If a woman has vaginal discharge, the provider uses the vaginal
discharge algorithm. If she also complains of lower abdominal
pain, the provider should use the lower abdominal pain algorithm
instead, which we will discuss below.
Vaginal discharge is common and often seen in FP/MCH clinics.
Women normally have some vaginal discharge, which may be more
pronounced during certain phases of the menstrual cycle, during
and after sexual activity, and during pregnancy and lactation.
In general, women only seek care for vaginal discharge if they
perceive it as unusual, or if it causes itching or discomfort.
In the vaginal discharge syndrome, symptoms are abnormal vaginal
discharge, vaginal itching, painful urination and pain during
sexual intercourse. The signs a provider should look for are
abnormal vaginal discharge and, if a speculum exam is possible,
cervical discharge. Abnormal discharge may have a different
color, odor, consistency or amount than normal discharge.
Often, vaginal discharge indicates vaginitis. Less often, it
indicates cervicitis. Sometimes both infections are present.
Infections that may cause vaginitis are trichomoniasis [trik-o-mo-ní-ah-sis],
the most common STD, or two naturally occurring infections.
One is bacterial vaginosis. The other is candidiasis [can-di-dí-ah-sis],
also known as thrush or yeast infection.
Cervicitis is caused by gonorrhea or chlamydia, which are both