Vaginal discharge: common causes and management

Vaginal discharge is a common symptom in women of reproductive age. The causes can be divided into those that are infective or non-infective, the most common being the infective agents. Initial assessment of a patient with vaginal discharge requires a thorough history, including sexual history, examination, and testing for these common infections.

The non-sexually transmitted infections (STIs)—bacterial vaginosis and candidiasis—are the most frequently encountered and these can often be diagnosed immediately by the clinical findings and simple bedside tests. Persistence or recurrence of these infections is also seen and might require repeated or prolonged courses of treatment.

The STIs—chlamydia, gonorrhoea and trichomoniasis—can also cause vaginal discharge and diagnosis requires appropriate laboratory tests to be performed. Partner notification and treatment is an essential part of the management.

In the absence of any infections, physiological discharge should be considered as a possible cause.