Management of Vaginitis - American Family Physician

See page 2131 for definitions of strength-ofrecommendation labels. V aginitis is among the most common conditions for which women seek medical care, with vaginal discharge accounting for approximately 10 million office visits each year.1 Although vaginitis can have a variety of causes (Table 1), it most often is associated with infection or atrophic changes. Common infectious forms of vaginitis include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Although these infections generally respond to treatment, misdiagnosis and, rarely, pharmacologic resistance may occur. In almost all patients with vaginitis, it is important to perform a thorough assessment that includes speculum examination, pH testing, wet-mount and potassium hydroxide (KOH) preparations, and cultures when indicated. This article reviews the diagnosis and management of bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, and vaginal atrophy.