Vaginitis Diagnosis
Clinical Tests For Diagnosing Vaginitis

Vaginitis Guide

Diagnosing Vaginitis

Vaginitis Diagnosis


Diagnosing Vaginitis
Why Is A Correct Diagnosis Important?
How Is Vaginitis Diagnosed?
What If The Results Are Negative?

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Vaginitis Guide

Diagnosing Vaginitis

Many women, particularly if they have had vaginitis in the past, tend to self-diagnose. Others may phone their doctor to know if it is ok to take an over the counter preparation vaginitis treatment. Very often a doctors will say yes but advise the woman to come and see them if symptoms do not clear up within 5 days. Vaginitis, particularly if it is recurring can be a very uncomfortable condition which can seriously affect the quality of a woman's life. Unfortunately it is not always taken seriously by clinicians who are prone to making a quick diagnosis without carrying out the appropriate tests. As there are different types of vaginitis, the treatment they require are different. One of the problems of relying solely on a visual inspection is that symptoms appear very similar. In addition to doctor-error, one study showed that nearly 65 percent of women who self-diagnosed a yeast infection were incorrect.

Why Is A Correct Diagnosis Important?

When a woman appears at a doctor's surgery and mentions vaginal itching and a white discharge, very often a quick diagnosis of a yeast infection (Candida) will be given. If the woman returns a few months later with the same symptoms, a diagnosis of 'recurring’ infection may be given (or chronic if it recurs more than 4 times in a year). As the symptoms of the various types of vaginitis are similar, it is easy to see how this diagnosis can occur. However the woman could in fact for example have had bacterial vaginosis the first time, and a yeast infection the second time (or vice versa). In other words, she was misdiagnosed on the original problem, and further mislabeled as having a 'recurrent' issue. This sort of misdiagnosis leads to incorrect treatment and conditions becoming chronic. If the doctor had taken the time to carry out some simple tests, it could have been avoided.

How Is Vaginitis Diagnosed?

By spending a little extra time on a patient, a doctor can easily and inexpensively obtain a diagnosis by carrying out a few simple tests.

Physical Examination

First a routine pelvic exam will look for vaginal discharge. The discharge will be noted for:

• Color
• Viscosity or thickness
• Smell, if any
• If it sticks to the vaginal walls

A visual inspection of the cervix is also important to rule out cervicitis, a common infection of the cervix which can cause unusual vaginal discharge.

Useful: Vaginitis Prevention Tips.

Clinical Test

A specimen of the vaginal discharge should be collected from the wall of the vagina using a swab. It is then placed on a slide and immediately examined under a microscope. This test is known as a vaginal wet mount or vaginal smear and can be carried out by any doctor. The microscopic appearance of the discharge, in addition to a test of vaginal acidity (pH) will distinguish one type of vaginitis from another. Doctors use the following chart to differentiate between the types of vaginitis:

Diagnosis Chart

  Normal Range Bacterial Vaginosis Candida (Yeast Infections) Trichomoniasis
Symptoms None Odor, discharge, itchiness Itch, discomfort, thick discharge, pain on urination (dysuria) Itchiness, discharge, 50% of cases show no symptoms
Vaginal Discharge Clear to white Thin, milky, white, foul fishy Thick, clumpy, white like cottage cheese Frothy, gray, yellow or green, unpleasant smell
Clinical Findings     Inflammation & redness of skin (erythema) 'Strawberry cervix' (tiny lesions on cervix wall)
Vaginal pH 3.8 to 4.2 More than 4.5 Usually less than 4.5 More than 4.5
KOH Whiff Test Negative Positive Negative Often Positive

Whiff Test

The whiff test (aptly named!) tests the odor or smell of the discharge. The doctor carries out this test by adding several drops of potassium hydroxide (KOH) to a sample of vaginal discharge. A strong fishy odor means the test is positive and a bacterial infection is present.

How To Prepare For A Clinical Test

In order to ensure that test results are accurate:

1. Avoid intercourse for 24 hours before the test as this can affect the pH balance of the vagina.
2. Avoid using vaginal medications, including over the counter products for 2 or 3 days before the test.
3. If you have a period, wait until it has finished before making your doctor's appointment

What If The Result Is Negative?

Where patients show symptoms of vaginitis, but under closer examination show no presence of microorganisms, other causes can then be considered. Possible causes considered include hypersensitivity or allergic vulvovaginitis (where an allergic reaction to something causes irritation to the area. Commonly it is caused by a reaction to semen). Or physiologic leucorrhea (an infection due to estrogen stimulation) may be considered. It may then be necessary for a clinician to culture cells from the discharge in order to see what microorganisms are involved. This will help rule out other possible causes like cancer of the reproductive organs (cervical cancer, uterus cancer and cancer of the vagina), which also cause discharges. If the patient experiences painful intercourse the test will also rule out vulvar vestibulitis which is usually treated by local injections or surgery. Other skin conditions of the vulva can cause symptoms which appear like vaginitis and will need to be considered. If, when all tests are completed, no cause is found, a doctor may ask if symptoms are psychosomatic. 'Psychosomatic vaginitis' is a diagnosis where there is no apparent infection but there is a history of symptoms which have not responded to treatment. Alternative treatments may be recommended, such as stress management.

  Related Articles on Vaginitis Diagnosis

For more reproductive disorders information, see the following:

Vaginitis Causes
How Douching Works

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