Cause | Common Features* | Diagnostic Approach |
---|---|---|
During childhood | ||
A foreign object (often toilet paper or a small object) 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 | Itching, redness, and swelling in the genital area Often pain during urination 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 |
Itching that worsens at night | Examination of the genital area and anus to check for pinworms | |
Irritation caused by urine or stool | Itching, redness, and a foul odor coming from the genital area Sometimes pain during urination No discharge | A doctor's examination |
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 infections, examination under a microscope and analysis of a sample of the discharge | |
During the childbearing years | ||
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 | |
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 | |
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 infections using a sample of secretions taken from the cervix Sometimes ultrasonography of the pelvis | |
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 | ||
Thinning of the lining of the vagina (atrophic vaginitis)† | A scant discharge Pain during sexual intercourse | 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 |
At any age | ||
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 |
Inflammation due to
| Recent treatment of a disorder affecting the pelvis A scant white or yellow discharge Pain during sexual intercourse Sometimes 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 Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune... read more , lichen sclerosus Lichen Sclerosus Lichen sclerosus is a disorder that tends to cause itching and can cause scarring in the area around the anus and genitals. The cause of lichen sclerosis is unknown, but it may involve the immune... read more , and lichen planus (due to an autoimmune reaction, when the body attacks its own tissues) | Rashes, itching, or other symptoms, depending on the disorder | Usually a doctor's examination alone Sometime a biopsy |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Thinning of the lining of the vagina is a symptom of the genitourinary syndrome of menopause, which also includes vaginal dryness, pain during sexual intercourse, urinary urgency, and urinary tract infections. | ||
CT = computed tomography; MRI = magnetic resonance imaging. |