Management of Abnormal Vaginal Discharge in Reproductive-Aged Women

Abstract

Abnormal vaginal discharge is one of the most common presenting symptoms at obstetric-gynaecologic clinics. It can be caused by either vaginal dysbiosis or infections of which a part is sexually transmitted infections (STIs). STI is the global health issue that also results in marked economic burden. The delayed or improper treatment may lead to severe morbidity or even mortality. The national statistics have shown the rising trend of STIs, especially among young people aged 15-24 years. The most commonly reported STIs which cause abnormal vaginal discharge are gonococcal and non-gonococcal cervicitis. In this year, the Division of Autoimmune Deficiency Syndrome (AIDS) and Sexually Transmitted Infections (STIs), Thai Ministry of Public Health, in collaboration with Institute of HIV Research and Innovation (IHRI), Institute of Dermatology, Faculty of Medicine, Chulalongkorn University, and Faculty of Medicine Siriraj Hospital, Mahidol University, has issued the Thai national guideline for diagnosis and treatment of sexually transmitted infections, 2022 based on the current knowledge and available medications in Thailand. In line with the national guideline, the Royal Thai College of Obstetricians and Gynaecologists has also launched the treatment guideline for managing reproductive-aged womenwith abnormal vaginal discharge. The guideline aims to provide obstetricians, gynaecologists and medical practictioners with updated diagnostic tools and treatment alternatives of each cause of abnormal vaginal discharge. However, the implementation of the guideline can vary according to the context of each healthcare setting, including resource, manpower, characteristics of clients etc. Not being able to comply with the guideline does not bring about any legal impact.