Differential diagnosis
Differential diagnosis
During a consultation, a woman may reveal symptoms that are not typical of VA. In these cases, local oestrogen therapy will not improve these conditions.
It is important for pharmacists to act accordingly in response to symptoms that warrant referral to a GP. The table below provides examples of a possible differential diagnosis depending on symptom presentation:
| Presenting symptoms | Possible differential diagnosis22 |
|---|---|
| Vaginal or genital bleeding or spotting | Endometrial cancer or endometrial hyperplasia23
|
| Pain, bloating, or swelling in the lower abdomen or pelvis | Ovarian cancer24
|
| Smelly or unusual vaginal discharge | Vaginal infection25
|
| Changes to look/feel of vulval area e.g. thickening or a lump; raised and/or sore patches of red or dark skin; shrinking or scarring Severe vaginal itching(interferes with sleep or daily living activities), itchy patches, vulval rash |
Vulval dermatoses26,27
|
For a full list of symptoms and differential diagnoses, refer to the Pharmacy Guide for the Supply of Gina.