Vaginitis

Vaginitis describes irritation or inflammation involving the vagina, often with vulvar symptoms as well. Discharge, odour, itching, burning, dyspareunia, and external dysuria are clues—not a diagnosis. The same symptom can arise from different mechanisms, so treatment based on appearance alone can miss an STI, a urinary problem, or a noninfectious cause. Most infectious presentations fall into three patterns: - Bacterial vaginosis (BV): the normal lactobacillus-dominant microbiota shifts, allowing anaerobic bacteria to proliferate. The vaginal environment becomes less acidic. BV commonly produces a thin, homogeneous grey or white discharge and a fishy odour, often with little visible inflammation. - Vulvovaginal candidiasis: Candida, normally present in small amounts, overgrows. Intense vulvar pruritus, erythema, soreness, and thick white discharge are typical. Vaginal pH usually remains at or below 4.5 because Candida does not produce the same alkaline shift as BV or trichomoniasis. - Trichomoniasis: Trichomonas vaginalis is a sexually transmitted protozoan infection. Discharge may be yellow-green, frothy, or malodorous, with vulvar irritation and sometimes a punctate “strawberry” appearance of the cervix. The pH is commonly above 4.5. An experienced nurse first notices whether...