ACOG Releases Practice Guideline on Management of Vaginitis

Vaginitis can lead to discomfort, days lost from school or work, and sexual dysfunction. Treatment generally is focused on specific causes of vulvovaginal symptoms, including bacterial vaginosis, vulvovaginal candidiasis, or trichomoniasis. The American College of Obstetricians and Gynecologists (ACOG) has released recommendations on the diagnosis and treatment of vaginitis. The full practice guideline was published in the May 2006 issue of Obstetrics & Gynecology.

The ACOG guideline includes the following recommendations:

• Women with complicated vulvovaginal candidiasis should receive more aggressive treatment than those with uncomplicated infections.

• Women with trichomoniasis should avoid intercourse until they and their partners have been treated.

• Microscopy is recommended for diagnosing vulvovaginal candidiasis and trichomoniasis; however, cultures also should be obtained.

• Douching is not recommended to prevent or treat vaginitis.

• A patient’s self-diagnosis of vaginitis is not reliable.

• Women with vaginal symptoms should receive clinical evaluation, especially women with infections that have not responded to self-treatment with over-the-counter antifungals.