Differential Diagnosis for White Vaginal Discharge, Vaginal Pain, and Itching

Single Most Likely Diagnosis

• Vaginal Candidiasis (Yeast Infection): This is the most common cause of white vaginal discharge, often accompanied by itching and burning sensations. The discharge is typically thick, white, and cottage cheese-like.

Other Likely Diagnoses

• Bacterial Vaginosis (BV): Although BV typically presents with a thin, grayish-white discharge and a fishy odor, some cases can have a white discharge. Itching and burning are also common symptoms.
• Trichomoniasis: This sexually transmitted infection can cause a white, yellowish, or greenish discharge, along with itching, burning, and irritation.
• Vaginal Atrophy: Thinning and drying of the vaginal walls, often due to hormonal changes, can lead to itching, burning, and a thin, white discharge.

Do Not Miss Diagnoses

• Cervical Cancer: Although rare, cervical cancer can cause abnormal vaginal discharge, including white discharge, along with pelvic pain and itching. Regular screening is crucial for early detection.
• Gonorrhea and Chlamydia: These sexually transmitted infections can cause abnormal discharge, pain, and itching. If left untreated, they can lead to serious complications like pelvic inflammatory disease (PID).
• Vulvar Cancer: A rare type of cancer that can cause itching, burning, and abnormal discharge. Early detection is key to effective treatment.

Rare Diagnoses

• Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a thick, white discharge and significant inflammation of the vaginal walls.
• Lichen Sclerosus: A chronic skin condition that can cause itching, burning, and a thin, white discharge due to the thinning of the vaginal skin.
• Vaginal Foreign Body: The presence of a foreign object in the vagina can cause a range of symptoms, including abnormal discharge, pain, and itching. This is more common in young girls but can occur in anyone.