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Chapter 31 - Non-infectious Benign Vaginal Conditions

from Section 6 - Vulva and Vagina

Published online by Cambridge University Press:  24 November 2021

By
Orna Reichman  and
Jack D. Sobel
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Non-infectious benign vaginal conditions are a small fraction of genital conditions causing pruritus, irritation, dyspareunia, vaginal discharge, malodour and burning. In an attempt to differentiate between the various aetiologies – infectious (Candidiasis, Trichomonas, group A Streptococcus, bacterial vaginosis), hormone-related (vaginal atrophy), immune mediated (desquamative inflammatory vaginitis, erosive lichen planus), miscellaneous (contact dermatitis, trauma) – one needs to understand the delicate equilibrium between vaginal epithelium, microbiota and reproductive hormones, and learn to use the wet mount (microscopy) and pH as basic tools for conducting a thorough evaluation of vaginal secretions. Differentiating between a normal to an abnormal discharge is crucial and is a basic clinical skill needed in primary gynaecological clinics. A flow chart combining pH and wet mount will be presented in order to diagnose causation of vaginal discomfort. Two non-infectious benign vaginal conditions will be presented in detail; vaginal atrophy (genitourinary syndrome of the menopause) and desquamative inflammatory vaginitis.

Keywords

vaginal dischargewet mount microscopycandidiasisbacterial vaginosisTrichomoniasisgenitourinary symptoms of menopause
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 257 - 265
Publisher: Cambridge University Press
Print publication year: 2021

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