Vaginal complaints account for a significant proportion of visits to h
ealth care providers and are an ongoing challenge to every clinician i
n terms of diagnosis and management. Midwives traditionally have viewe
d such complaints as a disruption of the vaginal ecosystem and have ad
opted a combination of pharmacologic and nonpharmacologic treatment mo
dalities in the management of vulvovaginitis and sexually transmitted
diseases. This article presents a review of the literature that focuse
s primarily on the pharmacologic management of some of the more common
sexually transmitted diseases. The management of vulvovaginal candidi
asis and bacterial vaginosis also is reviewed. Although neither condit
ion is sexually transmitted, they always should be considered in the d
ifferential diagnosis of vaginal complaints. (C) 1997 by the American
College of Nurse-Midwives.