bleeding and vulvovaginitis in the pediatric age group. Clin Obstet Gynecol. 1987 Sep;30(3):653-61. Abstract

60. McGreal S, Wood P. Recurrent vaginal discharge in children. J Pediatr Adolesc Gynecol. 2013 Aug;26(4):205-8. Abstract

61. Jaquiery A, Stylianopoulos A, Hogg G, et al. Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract. Arch Dis Child. 1999 Jul;81(1):64-7.Full text  Abstract

62. Striegel AM, Myers JB, Sorensen MD, et al. Vaginal discharge and bleeding in girls younger than 6 years. J Urol. 2006 Dec;176(6 Pt 1):2632-5. Abstract

63. Simon DA, Berry S, Brannian J, et al. Recurrent, purulent vaginal discharge associated with longstanding presence of a foreign body and vaginal stenosis. J Pediatr Adolesc Gynecol. 2003 Dec;16(6):361-3. Abstract

64. Merkley K. Vulvovaginitis and vaginal discharge in the pediatric patient. J Emerg Nurs. 2005 Aug;31(4):400-2. Abstract

65. Workowski KA, Bachmann LH, Chan PA, et al. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text  Abstract

66. Singh RH, Zenilman JM, Brown KM, et al. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sex Transm Infect.2013 May;89(3):185-90. Abstract

67. Chinnock B, Yore M, Mason J, et al. Self-obtained vaginal swabs are not inferior to provider-performed endocervical sampling for emergency department diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis. Acad Emerg Med. 2021 Jun;28(6):612-20.Full text  Abstract

68. Barnes P, Vieira R, Harwood J, et al. Self-taken vaginal swabs versus clinician-taken for detection of candida and bacterial vaginosis: a case-control study in primary care. Br J Gen Pract. 2017 Dec;67(665):e824-9.Full text  Abstract

69. Strauss RA, Eucker B, Savitz DA, et al. Diagnosis of bacterial vaginosis from self-obtained vaginal swabs. Infect Dis Obstet Gynecol. 2005 Mar;13(1):31-5.Full text  Abstract

70. Smith K, Harrington K, Wingood G, et al. Self-obtained vaginal swabs for diagnosis of treatable sexually transmitted diseases in adolescent girls. Arch Pediatr Adolesc Med. 2001 Jun;155(6):676-9.Full text  Abstract

71. Van Der Pol B, Williams JA, Taylor SN, et al. Detection of Trichomonas vaginalis DNA by use of self-obtained vaginal swabs with the BD ProbeTec Qx assay on the BD Viper system. J Clin Microbiol. 2014 Mar;52(3):885-9.Full text  Abstract

72. Miller JM, Binnicker MJ, Campbell S, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018 Aug 31;67(6):e1-94.Full text  Abstract

73. Coleman JS, Gaydos CA. Molecular diagnosis of bacterial vaginosis: an update. J Clin Microbiol. 2018 Sep;56(9):e00342-18.Full text  Abstract

74. Soni S, Horner P, Rayment M, et al. British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018). Int J STD AIDS. 2019 Sep;30(10):938-50. Abstract

75. Phillips NA, Bachmann GA. Genitourinary syndrome of menopause: common problem, effective treatments. Cleve Clin J Med. 2018 May;85(5):390-8.Full text  Abstract

76. Kleppa E, Holmen SD, Lillebø K, et al. Re: Al-Baghdadi O, Samarasinghe A, Wissa I. 2014. Cervical schistosomiasis. Journal of Obstetrics and Gynaecology 34:206. J Obstet Gynaecol. 2014 Nov;34(8):755-6. Abstract

77. Stott D, Zakaria M. The transcervical expulsion of a large fibroid. BMJ Case Reports. BMJ Case Rep. 2012 Sep 24;2012:bcr0120125523.Full text  Abstract

78. de la Poza G, López-Sanroman A, Taxonera C, et al. Genital fistulas in female Crohn's disease patients: clinical characteristics and response to therapy. J Crohns Colitis. 2012 Apr;6(3):276-80. Abstract

79. Ou YC, Huang HY, Huang CC, et al. Primary fallopian tube carcinoma: clinicopathological analysis of 12 cases. Taiwan J Obstet Gynecol. 2011 Jun;50(2):141-4. Abstract

80. Cao XX, Li J, Zhang W, et al. Patients with primary diffuse large B-cell lymphoma of female genital tract have high risk of central nervous system relapse. Ann Hematol. 2014 Jun;93(6):1001-5. Abstract

81. Bull L, Knowles A, Ogden S, et al. Primary cervical lymphoma: a rare presentation to a genitourinary medicine clinic. Int J STD AIDS. 2013 Jul;24(7):587-9. Abstract

82. Nelson TM, Borgogna JC, Michalek RD, et al. Cigarette smoking is associated with an altered vaginal tract metabolomic profile. Sci Rep. 2018 Jan 16;8(1):852.Full text  Abstract

83. Mittal V, Jain A, Pradeep Y. Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries. J Infect Dev Ctries. 2012 May 14;6(5):373-7. Abstract

84. Amsel R, Totten PA, Spiegel CA, et al. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983 Jan;74(1):14-22. Abstract

85. Simoes JA, Discacciati MG, Brolazo EM, et al. Clinical diagnosis of bacterial vaginosis. Int J Gynaecol Obstet. 2006 Jul;94(1):28-32. Abstract

86. Gaydos CA, Hsieh YH, Barnes M, et al. Trichomonas vaginalis infection in women who submit self-obtained vaginal samples after internet recruitment. Sex Transm Dis. 2011 Sep;38(9):828-32. Abstract

87. Petrin D, Delgaty K, Bhatt R, et al. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. 1998 Apr;11(2):300-17.Full text  Abstract

88. Centers for Disease Control and Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae - 2014. MMWR Recomm Rep. 2014 Mar 14;63(RR-02):1-19.Full text  Abstract

89. Geisler WM, Chow JM, Schachter J, et al. Pelvic examination findings and Chlamydia trachomatis infection in asymptomatic young women screened with a nucleic acid amplification test. Sex Transm Dis. 2007 Jun;34(6):335-8. Abstract

90. Stenchever MA, Droegemueller W, Herbst AL, et al. Comprehensive gynecology. 4th ed. St. Louis, Missouri: Mosby; 2006; 655-6.

91. Centers for Disease Control and Prevention. Genital herpes. Sexually transmitted infections treatment guidelines, 2021. Sep 2022 ​[internet publication].Full text

92. Pretorius R, Semrad N, Watring W, et al. Presentation of cervical cancer. Gynecol Oncol. 1991 Jul;42(1):48-53. Abstract

Use of this content is subject to our disclaimer