Clinical evaluation

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A. Symptoms of vaginitis include vaginal discharge, pruritus, irritation, soreness, odor, dyspareunia and dysuria. Dyspareunia is a common feature of atrophic vaginitis. Abdominal pain is suggestive of pelvic inflammatory disease and suprapubic pain is suggestive of cystitis.

B. A new sexual partner increases the risk of acquiring sexually transmitted diseases, such as trichomonas, chlamydia, or Neisseria gonorrheae. Trichomoniasis often occurs during or immediately after the menstrual period; candida vulvovaginitis often occurs during the premenstrual period.

C. Antibiotics and high-estrogen oral contraceptive pills may predispose to candida vulvovaginitis; increased physiologic discharge can occur with oral contraceptives; pruritus unresponsive to antifungal agents suggests vulvar dermatitis.

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