"What's really going on down there?" A practical approach to the adolescent who has gynecologic complaints

The purpose of this article is to review the common complaints related to the vaginal area in pubertal girls and offer an approach to those presenting with nonurologic perineal problems or issues related to emerging sexuality. Included is a discussion of the symptoms, diagnosis, and treatment of physiologic discharge, vulvovaginal candidiasis, bacterial vaginosis, trichomoniasis, gonorrhea, and chlamydia. Other vulvovaginal complaints are considered, and screening tests that can help differentiate the origin of the problem as urologic or gynecologic are briefly addressed.