Vaginal discharge, bacterial vaginosis and candidiasis
Separating physiological discharge, bacterial vaginosis, candidiasis, trichomoniasis and cervicitis at the bedside, ASHM treatment regimens, male partner treatment for BV, recurrent thrush and the pregnancy rules.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Most abnormal discharge in reproductive-age women is bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) or trichomoniasis. Cervicitis from chlamydia, gonorrhoea or Mycoplasma genitalium is less common but matters more.
- Three bedside tests do most of the work: vaginal pH, the whiff test and microscopy.
- BV: pH above 4.5, fishy odour, clue cells. Treat with metronidazole 400 mg twice daily for 7 days, and now treat a regular male partner too.
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Sources
- Australian STI Management Guidelines for Use in Primary Care: Vaginal discharge; Bacterial vaginosis; Candidiasis; TrichomoniasisAU/NZAustralasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Online, accessed November 2026
- Therapeutic Guidelines: Sexual and Reproductive Health (vaginal discharge and vulvovaginitis)AU/NZTherapeutic Guidelines Limited
- Vodstrcil LA et al. Male-partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med 2025;392:947-57AU/NZNew England Journal of Medicine, 2025
- Sexually Transmitted Infections Treatment Guidelines, 2021US Centers for Disease Control and Prevention, 2021
- Pacheco Vieira LL et al. The efficacy of male partner treatment to prevent recurrence of bacterial vaginosis: a systematic review with meta-analysis. Eur J Obstet Gynecol Reprod Biol 2026;321:115047European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2026
- Kissinger P et al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018;18:1251-9The Lancet Infectious Diseases, 2018
- Last updated
- 14 November 2026
What changed
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