1)      Physiological – scanty, clear, thin discharge turning thicker with ovulation, breastfeeding, sex, colorless, odorless, no itching or burning or pain at genitals,

2)      Cervical ectopy

3)      Foreign body – foul smelling, purulent discharge

4)      Bacterial Vaginosis – Most asymptomatic, others scanty, thin, white or grey discharge, fishy odor, strongest after sex, vulval itching and burning, redness, and swelling of the vulvovaginal area, Ix – wet vaginal smear clue cells seen, Whiff’s test positive ie, add KOH to the discharge gives a strong amine odor.  Tx – oral metronidazole 400-500 mg bid for 5-7 days OR a single 2 G dose, in recurrent BV advise avoidance of douches, shower gels, antiseptic agents, shampoos in bath,

5)      VulvoVaginal Candidiasis – white, cottage-cheese like, vulval pain and swelling and itching, dyspareunia, recurrent attacks, predisposing factors like pregnancy, diabetes, hot and sweaty genitals,   Tx – Topical azole therapy – Clotrimazole 1% cream 5 G per day intravaginally for 1-2/52 OR Clotrimazole 100 mg vaginal tablet intravaginally bid for 3 days OR Clotriazole 500 mg vaginal tablet intravaginally once OR Miconazole 2% cream 4 G daily intravaginally for 1/52, OR Miconazole 200 mg vaginal supp daily for 3 days OR Miconazole 100 mg vaginal supp daily for 1/52 OR Nystatin 100,000 unit vaginal tablet intravaginally for 2/52 OR Tioconazole 6.5% cream 5 G intravaginally once OR Terconazole cream 0.4% 5 G vaginally daily for 1/52 OR Terconazole 0.8% cream 5 G daily intravaginally for 3 days OR Terconazole 80 mg vaginal tablet 1 supp daily for 3 days, Oral antifungals - Fluconazole 150 mg once PO OR any topical antifungal therapy, in pregnancy topical therapy only for 1 week, in recurrences for more than 4 per annum, exclude antibacterial therapy, pregnancy, DM, OC use, infection reservoirs at digits, nails, umbilicus, GIT, bladder, partner, treat with Fluconazole 100 mg one dose PO weekly for 6/12 OR Itraconazole 200 mg 2 doses in a day every month for 6/12 OR Clotrimazole vaginal pessary one dose every week for 6/12,

6)      Trichomonas vaginalis – watery, yellowish or greenish bubbly discharge, unpleasant  odor, vulval itching, dysuria, worse after periods, Tx – oral metronidazole 400 mg bid for 5-7 days OR a single 2 g oral dose, partner notification and treatment essential

7)      Chlamydia trachomatis – see under genital discharge

8)      Neisseria Gonorrhea – see under genital discharge

9)      Genital herpes – see under genital ulcers

10)    Pregnancy – minor symptoms of pregnancy

11)    Pelvic inflammatory disease – see under abdominal pain