Evaluation of vaginitis and its treatment.

PURPOSE OF REVIEW: Vaginitis is one of the most common reasons a patient will present for care in both the ambulatory and urgent care settings. The objective of this review is to summarize traditional methods of evaluation and treatment for the most commonly seen vaginitis and vaginosis, but also to present updated literature and future management directions for this common and sometimes resilient medical problem.

RECENT FINDINGS: A randomized controlled trial of partners in monogamous heterosexual relationships and the recurrence rate of bacterial vaginosis when male partners were simultaneously treated. Systematic review investigating the effectiveness of intravaginal vitamin C in treating and preventing recurrent bacterial vaginosis. Randomized controlled trial evaluating oteseconazole and its benefit against recurrent vulvovaginal candidiasis. A meta-analysis to evaluate breast cancer recurrence and mortality among breast cancer survivors using vaginal estrogen for genitourinary syndrome of menopause.

SUMMARY: Vaginitis is an incredibly common problem among women of all ages globally. Traditional therapies, including oral and topical antibiotics and antifungals, are effective in many patients, but recurrence is common, necessitating prolonged suppressive therapy. Newer therapies include partner treatment, but also the use of newer medications with different mechanisms of action and consideration of adjunctive therapies such as vaginal pH-modulating topicals and adjunctive live biotherapeutic products.