Patients may complain of symptoms or changes to their vulva or vagina during a consultation , or you may notice something during an examination . Here are some of the key signs and symptoms to look out for and what to advise patients .

What are the main infections to recognise ? How are they treated ? Thrush Thrush ( Candida albicans ) is a common yeast infection that can cause a change in vaginal discharge , as well as soreness and itching . It is not considered a sexually transmitted infection ( STI ), but it can be triggered by sex and sometimes passed between partners .

Treatment involves a vaginal pessary , used overnight , and a topical antifungal ( clotrimazole 1 % cream ). The patient can take an oral tablet ( fluconazole ) as an alternative to a pessary .

ONLINE To read the full article scan the QR code above or visit nursinginpractice . co . uk

These treatments can be accessed over the counter ( OTC ) from pharmacies . However , in some cases a prescription may be necessary – for example , if the patient is vulnerable , does not have the funds to pay for treatment or cannot access a pharmacy .

For recurring or chronic thrush , the GP or prescribing nurse should advise on alternative treatment strategies , in line with the BNF . ¹ These patients should be tested for diabetes and may need referral to a specialist service .

Bacterial vaginosis Another common cause of unusual discharge is bacterial vaginosis ( BV ). Again , this is not sexually transmitted , although it can be triggered by sex . A change in vaginal environment , due to a penis or sperm entering the vagina in unprotected sex , can cause BV . The patient may notice their discharge has become watery or greyish in colour and has a bad ( fishy ) odour .

GETTY