Trichomoniasis is caused by a flagellated protozoan, Trichomonas vaginalis. It is always sexually transmitted.

Bacterial vaginosis is the most common cause of vaginitis, vaginal discharge or malodor. Its prevalence is similar in both pregnant and non-pregnant women.

Vulvovaginal candidiasis is caused by overgrowth of yeasts where 70-90% of cases are secondary to Candida albicans. It most commonly occurs when the vagina is exposed to estrogen (ie, reproductive years, pregnancy) and may be precipitated by antibiotic or corticosteroid use. Immunocompromised and diabetic women are also at risk.

Vaginitis: Trichomoniasis, Candidiasis, Bacterial Vaginosis References

  1. Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009 Mar;48(5):503-535. doi: 10.1086/596757. PMID: 19191635
  2. Van Vranken M. Prevention and treatment of sexually transmitted diseases: an update. Am Fam Physician. 2007 Dec;76(12):1827-1832. PMID: 18217521
  3. Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010 Dec;59(RR-12):1-110. Accessed 01 Jun 2012. PMID: 21160459
  4. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2006. MMWR. 2006 Aug;55:1-94. Accessed 21 Jun 2010. PMID: 16888612
  5. Radcliffe K. European STD guidelines. Int J STD AIDS. 2001 Oct;12(Suppl 3):1-102. PMID: 11589789
  6. Nyirjesy P. Vulvovaginal candidiasis and bacterial vaginosis. Infect Dis Clin North Am. 2008 Dec;22(4):637-652. doi: 10.1016/j.idc.2008.05.002. PMID: 18954756
  7. Shivadas A. Vaginitis. In: Carey WD. Cleveland Clinic: Current Clinical Medicine. 2nd. Philadelphia: Saunders, Elsevier; 2010.
  8. MedWorm
  9. MedWorm
  10. Ministry of Health Singapore. Management of genital ulcers and discharges. MOH (Singapore). 2009. Accessed 21 Jun 2010.
  11. World Health Organization. Guidelines for the management of sexually transmitted infections. WHO. 2003. Accessed 28 May 2010.
  12. Sherrard J, Donders G, White D. 2009 European (IUSTI/WHO) guideline on the management of vaginal discharge in women of reproductive age. Accessed 07 Sep 2010.
  13. Clinical Effectiveness Group British Association of Sexual Health and HIV. National guideline for the management of bacterial vaginosis 2006. Accessed 07 Sep 2010.
  14. Faculty of Sexual and Reproductive Healthcare. Management of vaginal discharge in non-genitourinary medicine settings. Feb 2012. Accessed 19 Jun 2012.
  15. Clinical Effectiveness Group British Association of Sexual Health and HIV. United Kingdom national guideline on the management of Trichomonas vaginalis. 2007. Accessed 07 Sep 2010.
  16. Clinical Effectiveness Group British Association of Sexual Health and HIV. United Kingdom national guideline on the management of vulvovaginal candidiasis. 2007. Accessed 07 Sep 2010.
  17. Expert Working Group for the Canadian Guidelines on Sexually Transmitted Infections. Vaginal discharge (bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis). Jan 2008. Accessed 07 Sep 2010.
  18. Lazaro N. Sexually transmitted infections in primary care 2013 (RCGP/BASHH). Royal College of General Practitioners. 2013. Accessed 30 May 2014.
  19. Sherrard J, Ison C, Moody J, Wainwright E, Wilson J, Sullivan A. United Kingdom national guideline on the management of Trichomonas vaginalis 2014. Int J STD AIDS. 2014 Mar;25(8):541-549. PMID: 24616117
  20. ACOG Committee on Practice Bulletins - Gynecology. ACOG practice bulletin. Clinical management guidelines for obstetrician-gynecologists, Number 72, May 2006: vaginitis. Obstet Gynecol. 2006 May;107(5):1195-1206. PMID: 16648432
  21. Ministry of Health Malaysia. National antibiotic guideline 2014, 2nd edition. Pharmaceutical Services Divisions, Ministry of Health Malaysia. Dec 2014. Accessed 16 Jul 2015.
  22. Australasian Sexual Health Alliance (ASHA). Australian STI management guidelines for use in primary care. ASHA. 2016.
  23. van Schalkwyk J, Yudin MH; Infectious Disease Committee; Society of Obstetricians and Gynaecologists of Canada. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can. 2015 Mar;37(3):266-276. PMID: 26001874
  24. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137. PMID: 26042815
  25. Mendling W, Weissenbacher ER, Gerber S, et al. Use of locally delivered dequalinium chloride in the treatment of vaginal infections: a review. Arch Gynecol Obstet. 2016 Mar;293(3):469-484. doi: 10.1007/s00404-015-3914-8. PMID: 26506926
  26. International Union Against Sexually Transmitted Infections (IUSTI). STI treatment pocket European guidelines 2018. IUSTI. 2018.
  27. Paladine HL, Desai UA. Vaginitis: Diagnosis and treatment. Am Fam Physician. 2018 Mar 1;97(5):321-329. PMID: 29671516
  28. Committee on Practice Bulletins-Gynecology. Vaginitis in nonpregnant patients: ACOG practice bulletin, number 215. Obstet Gynecol. 2020 Jan;135(1):e1-e17. doi: 10.1097/AOG.0000000000003604. Accessed 07 Apr 2020. PMID: 31856123
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