L iterature regarding vulvovaginal complaints is very limited despite the fact that vaginitis alone accounts for more than 10 million office visits each year. This approval was strongly opposed by many gynecologists, as well as the International Society for the Study of Vulvovaginal Disease. There was concern that women would misdiagnose their condition and self-treat, inappropriately.
Most women lack knowledge about vulvovaginal health.
They know little of normal cyclical variation in vaginal secretions. Cleanliness, especially by douching, is often overemphasized and can be detrimental. This confirmation may represent the discouraging reality that, among health care professionals, expertise in the diagnosis and treatment of vulvovaginal symptoms is often lacking. Many clinicians still believe they can look through the speculum and make a diagnosis, that discharge must be present for yeast infection to be diagnosed, and that a negative KOH test rules out yeast. Unfortunately, the already crowded curriculum for Ob-Gyn residents has little vulvovaginal instruction, and physicians continue to go into practice with limited diagnostic acumen in this area.