Abnormal vaginal dischargeBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4975 (Published 13 August 2013) Cite this as: BMJ 2013;347:f4975
- Radia Fahami, foundation year 2 doctor
- 1East Park Road Practice, Leicester LE5 5FD, UK
- Accepted 2 July 2013
A 29 year old woman complains of a one week history of thick, white, odourless vaginal discharge and vulval pruritus. There was no dyspareunia or abnormal vaginal bleeding. On examination, the abdomen is not tender, the vulva seems normal, and speculum examination reveals thick white discharge.
What you should cover
Characteristics of the discharge—Onset, duration, colour, odour, consistency (a discharge that is heavier, thicker, or more offensive than usual is abnormal), cyclical changes, exacerbating factors (such as after intercourse) (see table⇓ for details).
Any associated symptoms—Itch, dyspareunia, abdominal pain; abnormal vaginal bleeding or pyrexia is more likely to indicate sexually transmitted infection (see table⇑).
Sexual history—Is patient at increased risk of sexually transmitted infection (age <25 years, new sexual partner or more than one sexual partner in past year, previous sexually transmitted infection)?
Contraceptive use can affect vaginal discharge.
Pregnancy can affect vaginal …