Vaginitis is inflammation of the vagina causing vaginal discharge, painful micturition, painful sex and occasionally fever with chills. Due to cultural barriers this is often under reported.
Risk factors – Patients are at increased risk if their partner has symptoms of genito-urinary tract infection, if the patient has multiple sexual partners, or if the patient is symptomatic and in a new sexual relationship. If the patient has a vaginal discharge with no positive risk factors then treat for vaginitis alone. If the patient has a vaginal discharge, has positive risk factors then treat for both vaginitis and cervicitis.
Medications (in non- pregnant patients):
For vaginitis
- Clingen vaginal suppository (Clindamycin topical 100 mg, Clotrimazole topical 100 mg) intravaginally once at night-time for 7 days.
- V Wash plus (Lactic acid-based soap solution) regularly for perineal and vaginal hygeine.
- Tab. Flagyl 400 (Metronidazole 400 mg) 1 tablet twice a day for 7 days – for trichomonal vaginitis.
For cervicitis
- Tab. Topcef 200 (Cefixime 200 mg) 1 tablet twice a day for 5 days.
- Tab. Azee 1000 (Azithromycin 1000 mg) 1 tablet once as a single dose.
General measures:
- Ensure good perineal and genital hygiene.
- Advice on safe sex and avoid use of tampons.
- Control predisposing condition (e.g. diabetes mellitus)
- Encourage use of loose and dry cotton undergarments.
- Reduce exposure to predisposing medications (e.g. Corticosteroids)
- Avoid use of herbal or chemical soaps.
Investigations:
- High vaginal swab – for microscopy, culture and antibiotic sensitivity.
- CBC and CRP – identify and monitor for infection.
- Blood sugar levels and HbA1C – to rule out diabetes.
Referral:
Consider referral to gynaecologist if patients fail to respond to treatment or presents with additional complications.