Diagnosis of Vaginitis

By  , Expert Content
Feb 21, 2012

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Vaginitis is a common type of gynaecologic infection for which women visit their doctor. In most women, it is caused because of bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. There are several other causes of vaginitis. To diagnose the cause of your condition, the doctor will take a detailed medical history, do gynaecologic exam and recommend tests as needed.

Medical history and physical examination


The doctor will take a detailed medical history and may ask you questions related to:

  • current symptoms and when the symptoms started,
  • sexual history and if there is a history of sexually transmitted diseases and
  • menstrual history.

The doctor may also ask about other associated medical conditions that you may have and your medications (prescription and non-prescription).

Gynaecologic exam

If you have symptoms suggestive of vaginitis, the doctor will do a complete or full gynaecologic exam. This will include a speculum exam to examine the vagina. By virtue of this exam. a speculum (a metal or plastic device) is inserted in your vagina to open and spread the walls of your vagina so that the cervix (the mouth of your womb) and vagina are seen. It may be uncomfortable because of the pressure against the tissues. The doctor will look for signs and symptoms of genital lesions. If there is discharge or a lesion, the doctor may take a swab of the discharge and sample for examination. Specimen of vaginal discharge may also be taken for cultures to rule out other diseases. Pelvic examination may also be done. In this examination, the doctor inserts two fingers into your vagina to check the uterus, vagina, ovaries, fallopian tubes, bladder and surrounding areas to check for any tenderness or other problems.

Laboratory Evaluation

The doctor may do tests to confirm the cause of vaginitis. Some tests that may be done include:

  • Wet-mount preparation: A wet-mount preparation is done using vaginal discharge. Microscopic examination of a wet-mount preparation can help to diagnose bacterial vaginosis, fungal hyphae in vaginal candidiasis, increased number of polymorphonuclear cells (seen in trichomoniasis) or round parabasal cells (seen in atrophic vaginitis).
  • KOH preparation and Whiff test: Vaginal discharge is placed on a slide with a 10 percent KOH solution and examined under microscope. On microscopic examination, if candida is present, a specific branching pattern will be seen. The whiff test is positive if a “fishy” or amine odour is noted when KOH is added to the vaginal discharge.
  • Urine tests: Urine tests can help to diagnose urinary tract infection and chlamydia infection. You will be advised to take the sample at home and send it to a lab for testing.




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