Vaginal complaints account for a significant proportion of visits to health care providers and are an ongoing challenge to every clinician in terms of diagnosis and management. Midwives traditionally have viewed such complaints as a disruption of the vaginal ecosystem and have adopted a combination of pharmacologic and nonpharmacologic treatment modalities in the management of vulvovaginitis and sexually transmitted diseases. This article presents a review of the literature that focuses primarily on the pharmacologic management of some of the more common sexually transmitted diseases. The management of vulvovaginal candidiasis and bacterial vaginosis also is reviewed. Although neither condition is sexually transmitted, they always should be considered in the differential diagnosis of vaginal complaints.
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