Diagnosis and treatment of vulvovaginitis

Abstract

Vulvovaginitis symptoms are common and are the most frequent reason for visits to the obstetrician gynecologist. Vulvovaginitis symptoms are prevalent in a large range of age groups, and they can have a significant impact on women's lives. The most common cause of vaginitis is bacterial vaginosis and the other two common causes are candida vaginitis and trichomoniasis. Together theses account for over 90% of all vaginitis diagnosis. Selfdiagnosis is common but often inaccurate. Vaginitis is associated with increased risk of acquiring a sexually transmitted disease or other female genital tract infections including human immunodeficiency virus (HIV). Theses concurrent conditions may result in infection of the upper genital tract and can lead to infertility as well as adverse reproductive and medical outcomes in pregnant and non pregnant women. Evaluation consists of a detailed focused history, physical exam, and appropriate diagnostic testing. Empiric therapy based on history and physical examination alone should be avoided because of frequent misdiagnosis and inappropriate therapy. Treatment should be chosen based on diagnostic findings and may be guided by cost, patient convenience and patient preference and directed to treat the most common causes such as bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. A discussion on proper vaginal hygiene including gentle cleaning and drying the vulvar area may be useful.