Clinical meaning
Vaginitis represents disruption of the vaginal microbiome or infection of the vaginal epithelium. Bacterial vaginosis (BV) results from replacement of protective Lactobacillus species with anaerobic bacteria (Gardnerella vaginalis, Prevotella, Mobiluncus), producing malodorous thin grey discharge with clue cells on wet mount and positive whiff test (KOH releases amines). Vulvovaginal candidiasis involves Candida albicans overgrowth, producing thick white curd-like discharge with KOH preparation showing pseudohyphae. Trichomoniasis, caused by the protozoan Trichomonas vaginalis, produces frothy yellow-green discharge with motile trichomonads on wet mount and strawberry cervix on exam. Pelvic inflammatory disease (PID) results from ascending cervical infection (commonly Chlamydia and Gonorrhea) causing endometritis, salpingitis, and tubo-ovarian abscess. PCOS involves ovarian hyperandrogenism with anovulation, diagnosed by Rotterdam criteria (2 of 3: oligo/anovulation, clinical/biochemical hyperandrogenism, polycystic ovarian morphology on ultrasound). Endometriosis involves ectopic endometrial tissue implants causing cyclic inflammation, adhesions, and pain.