Cause |
Common Features* |
Tests |
During childhood |
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A foreign object (often toilet paper) in the vagina |
A discharge, usually with a foul odor and often containing small amounts of blood |
A doctor's examination, sometimes done after the girl is sedated or given a general anesthetic |
Infections such as
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Itching, redness, and swelling in the genital area Often pain during urination With pinworm infection, itching that worsens at night With streptococcal or staphylococcal infection, redness and swelling in the genital area |
Examination under a microscope and analysis of a sample of the discharge to check for microorganisms that can cause vaginal infections Examination of the genital area and anus to check for pinworms |
Poor hygiene |
Itching, redness, and a foul odor coming from the genital area Sometimes pain during urination No discharge |
A doctor's examination to eliminate other possible causes |
Soreness in the genital area Sometimes discharge that has a foul odor or contains blood Often vague symptoms (such as fatigue or abdominal pain) or changes in behavior (such as starting to have temper tantrums or to withdraw) |
A doctor's examination To check for sexually transmitted diseases: Examination under a microscope and analysis of a sample of the discharge If abuse is suspected, measures to ensure the child’s safety and a report to state authorities |
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During the childbearing years |
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A thin, white or gray cloudy discharge with a fishy odor Sometimes itching and irritation |
Examination under a microscope and analysis of a sample of the discharge |
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Irritation, itching, redness, and swelling in the genital area A thick, white, clumpy discharge that resembles cottage cheese Sometimes worsening of symptoms after intercourse and before menstrual periods Sometimes recent use of antibiotics or a history of diabetes |
Examination under a microscope and analysis of a sample of the discharge |
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Trichomoniasis (an infection caused by protozoa) |
A usually profuse, yellow-green, frothy discharge with a fishy odor Itching, redness, swelling, and soreness in the genital area Sometimes pain during sexual intercourse and urination |
Examination under a microscope and analysis of a sample of the discharge |
Aching pelvic pain that becomes increasingly severe and may be felt on one or both sides A discharge that sometimes has a foul odor and, as infection worsens, can become puslike and yellow-green Abnormal bleeding from the vagina Sometimes pain during sexual intercourse or urination, fever or chills, nausea, or vomiting |
Tests to detect sexually transmitted diseases using a sample of secretions taken from the cervix Sometimes ultrasonography of the pelvis |
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A foreign object (often a forgotten tampon) in the vagina |
An often profuse discharge with an extremely foul odor Often redness in the genital area and pain during urination and sometimes pain during sexual intercourse |
A doctor's examination |
After menopause |
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Thinning of the lining of the vagina (atrophic vaginitis) |
A scant discharge Pain during sexual intercourse |
A doctor's examination Examination under a microscope and analysis of a sample of the discharge |
Irritation caused by urine or stool |
General redness in the area around the genitals and anus Conditions that increase the risk of such irritation, such as being incontinent or bedbound |
A doctor's examination |
Cancer of the lining of the uterus (endometrium) |
A watery or bloody discharge Abnormal vaginal bleeding Often no other symptoms until the cancer is advanced Pain that develops gradually and sometimes becomes chronic Sometimes weight loss |
A biopsy Imaging tests such as ultrasonography and sometimes MRI or CT |
At any age |
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Chemical irritation (such as that due to soaps, bubble baths, hygiene sprays, or vaginal creams and ointments) |
Redness, itching, swelling, and soreness in the genital area |
A doctor's examination |
An abnormal opening (fistula) between the intestine and genital tract, which may result from |
A discharge with a foul odor Presence of stool in the vagina or in the vaginal discharge |
A doctor's examination CT Endoscopy (use of a viewing tube to examine internal structures) |
Inflammation due to |
Recent treatment of a disorder affecting the pelvis A discharge that contains pus Pain during urination and sexual intercourse Sometimes irritation, itching, redness, burning pain, and mild bleeding |
A doctor's examination Usually examination under a microscope and analysis of a sample of the discharge |
Skin disorders such as psoriasis, lichen sclerosus, and tinea versicolor (a fungal infection) |
Rashes, itching, or other symptoms, depending on the disorder |
A doctor's examination Biopsy |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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CT = computed tomography; MRI = magnetic resonance imaging. |