How to check for vaginitis

Vaginitis can be diagnosed through gynecological examination, vaginal secretion detection, pH value measurement, amine test, colposcopy and other methods. Vaginitis may be related to bacterial infection, fungal infection, trichomoniasis infection, changes in hormone levels, decreased immunity and other factors. It usually presents with symptoms such as vulvar itching, abnormal secretions, and urinary discomfort.

1. Gynecological examination

Gynecological examination is the basic method for diagnosing vaginitis. The doctor visually observes the vulva and vaginal mucosa to see whether there are abnormalities such as congestion, edema, and ulcers. Bacterial vaginosis may have gray-white homogeneous discharge, vulvovaginal candidiasis may have white bean-dregs-like discharge, and trichomonas vaginitis may be accompanied by foamy yellow-green discharge. A disposable speculum must be used during the examination to avoid cross-infection. Patients should avoid vaginal douching or sexual intercourse 24 hours before the examination.

2. Vaginal discharge detection

Vaginal secretion testing includes wet mount microscopy and Gram staining to identify the type of pathogen. Wet mount microscopy can directly observe trichomonas activity or Candida hyphae, and clue cells indicate bacterial vaginosis. Gram stain can identify overgrowth of anaerobic bacteria such as Gardnerella and Mobilflex. When sampling, secretions should be scraped from the vaginal side wall to avoid cervical mucus contamination. Stop using vaginal suppositories 48 hours before the examination, and it is not advisable to test during menstruation.

3. pH value measurement

The normal vaginal pH is 3.8-4.5, the pH of bacterial vaginosis often exceeds 4.5, and the pH of trichomonas vaginitis can reach 5.0-6.0. When testing, touch the pH test paper to the vaginal side wall secretions and read the value colorimetrically. The pH of vulvovaginal candidiasis is usually normal and can be used in differential diagnosis. Postmenopausal women may experience elevated pH due to estrogen deficiency, and this needs to be judged in combination with other examinations.

4. Amine test

The amine test, also called the whiff test, is used to detect bacterial vaginosis. The fishy smell produced after adding 10% potassium hydroxide solution to vaginal secretions is positive, indicating the release of amines produced by anaerobic bacteria. This test is simple to perform but has limited specificity and needs to be evaluated together with clinical manifestations and other test results. False positives may occur in menstrual or semen residual samples, and false negatives are common in patients who have recently taken antibiotics.

5. Colposcopy

Colposcopy is suitable for cases of refractory and recurrent vaginitis or suspected cancer, and can magnify and observe subtle changes in the vaginal mucosa. Trichomonas infection may show strawberry cervical signs, and Candida infection may cause mucous membrane leukoplakia. Targeted biopsies can be performed during the examination to identify special types such as atrophic vaginitis and lichen planus. Vaginal medication should be stopped 3 days before the examination. During the acute inflammation period, the infection should be controlled before the examination.

You should pay attention to keeping your vulva clean and dry on a daily basis. Choose cotton breathable underwear and change it daily. Avoid using soap or lotion to excessively clean the vagina. Cleaning before and after sex and using condoms can reduce the risk of infection. If abnormal discharge or vulvar discomfort occurs, seek medical advice promptly and avoid using vaginal douches or antibiotics on your own. Diabetic patients need to strictly control blood sugar, and menopausal women can use local estrogen preparations under the guidance of a doctor to maintain the balance of the vaginal microenvironment.