From the Guidelines
Yellow vaginal discharge is most commonly caused by infections such as bacterial vaginosis, trichomoniasis, or gonorrhea, and it is essential to seek medical attention for proper diagnosis and treatment. The discharge can be accompanied by a strong odor, itching, burning during urination, or pelvic pain, and it is crucial to address these symptoms to prevent further complications. According to the Centers for Disease Control and Prevention (CDC) guidelines 1, bacterial vaginosis, trichomoniasis, and gonorrhea are the most common causes of vaginal discharge.
Causes of Yellow Vaginal Discharge
- Bacterial vaginosis: characterized by a homogeneous, white, noninflammatory discharge that smoothly coats the vaginal walls, and is often associated with a fishy odor 1
- Trichomoniasis: caused by the protozoan T. vaginalis, and is characterized by a diffuse, malodorous, yellow-green discharge with vulvar irritation 1
- Gonorrhea: a sexually transmitted infection that can cause vaginal discharge, and is often treated with dual therapy 1
Treatment and Prevention
- Bacterial vaginosis: treatment typically involves antibiotics like metronidazole (500mg twice daily for 7 days) or clindamycin cream (2% applied intravaginally at bedtime for 7 days) 1
- Trichomoniasis: treatment requires metronidazole (2g as a single dose) or tinidazole (2g as a single dose) 1
- Gonorrhea: treatment needs dual therapy with ceftriaxone (500mg intramuscular injection) plus azithromycin (1g orally as a single dose) 1 While waiting for medical care, it is essential to avoid douching, scented products, and tight underwear, which can worsen symptoms. Maintaining good hygiene and practicing safe sex can help prevent recurrence of infection-related discharge.
From the FDA Drug Label
A clinical diagnosis of bacterial vaginosis was based on Amsel's criteria and defined by the presence of an abnormal homogeneous vaginal discharge that (a) has a pH of greater than 4. 5, (b) emits a "fishy" amine odor when mixed with a 10% KOH solution, and (c) contains ≥20% clue cells on microscopic examination.
The cause of yellow vaginal discharge is not explicitly stated in the provided drug labels. However, bacterial vaginosis is mentioned as a condition characterized by an abnormal homogeneous vaginal discharge, which may be related to yellow vaginal discharge. According to the label, bacterial vaginosis is diagnosed based on Amsel's criteria, including an abnormal vaginal discharge with a pH greater than 4.5, a "fishy" odor, and the presence of clue cells 2.
- Key points:
- Bacterial vaginosis is a possible cause of abnormal vaginal discharge.
- The discharge associated with bacterial vaginosis has a pH greater than 4.5 and a "fishy" odor.
- Tinidazole is used to treat bacterial vaginosis, but the label does not explicitly state that it treats yellow vaginal discharge 2.
From the Research
Causes of Yellow Vaginal Discharge
- Vaginal discharge can be caused by various infections, including bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis 3, 4, 5, 6.
- Trichomoniasis, a sexually transmitted disease, is associated with a copious yellow or green, sometimes frothy, discharge 3, 4, 6.
- Bacterial vaginosis is characterized by a malodorous discharge, but it is typically thin and white, not yellow 3, 4, 7.
- Vulvovaginal candidiasis is characterized by pruritus and a cottage cheese-like discharge, which is usually white, not yellow 3, 4, 6.
Diagnosis and Treatment
- Diagnosis of the cause of vaginal discharge requires a thorough history, vulvovaginal examination, and simple laboratory tests, including microscopy of the vaginal discharge 4, 6.
- Treatment of vaginal discharge depends on the underlying cause, with topical or oral metronidazole used for bacterial vaginosis and trichomoniasis, and antifungals used for vulvovaginal candidiasis 3, 4, 5.
- Accurate diagnosis is essential to ensure appropriate treatment and prevent over or under treatment of the patient 6.