Management of vaginal discharge in non-genitourinary medicine settings

Faculty of Sexual & Reproductive Healthcare, British Association of Sexual Health and HIV

Causes of vaginal discharge

  • Health professionals should be aware that the most common causes of altered vaginal discharge are physiological, bacterial vaginosis (BV) and candida, but sexually transmitted infections (STIs) and non-infective causes must be considered

Management of vaginal discharge

  • A detailed history, including sexual history, is essential to identify the necessary investigations and treatment options
  • Women experiencing vaginal discharge who are at low risk of STI can be treated by syndromic or empirical management (See management algorithm)
  • All women with persistent vaginal discharge should be examined to exclude serious pathology
  • Women assessed as being at risk of STI, or who request testing should be offered appropriate tests for chlamydia, gonorrhoea, syphilis and HIV
  • A high vaginal swab (HVS) is of limited diagnostic value in the management of vaginal discharge except in cases of inconclusive assessment, recurrent symptoms, treatment failure, or in pregnancy, postpartum, post-abortion or post-instrumentation

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